Is it possible to take rifampicin? Instructions for use of capsules, suppositories and rifampicin solution. Directions for use and doses

Rifampin is a semi-synthetic antibiotic that belongs to the group of anti-tuberculosis drugs and is used as part of combination therapy for a number of infectious diseases.

The bactericidal effect is based on the selective inhibition of DNA-dependent RNA polymerase in the microbial cell. Active against mycobacteria tuberculosis and leprosy, affects gram-positive (especially staphylococci) and gram-negative (meningococci, gonococci) microorganisms. Less active against gram-negative bacteria.

Refers to first-line anti-tuberculosis drugs. Due to the rapid development of microbial resistance in non-tuberculosis diseases, its use is limited to cases resistant to other antibiotics. Cross-resistance to other anti-tuberculosis drugs (with the exception of other rifamycins) was not observed.

At the therapeutic level, the concentration of the drug when administered orally and intravenously is maintained for 8-12 hours, for highly sensitive pathogens - for 24 hours.

Rifampicin penetrates well into body tissues and fluids and is found in therapeutic concentrations in pleural exudate (protein-rich fluid that accumulates between the membranes surrounding the lungs), sputum, the contents of caverns (cavities in the lungs formed due to tissue necrosis), and bone tissue.

The highest concentration of the drug is created in the tissues of the liver and kidneys. It is excreted from the body with bile and urine.

Indications for use

What does Rifampicin help with? According to the instructions, the drug is prescribed in the following cases:

• tuberculosis – all forms and localizations;
• treatment of infectious diseases caused by microorganisms sensitive to the drug, but resistant to other antibiotics (after excluding the diagnosis of leprosy and tuberculosis);
• brucellosis, in combination with doxycycline (tetracycline antibiotic);
• multibacillary types of leprosy (with simultaneous use of dapsone and clofazimine).

In addition, capsules are prescribed to carriers of the Neisseria meningitidis bacilli and after close contact with patients with meningococcal meningitis - to prevent the disease.

Instructions for use Rifampicin, dosage

Rifampin is taken orally on an empty stomach (2-1 hour before meals) or administered intravenously (adults only).

To prepare the solution, dilute 0.15 g of rifampicin in 2.5 ml of sterile water for injection, shake the ampoules with powder vigorously until completely dissolved, and dilute the resulting solution in 125 ml of 5% glucose solution.

Inject at a rate of 60-80 drops per minute.

When treating tuberculosis, the average daily dose of Rifampicin for adults is 0.45 g orally once a day.

In patients (especially during an exacerbation) with a body weight above 50 kg, the daily dose can be increased to 0.6 g.

The average daily dose for children over 3 years of age is 10 mg/kg (but not more than 0.45 g per day) 1 time per day.

If Rifampicin is poorly tolerated, the instructions for use recommend dividing the daily dose into 2 doses.

It is possible to administer the drug to the pathological focus (by intracavitary administration, inhalation, as well as injection into the focus of the skin lesion). In this case, the optimal dosage is 125-250 mg.

The maximum permissible dose for adults and children is 600 mg.

• Tuberculosis, in combination with isoniazid, ethambutol, pyrazinamide (anti-tuberculosis drugs): adults - 450 mg per day for body weight up to 50 kg, 600 mg per day for weight 50 kg and above; children - the dose is determined at the rate of 10–20 mg per 1 kg of child weight per day. The duration of treatment depends on individual tolerance and can be 1 month or more. After stabilization of the patient's condition, the patient is transferred to oral rifampicin, which can last up to 12 months. The maximum daily dose is 600 mg;
• Lepromatous, borderline-lepromatous or borderline type of leprosy: adults – 600 mg once a month in combination with clofazimine and dapsone, minimum course of therapy – 24 months;
• Tuberculoid or borderline tuberculoid type of leprosy: 600 mg once a month in combination with dapsone, treatment duration - 6 months;
• Infectious pathologies caused by microorganisms sensitive to rifampicin (with simultaneous use of other antimicrobial agents): adults - 600-1200 mg per day, children - at the rate of 10-20 mg per 1 kg of body weight per day, the prescribed dose is divided by 2-3 introduction. The course of treatment is 7–14 days, it is set individually depending on the clinical effect;
• Brucellosis: adults – 900 mg per day in combination with doxycycline, treatment duration – 1.5 months.

For the prevention of meningococcal meningitis - 2 times a day every 12 hours for 2 days. Single doses for adults – 600 mg; for children – 10 mg/kg; for newborns – 5 mg/kg.

In patients with impaired renal excretory function and preserved liver function, dose adjustment is required only when it exceeds 600 mg/day.

Side effects

The instructions warn about the possibility of developing the following side effects when prescribing Rifampicin:

• From the digestive system: nausea, vomiting, diarrhea, loss of appetite, erosive gastritis, pseudomembranous enterocolitis; increased activity of “liver” transaminases in the blood serum, hyperbilirubinemia, hepatitis.
• Allergic reactions: urticaria, eosinophilia, angioedema, bronchospasm, arthralgia, fever.
• From the nervous system: headache, decreased visual acuity, ataxia, disorientation.
• From the urinary system: nephronecosis, interstitial nephritis.
• Other: leukopenia, dysmenorrhea, induction of porphyria, myasthenia gravis, hyperuricemia, exacerbation of gout.
• If taken irregularly or when treatment is resumed after a break, flu-like syndrome (fever, chills, headache, dizziness, myalgia), skin reactions, hemolytic anemia, thrombocytopenic purpura, acute renal failure are possible.

Antibacterial therapy can lead to a reddish coloration of urine, tears, feces, sweat, skin and sputum. Permanent staining of contact lenses is possible.

Contraindications

Rifampicin is contraindicated in the following cases:

• pulmonary heart failure II–III degree;
• chronic renal failure;
• recent infectious hepatitis (less than 1 year), jaundice;
• pregnancy period (except when therapy is necessary for health reasons);
• breastfeeding period;
• children up to 12 months;
• hypersensitivity to rifampicin, other rifamycins or one of the components of the drug.

Rifampicin in the form of a lyophilisate for the preparation of infusions is used with caution in debilitated patients when resuming therapy after a break, in patients prone to alcohol abuse, as well as in those with a history of indications of liver disease.

During pregnancy, it is used exclusively for health reasons. Prescribing an antibiotic in the last days of pregnancy can cause bleeding in the newborn, as well as postpartum bleeding in the mother. In such cases, it is recommended to prescribe vitamin K. Women during antibiotic therapy should be reliably protected from pregnancy.

Overdose

Manifested by confusion, convulsive syndrome, pulmonary edema.

Gastric lavage, forced diuresis, and intake of enterosorbents are necessary.

Analogues and substitutes of Rifampicin, price in pharmacies

If necessary, you can replace Rifampicin with an analogue of the active substance - these are the following drugs:

1. Benemicin;
2. Macox;
3. Rimactan;
4. Rimpacin;
5. Rimpin;
6. Rifadin;
7. Rifamore;
8. Rifampicin Binergia;
9. Rifampicin Ferein;
10. Rifaren;
11. Eremfat.

Analogs by ATX code:

• Benemicin,
• Macox,
• Rimpatsin,
• Rifaren,
• Eremfat.

When choosing analogues, it is important to understand that the instructions for use of Rifampicin, price and reviews do not apply to drugs with similar effects. It is important to consult a doctor and not change the drug yourself.

Price in pharmacies in Moscow and Russia: Rifampicin 150 mg 20 capsules - not on sale, Rifampicin lyophilisate 150 mg 20 pcs. – from 339 to 420 rubles, according to 592 pharmacies.

Store in a dry place, protected from light, at a temperature not exceeding +25 °C. Shelf life – 2 years.

| Rifampicinum

Analogues (generics, synonyms)

Benemecin, Rifadin, Rifamor, Rifaldazin, Rifaldin, Rifampin, Rifoldin, Riforal, Rimactan, Ripamizin, Tubocin

Recipe (international)

Rp.: Rifampicini 0.15
D.t. d; N. 30 in caps.
S. 1 capsule 3 times a day 30-60 minutes before meals

pharmachologic effect

Rifampin is a broad-spectrum antibiotic. It is active against mycobacteria tuberculosis and leprosy, acts on gram-positive (especially staphylococci) and gram-negative (meningococci, gonococci) cocci, and is less active against gram-negative bacteria.

Rifampin is well absorbed from the gastrointestinal tract. The maximum concentration in the blood is achieved 2-2/2 hours after oral administration.
When administered intravenously, the maximum concentration of rifampicin is observed at the end of the infusion (infusion). At the therapeutic level, the concentration of the drug when administered orally and intravenously is maintained for 8-12 hours, for highly sensitive pathogens - for 24 hours. Rifampicin penetrates well into the tissues and fluids of the body and is found in therapeutic concentrations in pleural exudate (accumulating between the membranes, protein-rich fluid surrounding the lungs), sputum, the contents of caverns (cavities in the lungs formed as a result of tissue necrosis), bone tissue. The highest concentration of the drug is created in the tissues of the liver and kidneys. It is excreted from the body with bile and urine.

Resistance to rifampicin develops rapidly. Cross-resistance with other antibiotics is not observed (with the exception of rifamiin).

Mode of application

For adults: Rifampin is taken orally on an empty stomach (2-1 hours before meals) or administered intravenously (adults only).

To prepare the solution, dilute 0.15 g of rifampicin in 2.5 ml of sterile water for injection, shake the ampoules with powder vigorously until completely dissolved, and dilute the resulting solution in 125 ml of 5% glucose solution. Inject at a rate of 60-80 drops per minute.

When treating tuberculosis, the average daily dose for adults is 0.45 g orally once a day. In patients (especially during an exacerbation) with a body weight above 50 kg, the daily dose can be increased to 0.6 g. The average daily dose for children over 3 years of age is 10 mg/kg (but not more than 0.45 g per day) 1 once a day. If rifampicin is poorly tolerated, the daily dose can be divided into 2 doses.

Intravenous administration of rifampicin is recommended for acutely progressive and widespread forms of destructive pulmonary tuberculosis (pulmonary tuberculosis that occurs with a violation of the structure of the lung tissue), severe purulent-septic processes (microbial contamination of the blood with subsequent formation of ulcers in the tissues), when it is necessary to quickly create a high concentration of the drug in the blood and if taking the drug orally is difficult or poorly tolerated by the patient.

When administered intravenously, the daily dose for adults is 0.45 g, for severe rapidly progressing (developing) forms - 0.6 g and is administered in 1 dose. The drug is administered intravenously for 1 month. or more, followed by a transition to oral administration, depending on the tolerability of the drug. The total duration of use of rifampicin for tuberculosis is determined by the effectiveness of treatment and can reach 1 year.

When treating tuberculosis with rifampicin (intravenously) in patients with diabetes mellitus, it is recommended to administer 2 units of insulin for every 4-5 g of glucose (solvent).

Monotherapy (treatment with one drug) of tuberculosis with rifampicin is often accompanied by the development of pathogen resistance to the antibiotic, so it should be combined with other antituberculosis drugs (streptomycin, isoniazid, ethambutol, etc., 770, 781), to which the sensitivity of Mycobacterium tuberculosis (the causative agent of tuberculosis) is preserved. . For leprosy, rifampicin is used according to the following regimens: a) a daily dose of 0.3-0.45 g is administered in 1 dose: if poorly tolerated, in 2 doses. Duration of treatment is 3-6 months, courses are repeated at intervals of 1 month; b) against the background of combination therapy, a daily dose of 0.45 g is prescribed in 2-3 doses for 2-3 weeks. at intervals of 2-3 months. for 1 year - 2 years or at the same dose 2-3 times every 1 week. within 6 months. Treatment is carried out in combination with immunostimulating (increasing the body's defenses) agents.

For non-tuberculosis infections, adults take rifampicin orally at 0.45-0.9 g per day, and children - 8-10 mg/kg in 2-3 doses. Administered intravenously to adults in a daily dose of 0.3-0.9 g (2-3 injections). Administer over 7-10 days. As soon as the opportunity arises, switch to taking the drug orally.

For acute gonorrhea, it is prescribed orally at a dose of 0.9 g per day once or for 1-2 days.

To prevent rabies, adults are given 0.45-0.6 g per day orally; for severe injuries (bite to the face, head, hands) - 0.9 g per day; children under 12 years old - 8-10 mg/kg. The daily dose is divided into 2-3 doses.

Duration of use: 5-7 days. Treatment is carried out simultaneously with active immunization (vaccinations).

Indications

Rifampicin is used for tuberculosis (including tuberculous meningitis), as part of combination therapy; for infectious and inflammatory diseases caused by pathogens sensitive to the drug (including osteomyelitis, pneumonia, pyelonephritis, leprosy, gonorrhea, otitis, cholecystitis, etc.), as well as for meningococcal carriage.

Due to the rapid development of antibiotic resistance during treatment, the use of rifampicin for diseases of non-tuberculosis etiology is limited to cases that are not amenable to treatment with other antibiotics.

Contraindications

Hypersensitivity, jaundice, recent (less than 1 year) infectious hepatitis, lactation period, chronic renal failure, severe pulmonary heart failure, infancy.
With caution. Pregnancy (only for “vital” indications).

Side effects

Treatment with rifampicin should be carried out under close medical supervision. Allergic reactions (of varying severity) are possible, although they are relatively rare; in addition, dyspeptic symptoms (digestive disorders), dysfunction (impaired function) of the liver and pancreas. With long-term use of the drug, it is necessary to periodically examine liver function and carry out blood tests (due to the possibility of developing leukopenia/decrease in the level of leukocytes in the blood).

With rapid intravenous administration, blood pressure may decrease, and with prolonged administration, phlebitis (inflammation of the vein) may develop. The drug reduces the activity of indirect anticoagulants (drugs that inhibit blood clotting), oral hypoglycemic drugs (drugs taken by mouth that lower blood sugar), and digitalis preparations. When taking anticoagulants and rifampicin simultaneously, the dose of anticoagulants should be reduced when the latter is discontinued.

The drug has a bright brown-red color. It colors (especially at the beginning of treatment) urine, sputum, and tear fluid an orange-reddish color.

Release form

In capsules of 0.05 and 0.15 g in a package of 10-20 or 30 capsules; in ampoules of 0.15 g in the form of a porous mass in a package of 10 ampoules.

ATTENTION!

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J.04.A.B Antibiotics

J.04.A.B.02 Rifampicin

Semi-synthetic broad-spectrum antibiotic, first-line anti-tuberculosis drug.

At low concentrations it has a bactericidal effect on Mycobacteriumtuberculosis,Brucellaspp., Chlamydiatrachomatis, Legionellapneumophila, Rickettsiatyphi, Mycobacteriumleprae ; in high concentrations - against some gram-negative microorganisms.

Characterized by high activity against Staphylococcusspp. (including penicillinase-forming and many methicillin-resistant strains), Streptococcusspp., Clostridiumspp., Bacillusanthracis, gram-negative cocci: Neisseria meningitidis, Neisseria gonorrhoeae.

Effects on gram-positive bacteria in high concentrations.

Active against intracellular and extracellular microorganisms. Suppresses DNA-dependent RNA polymerase of microorganisms.

With rifampicin monotherapy, selection of rifampicin-resistant bacteria is observed relatively quickly. Cross-resistance with other antibiotics (with the exception of other rifamycins) does not develop.

When administered intravenously, the maximum concentration of rifampicin is observed at the end of the infusion. When administered intravenously, the therapeutic concentration is maintained for 8-12 hours, for highly sensitive pathogens - for 24 hours. Communication with plasma proteins is 84-91%. It is quickly distributed throughout organs and tissues (the highest concentration in the liver and kidneys), penetrates into bone tissue, the concentration in saliva is 20% of the plasma concentration. The apparent volume of distribution is 1.6 l/kg in adults and 1.1 l/kg in children.

It penetrates the blood-brain barrier only in case of inflammation of the meninges. Penetrates through the placenta (concentration in fetal plasma is 33% of the concentration in maternal plasma) and is excreted in breast milk (breastfed children receive no more than 1% of the therapeutic dose of the drug).

Metabolized in the liver to form a pharmacologically active metabolite - 25-O-deacetylrifampicin. It is an autoinducer - it accelerates its metabolism in the liver, resulting in systemic clearance of 6 l/h after taking the first dose, increasing to 9 l/h after repeated dosing.

Excreted primarily in bile - 80% in the form of a metabolite; kidneys - 20%. It is found in therapeutic concentrations in pleural exudate, sputum, and cavity contents.

In patients with impaired renal excretory function, the half-life (T 1/2) is prolonged only if the dose exceeds 600 mg. It is excreted during peritoneal dialysis and hemodialysis.

In patients with impaired liver function, there is an increase in the concentration of rifampicin in plasma and a prolongation of T1/2.

Tuberculosis (all forms) - as part of combination therapy.

Leprosy (multibacillary types of disease) - in combination with other antimicrobial drugs active against Mycobacteriumleprae .

Infectious diseases caused by microorganisms sensitive to rifampicin (in cases of resistance to other antibiotics and as part of combination antimicrobial therapy; after excluding the diagnosis of tuberculosis and leprosy).

Meningococcal meningitis (prevention for persons who have been in close contact with patients with meningococcal meningitis; for bacilli carriers Neisseriameningitidis ).

Brucellosis - as part of combination therapy with a tetracycline antibiotic (doxycycline).

Hypersensitivity to rifampicin and other rifamycins or to any of the components of the drug; jaundice, recent (less than 1 year) infectious hepatitis; lactation period; chronic renal failure; severe pulmonary heart failure; children's age up to 2 months, during treatment of brucellosis - up to 18 years.

During pregnancy (only for “vital” indications); in debilitated patients when resuming treatment with rifampicin after a break; in patients who abuse alcohol; when there is a history of liver disease; with porphyria.

During pregnancy, it is used only if the expected benefit to the mother outweighs the potential risk to the fetus. Therapy during pregnancy (especially in the first trimester) is possible only for “vital” indications. When used in the last weeks of pregnancy, postpartum bleeding in the mother and bleeding in the newborn may occur. In this case, vitamin K is prescribed.

If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Intravenous drip, injection rate - 60-80 drops/min.

Intravenous administration of the drug is recommended for acutely progressive and widespread forms of destructive pulmonary tuberculosis, severe purulent-septic processes, when it is necessary to quickly create high concentrations of the drug in the blood and at the site of infection, in cases where oral administration of the drug is difficult or poorly tolerated by patients.

The dose and duration of therapy should be based on the type and severity of the infection and the patient's condition.

In the treatment of tuberculosis

Adults and children over 18 years of age: 10 (8-12) mg/kg body weight, maximum daily dose - 600 mg, but not less than 450 mg.

Children from 12 to 18 years old: 10 (8-12) mg/kg body weight per day, maximum daily dose - 600 mg.

Children from 2 months to 12 years: 15 (10-20) mg/kg body weight per day, maximum daily dose - 600 mg.

When treating tuberculosis, a daily dose for adults of 450 mg to 600 mg is administered in one dose.

The duration of intravenous administration depends on tolerability and is 1 month or more (with subsequent transition to oral administration). The total duration of use of the drug for tuberculosis is determined by the effectiveness of treatment and can reach 1 year.

When treating tuberculosis, it is combined with at least one anti-tuberculosis drug (,).

For tuberculous meningitis, disseminated tuberculosis, spinal lesions with neurological manifestations, and when tuberculosis is combined with HIV infection, the total duration of treatment is 9 months. The drug is used daily, the first 2 months in combination with isoniazid, pyrazinamide, ethambutol (or streptomycin), 7 months - in combination with isoniazid.

In the case of pulmonary tuberculosis and detection of mycobacteria in sputum, the following 3 regimens are used (all lasting 6 months):

1. The first 2 months - as indicated above; 4 months - daily in combination with isoniazid.

2. The first 2 months - as indicated above; 4 months - daily in combination with isoniazid, 2-3 times every week.

3. Throughout the course - taken in combination with isoniazid, pyrazinamide, ethambutol (or streptomycin) 3 times every week. In cases where anti-tuberculosis drugs are used 2-3 times a week (as well as in case of exacerbation of the disease or ineffectiveness of therapy), their use should be carried out under the supervision of medical personnel.

For the treatment of leprosy

For the treatment of multibacillary types of leprosy (lepromatous, borderline, borderline-lepromatous): adults - 600 mg once a month, children over 2 months - 10 mg/kg once a month (maximum daily dose - 600 mg) in combination with other antimicrobials drugs active against Mycobacteriumleprae . The minimum duration of treatment is 2 years.

For the treatment of multibacillary types of leprosy (tuberculoid and borderline tuberculoid): adults - 600 mg once a month, children over 2 months - 10 mg/kg once a month (maximum daily dose - 600 mg) in combination with other antimicrobial drugs, active regarding Mycobacteriumleprae . Duration of treatment - 6 months.

For infections of non-tuberculous etiology

For infections of non-tuberculosis etiology caused by sensitive microorganisms, the daily dose for adults is 300-900 mg (maximum daily dose - 1200 mg), for children over 2 months - 10-20 mg/kg (maximum daily dose - 600 mg). The daily dose is divided into 2-3 injections.

The duration of treatment is determined individually, depends on the effectiveness and can be 7-10 days. Intravenous administration should be discontinued as soon as oral administration is possible.

For the prevention of meningococcal meningitis and eradication of meningococcal carriage

For adults: 600 mg, 2 times a day every 12 hours for 2 days.

Children from 2 months to 18 years: 10 mg/kg 2 times a day every 12 hours for 2 days.

The maximum daily dose is 600 mg.

Preferred is the use of oral dosage forms.

For the treatment of brucellosis

Adults - 900 mg/day once in combination with doxycycline. The average duration of treatment is 45 days.

Intravenous administration should be discontinued as soon as oral administration is possible.

In case of impaired renal and/or liver function

In patients with impaired renal excretory function and preserved liver function, dose adjustment is required only when it exceeds 600 mg/day.

Features of use after interruption of therapy

After interruption of therapy, it is prescribed with a gradual increase in dose. Monitoring of renal function is necessary, and if necessary, glucocorticosteroids are recommended.

Preparation of the solution

The contents of 1 ampoule/vial (150 mg of rifampicin) are dissolved in 2.5 ml of water for injection, shake vigorously until completely dissolved; the resulting solution is mixed with 125 ml of 5% dextrose solution.

From the digestive system : nausea, vomiting, diarrhea, loss of appetite, abdominal pain, flatulence, erosive gastritis, pseudomembranous colitis; increased activity of “liver” transaminases and alkaline phosphatase in the blood serum, hepatitis, jaundice, hyperbilirubinemia, acute pancreatitis.

Allergic reactions: urticaria, eosinophilia, angioedema, bronchospasm, arthralgia, fever.

From the nervous system: dizziness, headache, ataxia, disorientation, muscle weakness.

From the urinary system: nephronecosis, interstitial nephritis.

From the side of the organ of vision: decreased visual acuity, optic neuritis.

Others: leukopenia, dysmenorrhea, induction of porphyria, myasthenia gravis, hyperuricemia, exacerbation of gout.

Local reactions: phlebitis at the injection site.

With irregular therapy or when resuming treatment after a break, flu-like syndrome (fever, chills, headache, dizziness, myalgia), skin reactions, hemolytic anemia, thrombocytopenic purpura, acute renal failure are possible.

Symptoms: nausea, vomiting, drowsiness, enlarged liver, jaundice, increased concentration of bilirubin in the blood, increased activity of “liver” transaminases in the blood plasma; brown-red or orange coloration of the skin, sclera, mucous membranes, urine, saliva, sweat, tears and feces in proportion to the dose of the drug taken. In case of severe overdose: agitation, shortness of breath, tachycardia, convulsions, respiratory failure and cardiac arrest.

Treatment: discontinuation of drug administration. Symptomatic therapy (there is no specific antidote). Maintaining vital functions.

Rifampicin causes the induction of cytochrome P450 isoenzymes, accelerating the metabolism of drugs, and accordingly reduces the activity of indirect anticoagulants, oral hypoglycemic drugs, cardiac glycosides (and others), antiarrhythmic drugs (disopyramide, pyrmenol, tocainide), glucocorticosteroids, dapsone, hydantoins ( ), carbamazepine, buspirone, barbiturates (, hexobarbital, etc.), some tricyclic antidepressants (nortriptyline), antiviral drugs (including nucleoside reverse transcriptase inhibitors (NRTIs):, etc.); (including non-nucleoside reverse transcriptase inhibitors (NNRTIs): delavirdine, etc.), benzodiazepines (and others), theophylline, chloramphenicol, antipsychotics (and others), antifungal drugs (, and others), cyclosporine, azathioprine, beta-blockers (and others), blockers of "slow" calcium channels (,), lipid-lowering drugs (and others), antimalarial drugs (and others), cytostatics (and others), cyclooxygenase-2 inhibitors (and etc.), losartan, enalapril, cimetidine, thyroxine, sex hormones.

Concomitant use with HIV protease inhibitors (, nelfinavir) should be avoided.

Rifampicin accelerates the metabolism of estrogens and gestagens (the effect of oral contraceptives is reduced).

With simultaneous use of rifampicin (600 mg/day), ritonavir (100 mg 2 times a day) and saquinavir (1000 mg), severe hepatotoxicity may develop.

When used together, it significantly reduces the plasma concentrations of atazanavir, darunavir, fosamprenavir, saquinavir and tipranavir, which may lead to a decrease in antiviral activity.

Isoniazid and/or increase the incidence and severity of liver dysfunction to a greater extent than with rifampicin alone in patients with pre-existing liver disease.

Co-trimoxazole (sulfamethoxazole/trimethoprim) increases the concentration of rifampicin in the blood.

Rifampicin interacts with contrast agents used in cholecystography. Under its influence, the results of radiographic studies may be distorted.

During treatment, the skin, sputum, sweat, feces, tear fluid, and urine become orange-red. Can permanently stain soft contact lenses.

Intravenous infusion is carried out under blood pressure control; with prolonged administration, phlebitis may develop. With rapid intravenous administration, a decrease in blood pressure may occur.

To prevent the development of resistance of microorganisms, it must be used in combination with other antimicrobial drugs.

In the event of the development of influenza-like syndrome, uncomplicated by thrombocytopenia, hemolytic anemia, bronchospasm, shortness of breath, shock and renal failure, in patients receiving the drug on an intermittent regimen, the possibility of switching to daily dosing should be considered. In these cases, the dose is increased slowly: 75-150 mg is prescribed on the first day, and the desired therapeutic dose is reached in 3-4 days. If the above serious complications are noted, cancel.

Renal function must be monitored; additional administration of glucocorticosteroids (GCS) is possible.

Women of reproductive age should use reliable methods of contraception (oral hormonal contraceptives and additional non-hormonal methods of contraception) during treatment.

In the case of prophylactic use in meningococcal bacilli carriers, strict monitoring of patients is necessary in order to promptly identify symptoms of the disease in the event of resistance to rifampicin.

With long-term use, systematic monitoring of peripheral blood patterns and liver function is indicated. During the treatment period, microbiological methods for determining the concentration of folic acid and vitamin B 12 in blood serum should not be used.

A false positive result is possible in the immunological determination of opiates in the blood.

The potential for side effects such as dizziness, disorientation and visual disturbances should be taken into account. If the described adverse events occur, you should refrain from driving and engaging in other activities that require increased concentration and speed of psychomotor reactions.

Lyophilisate for the preparation of a concentrate for the preparation of a solution for infusion, 150 mg.

150 mg of active ingredient in glass ampoules or vials.

10 ampoules, along with instructions for use and an ampoule scarifier, are placed in a cardboard pack with partitions or special slots.

When using ampoules with a break ring, packaging of ampoules without an ampoule scarifier is allowed.

Each bottle, along with instructions for use, is placed in a cardboard pack.

Packaging for hospitals: 40 bottles with an equal number of instructions for use in a group container.

In a place protected from light, at a temperature not exceeding 25 ° C.

Keep out of the reach of children.