Rifagen
Generic Name
Rifampicin
Manufacturer
Specific manufacturer (e.g., Incepta Pharmaceuticals Ltd. in Bangladesh)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rifagen 450 mg tablet | ৳ 17.49 | N/A |
Description
Overview of the medicine
Rifagen 450 mg Tablet contains Rifampicin, a broad-spectrum antibiotic from the rifamycin group. It is primarily used in the treatment of various bacterial infections, most notably tuberculosis (TB) and leprosy, as well as for prophylaxis against certain meningococcal and Haemophilus influenzae infections.
Uses & Indications
Dosage
Adults
For Tuberculosis: 10 mg/kg orally once daily (maximum 600 mg). For 450 mg, it is often part of a fixed-dose combination or for patients weighing around 45 kg. Should always be used in combination therapy.
Elderly
Similar to adults, but monitor for hepatic and renal function. Dosage adjustment may be required in severe impairment.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. Caution and monitoring in severe renal impairment (CrCl <10 mL/min).
How to Take
Take Rifagen 450 mg Tablet orally once daily, preferably on an empty stomach (at least 30 minutes before or 2 hours after a meal) with a full glass of water, to ensure optimal absorption. Do not crush or chew the tablet.
Mechanism of Action
Rifampicin exerts its bactericidal effect by inhibiting bacterial DNA-dependent RNA polymerase, thereby preventing RNA synthesis in susceptible organisms. This selective action leads to the death of bacterial cells without significantly affecting human cells.
Pharmacokinetics
Onset
Rapid onset of action against susceptible bacteria.
Excretion
Mainly excreted in bile and feces, with a small portion excreted in urine.
Half life
Initially 2-5 hours, but decreases to 1.5-3 hours with repeated administration due to autoinduction of hepatic enzymes.
Absorption
Well absorbed orally, peak plasma concentrations reached within 2-4 hours. Absorption is reduced by food.
Metabolism
Primarily hepatic, deacetylation to an active metabolite (desacetylrifampicin). Undergoes enterohepatic recirculation.
Side Effects
Contraindications
- Hypersensitivity to rifamycins or any component of the formulation
- Concurrent use with certain protease inhibitors (e.g., ritonavir-boosted saquinavir) or non-nucleoside reverse transcriptase inhibitors (e.g., delavirdine, etravirine)
- Severe liver disease or active hepatitis
Drug Interactions
Warfarin
Potent induction of CYP2C9, CYP1A2, and CYP3A4 enzymes can reduce warfarin levels, requiring increased warfarin dosage and careful INR monitoring.
Corticosteroids
Decreases plasma concentrations of corticosteroids, requiring increased corticosteroid dosage.
Oral Hypoglycemics
Reduced efficacy, leading to poor glycemic control. Monitor blood glucose levels closely.
Oral Contraceptives
Rifampicin significantly reduces the efficacy of oral contraceptives due to CYP450 enzyme induction, leading to potential contraceptive failure. Advise alternative birth control.
Antiretrovirals (HIV drugs)
Many antiretrovirals are metabolized by CYP450 enzymes; rifampicin can drastically reduce their plasma concentrations, leading to treatment failure. Co-administration is often contraindicated or requires significant dose adjustments/alternative regimens.
Beta-blockers, Calcium channel blockers
Reduced plasma concentrations, leading to decreased efficacy. Dose adjustments may be needed.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, abdominal pain, lethargy, increasing somnolence, and characteristic 'red man syndrome' with reddish-orange discoloration of skin, urine, sweat, saliva, and tears. Liver enlargement and jaundice may also occur. Management is supportive, including gastric lavage and activated charcoal, and monitoring of vital signs and liver function.
Pregnancy & Lactation
Pregnancy Category C. Rifampicin crosses the placenta. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk; caution should be exercised when administered to a nursing mother. Monitor infants for adverse effects.
Side Effects
Contraindications
- Hypersensitivity to rifamycins or any component of the formulation
- Concurrent use with certain protease inhibitors (e.g., ritonavir-boosted saquinavir) or non-nucleoside reverse transcriptase inhibitors (e.g., delavirdine, etravirine)
- Severe liver disease or active hepatitis
Drug Interactions
Warfarin
Potent induction of CYP2C9, CYP1A2, and CYP3A4 enzymes can reduce warfarin levels, requiring increased warfarin dosage and careful INR monitoring.
Corticosteroids
Decreases plasma concentrations of corticosteroids, requiring increased corticosteroid dosage.
Oral Hypoglycemics
Reduced efficacy, leading to poor glycemic control. Monitor blood glucose levels closely.
Oral Contraceptives
Rifampicin significantly reduces the efficacy of oral contraceptives due to CYP450 enzyme induction, leading to potential contraceptive failure. Advise alternative birth control.
Antiretrovirals (HIV drugs)
Many antiretrovirals are metabolized by CYP450 enzymes; rifampicin can drastically reduce their plasma concentrations, leading to treatment failure. Co-administration is often contraindicated or requires significant dose adjustments/alternative regimens.
Beta-blockers, Calcium channel blockers
Reduced plasma concentrations, leading to decreased efficacy. Dose adjustments may be needed.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, abdominal pain, lethargy, increasing somnolence, and characteristic 'red man syndrome' with reddish-orange discoloration of skin, urine, sweat, saliva, and tears. Liver enlargement and jaundice may also occur. Management is supportive, including gastric lavage and activated charcoal, and monitoring of vital signs and liver function.
Pregnancy & Lactation
Pregnancy Category C. Rifampicin crosses the placenta. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk; caution should be exercised when administered to a nursing mother. Monitor infants for adverse effects.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from the date of manufacture, specific to the manufacturer's label.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (Globally and in Bangladesh)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Rifampicin has undergone extensive clinical trials over decades, particularly in the context of tuberculosis and leprosy treatment, establishing its efficacy and safety profile as a cornerstone of combination therapy.
Lab Monitoring
- Liver function tests (ALT, AST, bilirubin) at baseline and monthly during therapy, especially in patients with pre-existing liver disease or those receiving other hepatotoxic drugs.
- Complete Blood Count (CBC) including platelets.
- Renal function tests (BUN, creatinine).
Doctor Notes
- Emphasize strict adherence to the prescribed regimen to ensure treatment success and prevent resistance.
- Monitor liver function tests (ALT, AST, bilirubin) regularly, especially at the initiation of therapy and in patients at risk.
- Advise patients about significant drug interactions, particularly with oral contraceptives and HIV medications.
- Educate patients about the harmless reddish-orange discoloration of bodily fluids.
- Consider alternative regimens or dose adjustments for patients with severe hepatic or renal impairment.
Patient Guidelines
- Adherence to the prescribed regimen is crucial for treatment success and to prevent drug resistance.
- Take on an empty stomach for better absorption.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements, due to significant drug interactions.
- Do not stop taking the medicine abruptly without consulting your doctor.
- Urine, sweat, tears, and other bodily fluids may turn reddish-orange; this is a harmless side effect, but it can permanently stain soft contact lenses.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Rifampicin may cause dizziness, lightheadedness, or visual disturbances in some patients. If you experience these symptoms, avoid driving or operating heavy machinery.
Lifestyle Advice
- Avoid alcohol consumption while on rifampicin therapy due to increased risk of hepatotoxicity.
- Maintain adequate hydration.
- Ensure a balanced diet to support overall health.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.