Rifampin (Intravenous)

Rifampin injection is used along with other medicines to treat tuberculosis (TB) infections in various parts of the body. It is also used in patients who have meningitis bacteria in their nose or throat but do not have symptoms, to help prevent the spread of the bacteria to other patients. Rifampin is an antibiotic and works to kill or stop the growth of bacteria (for example, TB). However, it will not work for colds, flu, or other viral infections.

This medicine should only be given by your doctor or under their direct supervision.

It is very important for your doctor to monitor you or your child's progress while receiving this medicine. Blood and urine tests may be needed to check for side effects.

You should not receive this medicine if you or your child are also using certain medicines to treat HIV infection (for example, atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir, Aptivus®, Fortovase®, Invirase®, Lexiva®, Norvir®, Prezista®, or Reyataz®).

Do not take this medicine with praziquantel. If you need to take praziquantel, stop receiving rifampin 4 weeks before starting praziquantel. You can restart rifampin one day after the last dose of praziquantel.

Liver problems may be more likely if you drink alcohol regularly while receiving this medicine. Also, regular alcohol use may prevent this medicine from working properly. Therefore, you should strictly limit alcoholic beverages while receiving this medicine.

Contact your doctor right away if you or your child experience pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be signs of a serious liver issue.

Serious skin reactions (such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis) can occur with this medicine. Contact your doctor immediately if you or your child have blistering, peeling, or loosening skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills while using this medicine.

Seek immediate medical attention if you or your child develop fever, chills, cough, sore throat, swollen, painful, or tender lymph glands in the neck, armpit, or groin, or yellow skin or eyes while receiving this medicine. These could be symptoms of a serious condition called drug reaction with eosinophilia and systemic symptoms (DRESS).

Notify your doctor right away if you have chest pain, cough, coughing or spitting up blood, difficulty breathing, sore throat, muscle aches, night sweats, sudden high fever, or unusual tiredness. These could be signs of a paradoxical drug reaction to this medicine. If your symptoms do not improve within a few days or worsen, contact your doctor.

This medicine may cause severe tenderness and pain at the injection site. Contact your doctor immediately if you or your child notice any bleeding, blistering, burning, coldness, skin discoloration, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site.

This medicine may cause blood clotting problems, which can lead to bleeding. Contact your doctor right away if you or your child cough up blood, have bleeding gums, difficulty breathing or swallowing, dizziness, headache, increased menstrual flow or vaginal bleeding, nosebleeds, prolonged bleeding from cuts, red or dark brown urine, or red or black, tarry stools after receiving this medicine.

This medicine may cause lung or breathing problems (such as interstitial lung disease, pneumonitis, pneumonia, respiratory failure, pulmonary fibrosis, acute respiratory distress syndrome), which can be life-threatening and require immediate medical attention. Contact your doctor immediately if you have chest pain, chills, dry cough, fever, a general feeling of discomfort or illness, thickening of bronchial secretions, or trouble breathing.

Rifampin will cause urine, saliva, sputum, sweat, teeth, and tears to turn a reddish-orange to reddish-brown color. This is expected while you are receiving this medicine. This effect may permanently discolor soft contact lenses. Standard cleaning solutions may not remove all the discoloration. Therefore, it is best not to wear soft contact lenses while taking this medicine. Hard contact lenses are not affected by this medicine. This condition will return to normal once you stop receiving this medicine. If you have any questions about this, contact your doctor.

This medicine may cause thrombotic microangiopathy (damage in the smallest blood vessels), including hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. Notify your doctor immediately if you have a change in mental status, dark or bloody urine, decreased urine output, difficulty speaking, fever, pale skin, pinpoint red spots on the skin, seizures, severe chest pain, sudden weakness in the arms or legs, unusual bleeding or bruising, or yellow eyes or skin.

If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, contact your doctor right away.

Birth control pills may not work properly while you are receiving this medicine. To prevent pregnancy, use another form of birth control along with your birth control pills. Other forms include condoms, diaphragms, or contraceptive foams or jellies.

Before any medical tests, inform the doctor in charge that you or your child are receiving this medicine. Some test results may be affected by this medicine.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medication, the chances of using the drug must be weighed against the beneficial it will do. This is a decision you and your clinician will make. For this medication, the following should be considered:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medication or any other medications. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific issues that would limit the usefulness of rifampin injection in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of rifampin injection in the elderly.

Breast Feeding

Studies in women suggest that this drug poses minimal chance to the infant when used during breastfeeding.

Interactions with Drugs

Although certain medications should not be used together at all, in other cases two different medications may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially essential that your healthcare professional know if you are taking any of the drugs listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your physician may decide not to treat you with this medication or change some of the other medicines you take.

• Artemether
• Atazanavir
• Bictegravir
• Boceprevir
• Cabotegravir
• Cobicistat
• Daclatasvir
• Darunavir
• Dasabuvir
• Delamanid
• Doravirine
• Elbasvir
• Elvitegravir
• Fosamprenavir
• Fostemsavir
• Glecaprevir
• Grazoprevir
• Isavuconazonium
• Lenacapavir
• Lopinavir
• Lorlatinib
• Lurasidone
• Maraviroc
• Mavacamten
• Nelfinavir
• Nirmatrelvir
• Ombitasvir
• Pacritinib
• Paritaprevir
• Pibrentasvir
• Praziquantel
• Ranolazine
• Rilpivirine
• Ritonavir
• Saquinavir
• Sofosbuvir
• Telaprevir
• Tenofovir Alafenamide
• Tipranavir
• Velpatasvir
• Voriconazole
• Voxilaprevir

Using this medication with any of the following drugs is normally not recommended, but may be required in some cases. If both medications are prescribed together, your clinician may change the dose or how frequently you use one or both of the medicines.

• Abemaciclib
• Abiraterone Acetate
• Abrocitinib
• Acalabrutinib
• Adagrasib
• Afatinib
• Alfentanil
• Alpelisib
• Amiodarone
• Amlodipine
• Amprenavir
• Apixaban
• Apremilast
• Aprepitant
• Aripiprazole
• Atogepant
• Atovaquone
• Avacopan
• Avapritinib
• Avatrombopag
• Axitinib
• Bedaquiline
• Belumosudil
• Bendamustine
• Benzhydrocodone
• Berotralstat
• Betrixaban
• Bortezomib
• Bosutinib
• Brexpiprazole
• Brigatinib
• Brivaracetam
• Buprenorphine
• Bupropion
• Cabozantinib
• Cannabidiol
• Capmatinib
• Cariprazine
• Ceritinib
• Cholera Vaccine, Live
• Clopidogrel
• Clozapine
• Cobimetinib
• Codeine
• Copanlisib
• Crizotinib
• Cyclosporine
• Dabigatran Etexilate
• Daprodustat
• Daridorexant
• Darolutamide
• Dasatinib
• Deferasirox
• Deflazacort
• Delavirdine
• Desogestrel
• Dexamethasone
• Dienogest
• Digoxin
• Dihydrocodeine
• Dolutegravir
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Dronedarone
• Drospirenone
• Duvelisib
• Edoxaban
• Efavirenz
• Elacestrant
• Elagolix
• Elexacaftor
• Eliglustat
• Eluxadoline
• Encorafenib
• Entrectinib
• Enzalutamide
• Eravacycline
• Erdafitinib
• Erlotinib
• Estetrol
• Estradiol
• Ethinyl Estradiol
• Ethionamide
• Ethynodiol
• Etonogestrel
• Etrasimod
• Etravirine
• Everolimus
• Exemestane
• Fedratinib
• Fenfluramine
• Fentanyl
• Fexinidazole
• Finerenone
• Fosaprepitant
• Fosnetupitant
• Fosphenytoin
• Fostamatinib
• Futibatinib
• Gefitinib
• Gepirone
• Gestodene
• Gilteritinib
• Glasdegib
• Halothane
• Hemin
• Hydrocodone
• Hydroxychloroquine
• Ibrexafungerp
• Ibrutinib
• Idelalisib
• Ifosfamide
• Imatinib
• Indinavir
• Infigratinib
• Irinotecan
• Irinotecan Liposome
• Isoniazid
• Istradefylline
• Itraconazole
• Ivabradine
• Ivacaftor
• Ivosidenib
• Ixabepilone
• Ixazomib
• Ketoconazole
• Lamotrigine
• Lapatinib
• Larotrectinib
• Ledipasvir
• Lefamulin
• Lemborexant
• Leniolisib
• Letermovir
• Levoketoconazole
• Levonorgestrel
• Linagliptin
• Lorcainide
• Lumateperone
• Lurbinectedin
• Macimorelin
• Macitentan
• Manidipine
• Maribavir
• Medroxyprogesterone
• Meperidine
• Mestranol
• Methadone
• Methotrexate
• Metoprolol
• Midostaurin
• Mifepristone
• Mirtazapine
• Mitapivat
• Mobocertinib
• Momelotinib
• Mycophenolate Mofetil
• Mycophenolic Acid
• Naloxegol
• Neratinib
• Netupitant
• Nevirapine
• Nifedipine
• Nilotinib
• Nimodipine
• Nintedanib
• Nomegestrol
• Norelgestromin
• Norethindrone
• Norgestimate
• Norgestrel
• Olanzapine
• Olaparib
• Olutasidenib
• Omaveloxolone
• Omeprazole
• Osimertinib
• Oxcarbazepine
• Oxycodone
• Ozanimod
• Palbociclib
• Paliperidone
• Palovarotene
• Panobinostat
• Pazopanib
• Pemigatinib
• Pentazocine
• Perampanel
• Pexidartinib
• Phenobarbital
• Phenytoin
• Pimavanserin
• Piperaquine
• Pirtobrutinib
• Pitavastatin
• Pitolisant
• Ponatinib
• Ponesimod
• Posaconazole
• Pralsetinib
• Pretomanid
• Primidone
• Pyrazinamide
• Quetiapine
• Quinine
• Quizartinib
• Regorafenib
• Relugolix
• Revefenacin
• Ribociclib
• Rimegepant
• Ripretinib
• Risperidone
• Ritlecitinib
• Rivaroxaban
• Roflumilast
• Rolapitant
• Romidepsin
• Ruxolitinib
• Samidorphan
• Segesterone
• Selexipag
• Selpercatinib
• Selumetinib
• Sildenafil
• Simeprevir
• Siponimod
• Sirolimus
• Sirolimus Protein-Bound
• Sonidegib
• Sorafenib
• Sotagliflozin
• Sotorasib
• Sparsentan
• Stiripentol
• Sufentanil
• Sunitinib
• Tacrolimus
• Tamoxifen
• Tasimelteon
• Tazemetostat
• Telithromycin
• Temsirolimus
• Tezacaftor
• Thiotepa
• Ticagrelor
• Tivozanib
• Tofacitinib
• Tolvaptan
• Trabectedin
• Tramadol
• Tucatinib
• Ubrogepant
• Ulipristal
• Upadacitinib
• Valbenazine
• Vandetanib
• Vemurafenib
• Venetoclax
• Vilazodone
• Vincristine
• Vincristine Sulfate Liposome
• Vinflunine
• Voclosporin
• Vonoprazan
• Vorapaxar
• Vortioxetine
• Voxelotor
• Zanubrutinib
• Zavegepant
• Zolpidem
• Zuranolone

Using this medicine with any of the following medicines may cause an increased chance of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your clinician may change the dose or how frequently you use one or both of the drugs.

• Acetyldigoxin
• Aliskiren
• Anisindione
• Aripiprazole Lauroxil
• Atorvastatin
• Betamethasone
• Bexarotene
• Bosentan
• Buspirone
• Carbamazepine
• Carvedilol
• Caspofungin
• Chloramphenicol
• Chlorpropamide
• Citalopram
• Clarithromycin
• Clofibrate
• Cortisone
• Dicumarol
• Diltiazem
• Disopyramide
• Doxycycline
• Eltrombopag
• Enalaprilat
• Enalapril Maleate
• Etoricoxib
• Fluconazole
• Fludrocortisone
• Gliclazide
• Glyburide
• Haloperidol
• Isradipine
• Levomethadyl
• Levothyroxine
• Linezolid
• Losartan
• Mefloquine
• Metformin
• Methylprednisolone
• Morphine
• Morphine Sulfate Liposome
• Moxifloxacin
• Nisoldipine
• Ospemifene
• Phenprocoumon
• Pioglitazone
• Pirmenol
• Prednisolone
• Prednisone
• Propafenone
• Raltegravir
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Sertraline
• Simvastatin
• Tadalafil
• Theophylline
• Tocainide
• Triazolam
• Trimetrexate
• Valproic Acid
• Warfarin
• Zaleplon
• Zidovudine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain drugs may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Issues

The presence of other medical problems may affect the use of this medicine. Make sure you inform your clinician if you have any other medical issues, especially:

• Adrenal gland issue or
• Blood clotting issues or
• Diabetes, history of or
• Liver disease or
• Porphyria (an enzyme issue) or
• Vitamin K deficiency—Use with caution. May make these conditions worse.

• Alcohol abuse, or history of—Use with caution. May cause adverse effects to become worse.

• Liver disease, chronic or
• Patients with poor nutrition status—Use with caution. May raise risk for vitamin K deficiency, which may lead to excessive bleeding.

• Meningococcal disease (such as infections of the lining of the brain and spinal cord [meningitis] and bloodstream [eg, bacteremia, septicemia])—Should not be used in patients with this condition.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do, they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare

• Agitation
• Bleeding gums
• Blood in the urine or stools
• Bruising
• Chest tightness
• Confusion
• Cough
• Coughing or vomiting blood
• Dark urine
• Darkening of the skin
• Decreased frequency or amount of urine
• Difficulty in breathing and swallowing
• Dizziness
• Fainting
• Fast heartbeat
• Fever with or without chills
• General feeling of tiredness or weakness
• Headache
• Hives
• Hoarseness
• Hostility
• Increased blood pressure
• Increased thirst
• Irritability
• Light-colored stools
• Loss of appetite
• Lower back or side pain
• Mental depression
• Nausea
• Painful or difficult urination
• Persistent bleeding or oozing from puncture sites, mouth, or nose
• Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• Skin itching, rash, or redness
• Stomach pain
• Sores, ulcers, or white spots on the lips or in the mouth
• Swelling of the face, ankles, fingers, hands, or lower legs
• Unusual bleeding or bruising
• Unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• Vomiting
• Weight gain
• Yellow eyes or skin

Incidence not known

• Bleeding under the skin
• Blistering, peeling, or loosening of the skin
• Bloating
• Bloody, severe, or watery diarrhea
• Bloody nose
• Bone pain
• Chest pain
• Chills
• Cold, clammy skin
• Diarrhea
• Difficulty with speaking
• Double vision
• Dry cough
• Fast, weak pulse
• General feeling of discomfort or illness
• Heavier menstrual periods
• Inability to move the arms, legs, or facial muscles
• Inability to speak
• Increased menstrual flow or vaginal bleeding
• Joint or muscle pain
• Lightheadedness
• Muscle aches
• Night sweats
• Nosebleeds
• Pale skin
• Paralysis
• Pinpoint red spots on the skin
• Prolonged bleeding from cuts
• Red or black, tarry stools
• Red or dark brown urine
• Red skin lesions, often with a purple center
• Red, irritated eyes
• Runny nose
• Shivering
• Slow speech
• Sore throat
• Sores, welts, or blisters
• Sweating
• Swelling of the fingers, feet, or lower legs
• Swelling or puffiness of the face
• Swollen glands
• Trouble sleeping
• Unpleasant breath odor
• Unusual weight loss

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Blurred vision
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Fast, pounding, or irregular heartbeat or pulse
• Feeling of fullness in the upper abdomen or stomach
• Low blood pressure or slow pulse
• Pain in the upper abdomen or stomach
• Reddish-orange to reddish-brown color of the urine, stool, saliva, sputum, sweat, and tears
• Seizures
• Swelling around the eyes or face
• Unconsciousness
• Yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

• Feeling that others are watching you or controlling your behavior
• Feeling that others can hear your thoughts
• Feeling, seeing, or hearing things that are not there
• Muscle tenderness, wasting, or weakness
• Severe mood or mental changes
• Unusual behavior

Incidence not known

• Belching
• Bloated or full feeling
• Excess air or gas in the stomach or bowels
• Indigestion
• Not able to concentrate
• Pain or discomfort in the chest, upper stomach, or throat
• Tooth discoloration

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Rifadin IV

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antitubercular

Chemical Class: Rifamycin

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins.

Your doctor will only give you a few doses of this medicine until your condition improves, and then you will be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

If you use an antacid, take it at least 1 hour after you receive rifampin.

If you are taking itraconazole, do not receive rifampin 2 weeks before and during itraconazole treatment.

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