What Factors Affect a Sufficient Rifampicin Dose?

Rifampicin (also translated: rifamycin, mepirifamycin, mepirifamycin, rifampicin, centandrolum, rifampicin, or rimidin, INN: Rimapicin) is a rifampicin A broad-spectrum antibiotic drug of the fulomycin family, has a strong antibacterial effect on Mycobacterium tuberculosis, and also has a curative effect on Gram-positive or negative bacteria and viruses. Red or dark red crystalline powder, insoluble in water. Oral capsules or tablets are usually used in combination with other anti-tuberculosis drugs to synergize and delay the development of resistant strains. It is mainly used for the treatment of tuberculosis, meningitis and Staphylococcus aureus infection. Topical treatment can treat trachoma and so on ^[1] .

Drug Name: Rifampin
Alias: Mepirifamycin, rifampin, rimidine

Foreign name: RIFAMPICIN / Rifampin
Whether prescription drugs: prescription
Athletes use with caution: Inadvertent use

Rifampicin compounds

Rifampin Basic Information

Chinese name

Chinese alias: rifamycin SV; mepiperidamycin; isobutylpiperazine rifamycin; 3-[[(4-methyl-1-piperazinyl) imino] methyl] -li Fufamycin; rifampicin; mepirifamycin; rimidine

English name: rifampicin

English alias: rifobac; rifagen; Rifadin; Rifamycin AMP; Rifampicin; RIMACTANE RIFAMPIN; RFP

CAS number: 13292-46-1

Rifampicin chemical structural formula

Molecular formula: C ₄₃ H ₅₈ N ₄ O ₁₂

Molecular weight: 822.94000

Exact mass: 822.40500

PSA: 220.15000

LogP: 4.34920

Physical and chemical properties of rifampicin

Appearance and properties: red to orange crystalline solid

Density: 1.34 g / cm ³

Melting point: 183ºC (dec.)

Boiling point: 1004.42ºC at 760 mmHg

Flash point: 561.253ºC

Refractive index: 1.613

Stability: Stable under normal shipping and handling conditions.

Storage conditions: 2-8ºC Vapor pressure: 0mmHg at 25 ° C

Rifampicin safety information

Symbol: GHS07

Signal Word: Warning

Hazard statement: H302

Cautionary statement: P301 + P312 + P330

Customs Code: 2941903000

Danger category code: R22; R36 / 37/38

Safety instructions: S26-S36

Dangerous goods sign: Xn

Rifampicin production method

Rifampicin is a semi-synthetic derivative of rifamycin SV. The rifamycin SV is oxidized to rifamycin S, and then formylated with formaldehyde and tert-butylamine to form 3-formyl tert-butylamine rifamycin S, which is then reduced with vitamin C to react with 1-methyl-4- Aminopiperazine is condensed to give rifampicin.

Rifampin uses

It has a broad-spectrum antibacterial effect, and has good antibacterial activity against Gram-positive cocci and Mycobacterium tuberculosis. The antibacterial spectrum is the same as that of rifampicin ^[1] .

Rifampicin Pharmacopoeia Standard

Source (name), content (potency) of rifampicin

This product is 3-[[(4-methyl-1-piperazinyl) imino] methyl] -rifamycin. Calculated on dry basis, containing C43H58N4O12 should be 97.0% ~ 102.0%.

Rifampicin traits

This product is bright red or dark red crystalline powder.

This product is soluble in methanol and almost insoluble in water.

Rifampin identification

(1) Take about 10mg of this product, add 10ml of methanol to dissolve, take 1ml, dilute with phosphate buffer solution (pH 7.0) to make a solution containing about 20g per 1ml, according to the UV-visible spectrophotometry (2010 edition Pharmacopoeia The two appendixes IVA) determined that there was maximum absorption at the wavelengths of 237nm, 254nm, 334nm, and 473nm, and minimum absorption at the wavelengths of 296nm and 394nm.

(2) Take appropriate amounts of this product and rifampicin reference substance, dissolve and dilute with methanol to make a solution containing about 10mg per 1ml, as the test solution and reference solution; take the rifampicin reference substance and Each appropriate amount of rifapentin reference substance was dissolved in methanol and diluted to make a mixed solution containing about 10mg of rifampicin and 10mg of rifapentin per 1ml as a system suitability solution. According to the thin-layer chromatography (2010 Appendix B Pharmacopoeia Part II) test, draw 2 l of each of the three solutions, point them on the same silica gel G thin-layer plate, and use ethyl acetate-methanol-concentrated ammonia solution (8: 2: 0.2) As a developing agent, unfold, dry, and inspect under sunlight. The rifampicin and rifampin spots shown by a system suitability solution should be completely separated. The position and color of the main spots displayed by the test solution should be consistent with the main spots of the reference solution.

(3) In the chromatogram recorded under the content determination item, the retention time of the main peak of the test solution should be consistent with the retention time of the main peak of the reference solution.

(4) The infrared light absorption spectrum of this product should be the same as that of the control ("Infrared Spectra of Drugs" 198) or the reference (I or II crystal form) (Appendix IV C of Part Two of the Pharmacopoeia, 2010 Edition).

The above two items (2) and (3) are optional.

Rifampin check

Crystallinity

Take a little of this product and check it according to law (Appendix D of Part II of the Pharmacopoeia 2010), and it should meet the requirements.

acidity

Take this product, add water to make a suspension containing 10mg per 1ml, and determine it according to law (Appendix VIH of the second edition of the Pharmacopoeia, 2010 edition), the pH value should be 4.0 ~ 6.5.

relative substance

It can be used newly or stored within 2 ~ 8 for 6 hours. Take an appropriate amount of this product, accurately weigh, add a small amount of acetonitrile (about 10mg plus 1ml acetonitrile) to dissolve, and then quantitatively dilute with acetonitrile-water (1: 1) to make a solution containing about 1mg per 1ml, as the test solution ; Weigh the appropriate amount of rifampicin accurately, add a small amount of acetonitrile (about 10mg plus 1ml acetonitrile) to dissolve, and then quantitatively dilute with acetonitrile-water (1: 1) to make a solution containing about 10g per 1ml, as a control solution ; Accurately measure the appropriate amount of the control solution, and quantitatively dilute it with acetonitrile-water (1: 1) to make a solution containing about 0.5 g per 1 ml as the sensitivity solution. Also weigh the quinoline rifampicin reference substance and N-oxidation precisely. Rifampicin reference substance and 3-formyl rifamycin SV reference substance were each dissolved in an appropriate amount of acetonitrile (approximately 10 mg plus 1 ml of acetonitrile) and dissolved in acetonitrile-water (1: 1). Each solution contains about 10 g, which is used as impurity reference solution (1), (2), (3). According to the chromatographic conditions under the content determination item, take 10 l of the sensitivity solution into the liquid chromatograph, record the chromatogram, and the signal-to-noise ratio of the main component chromatographic peak height should be greater than 10; then accurately measure the reference solution and the impurity reference solution (1 ), (2), (3), and 10 l each of the test solution were injected into the liquid chromatograph, and the chromatogram was recorded to 4 times the peak retention time of the main component. If there is an impurity peak in the chromatogram of the test solution, quinoform rifampicin, N-oxidized rifampicin, and 3-formyl rifampicin SV are calculated based on the peak area of the external standard method, which should not exceed 1.5% and 0.5 respectively. %, 0.5%; the area of other single impurity peaks shall not be greater than the area of the main peak of the control solution (1.0%), and the sum of the areas of other impurity peaks shall not be greater than 3 times (3.0%) of the area of the main peak of the control solution.

Loss on drying

Take this product and dry it at 105 to constant weight, and the weight loss shall not exceed 1.0% (Appendix L of Part Two of the Pharmacopoeia of 2010 Edition).

Residue on ignition

Take 1g of this product and check it according to law (Appendix N of Part Two of the 2010 Pharmacopoeia). The residual residue shall not exceed 0.1%.

Heavy metal

Take the residue left under the item of burning residue and check it according to law (Appendix H of the second edition of the Pharmacopoeia of 2010 Edition, the second method H), the content of heavy metals must not exceed 20 parts per million.

Determination of rifampicin

It was determined by high performance liquid chromatography (Appendix D, Part Two of the Pharmacopoeia, 2010 Edition).

1 Chromatographic conditions and system suitability tests

Octylsilane-bonded silica gel was used as the filler; methanol-acetonitrile0.075mol / L potassium dihydrogen phosphate solution1.0mol / L citric acid solution (30: 30: 36: 4) was used as the mobile phase; the detection wavelength was 254nm. Take the appropriate amount of rifampicin reference substance, quinone rifampicin reference substance, N-oxidized rifampicin reference substance and rifamycin SV reference substance, add an appropriate amount of acetonitrile (about 10mg plus 1ml acetonitrile) to dissolve, and then use acetonitrile -Diluted with water (1: 1) to make a mixed solution containing about 0.04mg per 1ml [impurities A produced by quinoform rifampicin and N-oxidized rifampicin in this solution Adjacent impurities)], take 10 l into the liquid chromatograph, the resolution between the quinone rifampicin peak and the impurity A peak, the rifampicin peak and the rifamycin SV peak should meet the requirements.

2 Assay

It can be used newly or stored within 2 ~ 8 for 6 hours. Take an appropriate amount of this product, accurately weigh, add acetonitrile to dissolve and quantitatively dilute to make a solution containing about 1mg per 1ml; take an appropriate amount, and quantitatively dilute with acetonitrile-water (1: 1) to make about 0.1 per 1ml. A solution of mg was used as a test solution. A precise amount of 10 l was injected into the liquid chromatograph and the chromatogram was recorded. Another appropriate amount of rifampicin reference substance was accurately weighed and measured in the same way. Calculate the peak area according to the external standard method, and get ^[2-3] .

Rifampin Categories

Anti-TB drugs.

Rifampin storage

Sealed and stored in a dry and dark place.

Rifampicin

(1) Rifampicin tablets (2) Rifampicin capsules (3) Rifampicin for eye drops

Rifampin analysis

Method name: Rifampicin Tablets-Rifampicin-High Performance Liquid Chromatography

Application: This method uses high performance liquid chromatography to determine the content of rifampicin in rifampicin tablets.

This method is applicable to rifampicin tablets.

Principle of the method: The test product was dissolved in acetonitrile and quantitatively diluted, and then subjected to HPLC for chromatographic separation. The ultraviolet absorption detector was used to detect the peak area of rifampicin at a wavelength of 254 nm and calculate its content.

Reagent: 1. Methanol

Acetonitrile

3. Potassium dihydrogen phosphate solution (0.075mol / L)

4. Citric acid solution (1.0mol / L)

Equipment: 1. Instrument

1.1 HPLC

1.2 Column

Octylsilane-bonded silica gel is used as a filler, and the number of theoretical plates should not be less than 1500 by rifampin peak calculation.

1.3 UV absorption detector

Chromatographic conditions

2.1 Mobile phase: methanol acetonitrile 0.075mol / L potassium dihydrogen phosphate solution 1.0mol / L citric acid solution = 30 30 36 4

2.2 Detection wavelength: 254nm

2.3 Column temperature: room temperature

Sample preparation: 1. Preparation of reference solution

Accurately weigh the appropriate amount of rifampicin reference substance, dissolve it with acetonitrile and quantitatively dilute it into a solution containing about 0.08 mg per 1 mL, which is the reference substance solution.

2. Preparation of test solution

Take 10 test samples, accurately weigh, grind, and accurately weigh an appropriate amount (approximately 80mg of rifampicin), dissolve with acetonitrile and quantitatively dilute to a solution containing about 0.8mg per 1mL, use 0.45 & micro; m The filter is filtered, and an appropriate amount of the filtrate is accurately measured, and quantitatively diluted with acetonitrile to a solution containing about 0.08 mg per 1 mL, which is the test solution.

Note: "Precision weighing" means that the weighed weight should be accurate to one thousandth of the weighed weight. "Precision measurement" means that the accuracy of measuring the volume should meet the accuracy requirements of the volume pipette in national standards.

Operation steps: Precisely draw 10 mL of each of the reference solution and the test solution, inject them into a high-performance liquid chromatograph, and measure the peak area of rifampicin (C43H58N4O12) with a UV absorption detector at a wavelength of 254 nm, and calculate its content ^{[4 ]} .

Rifampicin drug description

Rifampicin pharmacology and toxicology

Rifampicin is a semi-synthetic broad-spectrum antibacterial drug of the rifamycin class, which has a variety of pathogenic microorganisms.

Vancomycin can enhance the effect Antibacterial activity. The drug has obvious bactericidal effect on mycobacterium tuberculosis and some non-tuberculous mycobacteria (including mycobacterium leprae, etc.) inside and outside the host cell. Rifampicin has a good antibacterial effect on aerobic gram-positive bacteria, including staphylococcal enzyme-producing strains and methicillin-resistant strains, streptococcus pneumoniae, other streptococcus, enterococcus, listeria, anthracnose, Perfringens, diphtheria, anaerobic, etc.

It also has high antibacterial activity against aerobic gram-negative bacteria such as Neisseria meningitidis, Haemophilus influenzae, and Neisseria gonorrhoeae. Rifampicin also has a good effect on Legionella, and it has inhibitory effects on pathogens such as Chlamydia trachomatis, sexually transmitted lymphogranuloma, and parrot fever. Bacteria are cross-resistant to rifamycin antibiotics. Rifampicin is strongly bound to the subunit of DNA-dependent RNA polymerase, inhibiting the synthesis of bacterial RNA, preventing the enzyme from linking with DNA, thereby blocking the RNA transcription process and stopping DNA and protein synthesis ^[5] .

Rifampicin pharmacokinetics

Rifampicin is well absorbed orally, and the blood concentration reaches 1.5 to 4 hours after taking the drug. Adult oral 60

RNA synthesis map After 0 mg, the peak drug concentration (Cmax) is 7-9 mg / L. For children from 6 months to 5 years old, 10 mg / kg is orally administered once. The peak drug concentration (Cmax) is 11 mg / L. The product is well distributed in most tissues and body fluids, including cerebrospinal fluid. When the meninges are inflamed, the concentration of the drug in the cerebrospinal fluid increases; it can also reach an effective therapeutic concentration in saliva; the product can pass through the placenta. The apparent distribution volume (Vd) is 1.6 L / kg. The protein binding rate was 80% to 91%. Taking the drug after eating can reduce the absorption of the drug by 30%. The blood elimination half-life (t1 / 2?) Of the drug is 3 to 5 hours, which is shortened after multiple administrations to 2 to 3 hours.

The product can be rapidly deacetylated in the liver by itself inducing the action of microsomal oxidase to become a metabolite deacetylrifampin with antibacterial activity. After hydrolysis, an inactive metabolite is formed and excreted in the urine. This product is mainly excreted through the bile and intestines, and can enter the enterohepatic circulation, but its deacetylated active metabolite has no enterohepatic circulation. 60% to 65% of the dose is excreted in the feces, 6% to 15% of the drug is excreted in the urine in the original form, 15% is the active metabolite, and 7% is excreted as an inactive 3-formyl derivative. Can also be excreted through milk. This product does not accumulate in patients with impaired renal function; due to the effect of self-induced liver microsomal oxidase, the excretion rate increases after 6 to 10 days of taking rifampicin; due to biliary excretion reaching saturation after high doses, the product's Excretion may be delayed. Rifampicin cannot be cleared by hemodialysis or peritoneal dialysis ^[5] .

Rifampicin indications

1. This product is used in combination with other anti-tuberculosis drugs for the initial and retreatment of various tuberculosis,

Rifampicin capsule products Including treatment of tuberculous meningitis. 2. This product is used in combination with other drugs for the treatment of leprosy and non-tuberculous mycobacterial infections.

3. This product can be used in combination with vancomycin (intravenous) for severe infections caused by methicillin-resistant staphylococci. The combination of rifampicin and erythromycin can be used for severe infections of Legionella.

4. Used for asymptomatic Neisseria meningitidis to eliminate Neisseria meningitidis; however, it is not suitable for the treatment of Neisseria meningitidis infection. ^[5]

Rifampicin dosage

1. Antituberculosis treatment: Adults, oral, 0.45g 0.60g per day, fasting meal, no more than 1.2g per day; children over 1 month, daily weight according to 10 ~ 20mg / kg, fasting meal, daily The amount does not exceed 0.6g.

2. Neisseria meningitidis carriers: 5 mg / kg for adults, once every 12 hours for 2 consecutive days; 10 mg / kg for children over 1 month, once every 12 hours, and even 4 times a day. 3. Elderly patients, take orally at 10 mg / kg daily, and take it on an empty stomach.

Rifampicin adverse reactions

1. The most common gastrointestinal reactions are anorexia, nausea, vomiting, upper abdominal discomfort, diarrhea and other gastrointestinal reactions after oral administration. The incidence rate is 1.7% to 4.0%, but they can all be tolerated.

2. Liver toxicity is the main adverse reaction of this product, with an incidence rate of about 1%. Within the first few weeks of treatment, a few patients may have elevated serum aminotransferases, hepatomegaly, and jaundice, and most of them are asymptomatic elevated serum aminotransferases, which can recover on their own during the course of treatment, the elderly, alcoholics , Malnutrition, liver disease or other factors cause liver function abnormalities are more likely to occur.

3. "Influenza-like syndromes" may occasionally occur after high-dose intermittent treatment of allergies, including chills, chills, fever, malaise, dyspnea, dizziness, drowsiness, and muscle pain. Obvious relationship. Occasionally, acute hemolysis or renal failure can occur, and its mechanism is currently considered to be an allergic reaction.

4. After taking this product, other patients' urine, saliva, sputum, tears, etc. can be orange-red. Occasionally leukocytopenia, shortened prothrombin time, headache, dizziness, visual impairment, etc. ^[5] .

Rifampicin contraindications

1. Those who are allergic to this product or rifamycin antibacterials are prohibited.

2. Patients with severe liver insufficiency, biliary obstruction and pregnant women within 3 months are prohibited.

Rifampin precautions

1. Use with caution in patients with alcoholism and impaired liver function. Use with caution for infants, pregnant women over 3 months and lactating women.

2. Interference to diagnosis: can cause direct antiglobulin test (Coom

Drugs cause jaundice bs test) positive; interfere with the determination of serum folic acid concentration and serum vitamin B12 concentration; can cause false positives in the retention of sodium sulfophthalophthalate test; can interfere with the results of various urine analysis tests using a spectrophotometer or color change ; It can increase blood urea nitrogen, serum alkaline phosphatase, serum alanine aminotransferase, aspartate aminotransferase, serum bilirubin and serum uric acid concentrations. 3. Rifampicin can cause liver insufficiency. There have been reports of deaths associated with jaundice in patients with original liver disease or when this product is taken with other hepatotoxic drugs. Therefore, patients with original liver disease can only be used under clear indications. Use with caution, closely observe changes in liver function before and during treatment, and discontinue treatment as soon as liver damage occurs.

4. Hyperbilirubinemia is a mixed type of hepatocyte and bile retention. Mild patients subside on their own, and severe cases need to be discontinued for observation. Elevated blood bilirubin may also be the result of competitive excretion of rifampicin and bilirubin. Liver function should be closely monitored during the first 2 to 3 months of treatment.

5. Rifampicin alone can rapidly develop drug resistance when treating tuberculosis or other bacterial infections, so this product must be used in combination with other drugs. Treatment may take 6 months to 2 years, or even years.

6. Rifampicin may cause white blood cells and thrombocytopenia, cause bleeding and infection of the gums, and delay wound healing. At this time, you should avoid surgery such as tooth extraction, and pay attention to oral hygiene, brushing and flossing until you get normal blood. The surrounding blood should be checked regularly during medication.

7. Rifampicin should be taken 1 hour before or 2 hours after a meal. It is best to take it once in the morning on an empty stomach, as it affects the absorption of this product.

8. Patients with impaired liver function often need to reduce the dose, daily dose 8mg / kg.

9. No reduction in renal function is required. There was no significant change in the plasma concentration of rifampicin in patients with reduced glomerular filtration rate or anuria.

10, urine, saliva, sweat and other feces can be orange-red after taking the drug ^[5] .

Medication during pregnancy

1. Rifampicin can pass through the placenta. Animal experiments have caused teratosis. Although no teratogenicity has been reported in humans, there is currently insufficient data to indicate that it can be safely used during pregnancy.

2. Rifampicin can be excreted by breast milk. The medication for lactating women should be fully weighed and decided.

Medication for children

The safety of this product in children under 5 years of age has not been established.

Medication for elderly patients

The liver function of elderly patients is reduced, and the dosage should be reduced.

Rifampicin drug interactions

1.Drinking alcohol can increase the incidence of rifampic liver toxicity and increase the generation of rifampicin

Combination with isoniazid increases liver toxicity Xie, the dose of rifampicin needs to be adjusted, and the patient is closely observed for liver toxicity.

2. Aminosalicylate can affect the absorption of this product, resulting in a decrease in its blood concentration; if it must be used in combination, the interval between the two should be at least 6 hours.

3. The risk of liver toxicity caused by the combination of isoniazid and isoniazid is increased, especially for those with original liver damage and patients with fast acetylation of isoniazid.

4. Rifampicin combined with ethionamide can aggravate its adverse reactions.

5. Chlorophenazine can reduce the absorption of rifampicin, delay the peak time and extend the half-life.

6. The combination of rifampicin and miconazole or ketoconazole can reduce the blood concentration of the latter two, so this product should not be used in combination with imidazoles.

7.Adrenal corticosteroids (glucocorticoids, mineralocorticoids), anticoagulants, aminophylline, theophylline, chloramphenicol, clobetin, cyclosporine, verapamil, verapamil, proper Carnitine, propafenone, trimethoprim, coumarin or indanedione derivatives, oral hypoglycemic agents, corticosteroids, dapsone, digitalis, propidamine, quinidine, etc. When rifampicin is used in combination, because the latter induces liver microsomal enzyme activity, the efficacy of the above drugs can be weakened. Therefore, in addition to digoxin and dapsone, the above drugs must be appropriately added before and during the treatment with rifampicin. Large dose. When this product is used in combination with coumarin or indanediones, the prothrombin time should be measured daily or regularly to adjust the dose accordingly.

Emetic 8. This product can promote the metabolism of estrogen or reduce its enterohepatic circulation, reduce the effect of oral contraceptives, cause irregular menstruation, intermenstrual bleeding and unplanned pregnancy. Therefore, when taking this product, patients should switch to other contraceptive methods.

9. This product can induce liver microsomal enzymes, increase the metabolism of the antitumor drugs dacarbazine and cyclophosphamide, form alkylated metabolites, and promote the reduction of leukocytes. Therefore, the dose needs to be adjusted.

10. The combination of diazepam and diazepam can increase the elimination of the latter and reduce its blood concentration, so the dose needs to be adjusted.

11. This product can increase the metabolism of phenytoin in the liver, so when the two are combined, the blood concentration of phenytoin should be measured and the dosage adjusted.

12. This product can increase the degradation of levothyroxine in the liver, so the dose of levothyroxine should be increased when the two are combined.

13. This product can also increase the metabolism of methadone and mexiletine in the liver, causing symptoms of methadone withdrawal and a decrease in the concentration of mexiletine in the blood, so the dose needs to be adjusted after the two are combined.

14. Probenecid can compete with the product for being taken by hepatocytes, which increases the drug's blood concentration and produces a toxic reaction. However, the effect is unstable, so it is generally not appropriate to add probenecid to increase the blood concentration of the product.

Rifampicin overdose

1. Excessive performance: mental retardation; edema around the eyes or face; pruritus throughout the body; red

Drug-induced rash Human syndrome (red or orange skin and mucous membranes and sclera). People with primary liver disease, alcoholics, or those taking other hepatotoxic drugs may cause death. 2. Processing:

1. Stop medicine.

2, gastric lavage, because patients often have nausea and vomiting, it is not appropriate to induce vomiting; activated carbon paste is given after gastric lavage to absorb residual rifampicin in the gastrointestinal tract; those with severe nausea and vomiting are given antiemetics.

3. Intravenous infusion and diuretics to promote excretion of drugs.

4. Symptomatic and supportive therapies.

Rifampicin history

Rifampicin was invented in 1965. The discovery of rifampicin made another big leap in the treatment of tuberculosis. Some experts evaluated the anti-tuberculosis effect of rifampicin very high, thinking that now anti-tuberculosis treatment has entered rifampicin. In ordinary times, and thought that tuberculosis that had to be treated with surgery in the past, with rifampicin, the condition can be controlled without surgery. In actual work, rifampicin has proven to be a good anti-paeony drug.

Rifampicin's sterilization characteristics are as follows: after combining with the bacterial cell ribonuclease polymerase, it interferes with the synthesis of DNA and protein, thereby achieving the purpose of sterilization. Moreover, the resistant strains of various strains of tuberculosis bacteria, regardless of the strength of the metabolic capacity of the bacteria, or tuberculosis bacteria within or outside the cell, have antibacterial activity. After oral administration, the digestive system is quickly absorbed into the blood and reaches a high serum concentration, which is also distributed to various organ tissues and tuberculosis lesions at the same time. After rifampicin is metabolized by the body, it is mainly excreted through the intestine, and about 10% of it is excreted from the urine through the kidney.

In addition, rifampicin also has antibacterial effects on a variety of bacteria, so rifampicin can not only treat tuberculosis but also play an antibacterial and anti-inflammatory role in other diseases.

Rifampicin has not had many side effects in the history of using it for almost forty years. The side effects are mainly elevated liver transaminase, but most of the responding patients are transient, such as some people. The living environment has changed and I am not used to it, but I will get used to it after a period of time. Rifampicin also has a process of adaptation in use. However, some patients, such as hepatitis patients, patients with abnormal liver function due to a certain disease, may develop jaundice. If the aminotransferase is slightly elevated, you can continue to use it under close observation and add liver protection drugs. If transaminase continues to rise and jaundice continues to deepen, in this case the drug must be stopped under the guidance of a physician.

The side effects of rifampicin can also be:

1. Cold-like symptoms such as headache, fever, cold and body aches.

2. The skin is very itchy, and there may be rashes and redness like skin diseases.

3. Symptoms of the digestive system can also occur, such as not wanting to eat, nausea, vomiting and even abdominal pain and diarrhea.

4. Some patients may have difficulty breathing.

5. When you go to the hospital, you can also find thrombocytopenia, anemia, decreased white blood cells, decreased vision, and decreased kidney function.

Therefore, I would like to tell readers that rifampicin must be applied under the guidance of a doctor. If you think that you are abnormal during taking it, you should talk to your doctor and tell if it is a side effect of rifampicin, and take the corresponding positive early. Measures. In addition, in the application process, even if there is no discomfort, the liver function test should be performed regularly at the initial application stage, usually once every half month. It should be reminded that patients with biliary obstruction are disabled. It must be pointed out that rifampicin is also disabled because of its teratogenic effect.

The usage of rifampicin is as follows: Adults are calculated at 10 mg per kilogram of body weight, so adults generally 450 mg (3 capsules) per day. If they weigh more than 55 kg, then 600 mg (4 capsules) per day is taken on an empty stomach in the morning. Take breakfast 2 hours after taking it. It is best to use warm water for medication. Avoid soy milk, milk, malted milk, etc. Otherwise, the treatment effect of rifampicin will decrease. Some patients have side effects due to fasting. Can also be taken about 2 hours after a meal, or 2 hours after dinner before going to bed. Children's dosage is calculated at 10-20 mg per kilogram of body weight per day.

The reader is finally informed: because rifampicin is ultimately excreted through the intestines and urethra. Therefore, after taking rifampicin, the color of stool, urine, and even sweat will be red. Don't be afraid, it is normal.

Rifampin Medical News

Rifampicin is not only a potent drug for the treatment of tuberculosis, but also can be used to treat various diseases such as pneumonia, trachoma, and enterococcal infections. Here are a few new clinical uses of rifampicin:

1. Acute bacterial dysentery: Adults can take 0.6 g of rifampicin each time (calculated as 10-15 mg per kilogram of body weight for children) 3 times a day for 4 days. Gonorrhea and urinary tract infection: adults can take 0.6 g of rifampicin and 1 g of erythromycin once daily for 3 days.

2. Dermatomyositis: Rifampicin 0.3 g, 3 times a day for two weeks, can quickly improve symptoms and slow blood sedimentation.

3. Biliary pruritus: Rifampicin is 0.3-0.45 g daily, divided into 3 doses, and administered for 2 weeks, sometimes the effect can be better than anti-allergic drugs.

4, keratitis or conjunctivitis: use 1.5% to 2% rifampicin eye drops, eye drops 6 to 8 times a day, you can get better results.

5. Pharyngitis and tonsillitis: Put rifampicin powder into the dry-powder sprayer evenly on the arch of the tongue, pharynx, mucous membrane of the posterior pharynx and the tonsils. After being dissolved, it contains 1 to 2 minutes. 2 times a day. It has good effects on acute and chronic pharyngitis and purulent tonsillitis.

6. Bedsore: After washing the affected area with normal saline, spread rifampicin on the wound surface, and it has a good effect in treating moderate bedsores.

7, acne: rifampicin ointment rubbed the affected area 3 times a day, 10 days as a course of treatment, combined with 2 courses, the effective rate is 99%.

8. Seborrheic dermatitis: apply 2% rifampicin solution to the affected area 2 to 3 times a day, the cure rate is 95.5%, and the curative effect is often better than prednisone.