What it does
Rifampicin is an antibiotic used to treat bacterial infections, especially tuberculosis.
Commonly used for: tuberculosis (TB), bacterial infections
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Source: Pharmacy and Poisons Board · fetched 2026-01-28 21:35:45 · updated 2026-07-20 11:10:04
Drug Interactions
283Severe (78)
Abemaciclib - decreases exposure
Rifampicin is predicted to markedly decrease the exposure to abemaciclib. Avoid.
Abiraterone - decreases exposure
Rifampicin is predicted to decrease the exposure to anti-androgens (abiraterone). Avoid.
Acalabrutinib - decreases exposure
Rifampicin is predicted to decrease the exposure to acalabrutinib. Avoid.
Anti-Androgens - decreases exposure
Rifampicin is predicted to decrease the exposure to anti-androgens (abiraterone). Avoid.
Antiarrhythmics - decreases exposure
Rifampicin is predicted to decrease the exposure to antiarrhythmics (disopyramide, dronedarone). Avoid.
Moderate (69)
Alprazolam - decreases exposure
Rifampicin is predicted to decrease the exposure to benzodiazepines (alprazolam). Adjust dose.
Amlodipine - decreases exposure
Rifampicin is predicted to decrease the exposure to calcium channel blockers (amlodipine, felodipine, lacidipine, lercanidipine, nicardipine, nimodipine). Monitor and adjust dose.
Antiepileptics - decreases exposure
Rifampicin slightly decreases the exposure to antiepileptics (brivaracetam). Adjust dose.
Antiepileptics - decreases concentration
Rifampicin decreases the concentration of antiepileptics (fosphenytoin, phenytoin). Use with caution and adjust dose.
Antifungals,azoles - decreases exposure
Rifampicin slightly decreases the exposure to antifungals, azoles (fluconazole). Adjust dose.
Unknown (136)
Abrocitinib - decreases exposure
Rifampicinispredictedtodecreasetheexposuretoabrocitinib. Avoid.oStudy
Afatinib - decreases exposure
Rifampicin is predicted to decrease the exposure to afatinib.
Agomelatine - decreases exposure
Rifampicinispredictedtodecreasetheexposureto agomelatine.oTheoretical
Alfentanil - decreases exposure
Rifampicin is predicted to decrease the exposure to opioids (alfentanil, fentanyl).
Aliskiren - decreases exposure
Rifampicin decreases the exposure to aliskiren.
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: exact
About this medicine
Rifampicin is an antibiotic used to treat bacterial infections, especially tuberculosis.
What it treats
- tuberculosis (TB)
- bacterial infections
How it works
Rifampicin works by stopping the growth of bacteria, helping to clear infections from the body.
Who it's for
Rifampicin is for adults and children who have specific bacterial infections, particularly those with tuberculosis.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Rifampicin
BNF-referencedRifampicin is a bactericidal antibiotic that is primarily used to treat infections caused by mycobacteria, particularly tuberculosis. It works by inhibiting RNA synthesis in bacteria, making it effective against both intracellular and extracellular strains of Mycobacterium tuberculosis. It is often used in combination with other antitubercular agents to prevent the development of drug resistance.
Indications
- Tuberculosis, in combination with other drugs
- Prevention of tuberculosis in susceptible close contacts
- Brucellosis in combination with other antibacterials
- Legionnaires disease in combination with other antibacterials
- Serious staphylococcal infections in combination with other antibacterials
- Endocarditis in combination with other drugs
Dosage
Children: For children aged 1–11 years: 10 mg/kg every 12 hours (maximum per dose 600 mg
Adults: 600 mg daily for 6 months, or 600 mg every 12 hours for 2 days in specific conditions such as endocarditis.
Mechanism of action
Rifampicin binds to the beta-subunit of microbial DNA-dependent RNA polymerase, inhibiting the enzyme and impeding RNA synthesis. This action forms a stable drug-enzyme complex that suppresses the initiation of chain formation in RNA synthesis, although it does not affect chain elongation. Importantly, rifampicin has no activity against mammalian RNA polymerase, highlighting its selective antibacterial properties.
Pharmacodynamics
Rifampicin exhibits broad-spectrum antimicrobial activity, particularly against Mycobacterium tuberculosis. It is bactericidal, effective in killing both intracellular and extracellular bacteria. The drug's efficacy is enhanced when used in combination with other antitubercular medications, helping to reduce the risk of developing multi-drug resistant tuberculosis.
Pharmacokinetics
Rifampicin is well absorbed after oral administration, with peak plasma concentrations occurring within 2 to 4 hours. It is extensively metabolized in the liver, primarily by cytochrome P450 enzymes, and has a half-life of approximately 3 to 5 hours. The drug is excreted mainly in bile, with some renal excretion. It also has the potential to induce liver enzymes, which may affect the metabolism of co-administered drugs.
Contra-indications
- Acute porphyrias
- Jaundice
Adverse effects
- Nausea
- Vomiting
- Diarrhoea
- Abdominal discomfort
- Thrombocytopenia
- Leucopenia
- Acute kidney injury
- Adrenal insufficiency
- Agranulocytosis
- Discoloration of soft contact lenses
Interactions
- Severe interaction with atovaquone (increases exposure)
- Severe interaction with abemaciclib (decreases exposure)
- Severe interaction with acalabrutinib (decreases exposure)
- Severe interaction with anti-androgens (decreases exposure)
- Severe interaction with abiraterone (decreases exposure)
- Severe interaction with darolutamide (decreases exposure)
- Severe interaction with antiarrhythmics (decreases exposure)
- Severe interaction with disopyramide (decreases exposure)
- Severe interaction with dronedarone (decreases exposure)
- Severe interaction with isavuconazole (decreases exposure)
Pregnancy
Rifampicin should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.
Breast-feeding
Rifampicin is excreted in breast milk. Caution is advised when administering to nursing mothers.
Storage
Store in a cool, dry place away from direct sunlight. Keep out of reach of children.
Formulations
- Oral capsules
- Oral suspension
- Injectable solution
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Rifampicin
PubChem CID 135398735Molecular formula: C43H58N4O12
Mechanism of action
Rifampin works by binding to the beta-subunit of microbial DNA-dependent RNA polymerase (RNAP), thereby inhibiting the enzyme and impeding RNA synthesis. It reduces the affinity of RNAP for short RNA transcripts. It has no activity against the mammalian RNAP enzyme. Although rifampin is most active during cell multiplication ... /it/ appears to have some effect on resting cells. Electron microscopy has revealed changes in cytoplasm and disappearance of ribosomes in tubercle bacilli exposed to rifampin, indicating inhibition of DNA-dependent RNA polymerase. Rifampin inhibits DNA-dependent RNA polymerase of mycobacteria and other microorganisms by forming a stable drug-enzyme complex, leading to suppression of initiation of chain formation (but not chain elongation) in RNA synthesis. More specifically, the beta subunit of this complex enzyme is the site of action of the drug, although rifampin binds only to the holoenzyme. Nuclear RNA polymerase from a variety of eukaryotic cells does not bind rifampin, and RNA synthesis is correspondingly unaffected. While rifampin can inhibit RNA synthesis in mammalian mitochondria, considerably higher concentrations of the drug are required than for the inhibition of the bacterial enzyme. High concentrations of rifamycin antibiotics also inhibit viral DNA-dependent RNA polymerases and reverse transcriptases. Rifampin is bactericidal for both intracellular and extracellular microorganisms. Developmental expression of CYPlAl, CYPlA2 and CYP3A6 in the rabbit have been studied. Cytochromes P450IAl, P450IA2 and P450IIIA6 exhibited comparable patterns of developmental expression. Present at low level (less than 0.05 mnol/ng) in the new born animal up to week 3, these proteins sharply accumulated between weeks 3 and 4 to reach a maximum by week 4 (P450IAl, 0.2 nmol/mg; P450IA2, 0.8 nmol/ng; P450IIIA6, 0.12 nmol/mg) and decr in the adult (P450IAl, 0.2 nmol/mg; P450IA2, 0.4 mnol/mg; P450IIIA6, 0.09 nmol/mg). Cytochromes P450IAl and P450IA2 were not expressed in the untreated fetus. Onset of CYP3A6 gene expression occurred at day 30 of gestation and both transcription and mRNA accumulation were transplacentally inducible by rifampicin only shortly before birth, i.e. after treatment of the females between days 28 and 30 of gestation. Both long (1.85 kb) and short (1.7 kb) mRNA transcripts were expressed in untreated or rifampicin treated fetuses. CYP3A6 gene expression was also induced by rifampicin in l week old and 2 week old animals. Developmental expression of CYPlAl and CYPlA2 genes was shown to be closely related to the diet change accompanying weaning which occurs at weeks 3-4. In animals subjected to either delayed (week 6) or early (week 2) weaning, sharp accumulation of messages, proteins and related activities were delayed or anticipated accordingly with respect to normal weaning. Artificially scheduled weaning gave similar results when repeated with biological grade lucern (grown in the absence of chemical fertilizers, pesticides) ... the main constituent of commercial rabbit chow. While CYP3A6 gene expression could be brought forward by early weaning at week 2, both message and protein did not exhibit incr accumulation after delayed weaning at week 6, and remained at the low level of the new born animal. Treatment of l week old and 2 week old animals with triiodothyronine or of 3 week old animals with propylthiouracil, an antithyroid factor, did not modify the normal pattern of developmental expression of genes CYPlAl, CYPlA2 and CYP3A6. ...
Pharmacodynamics
Rifampin is an antimicrobial agent with bactericidal effects and a broad-spectrum activity. It is active against intracellular and extracellular _Mycobacterium tuberculosis_.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
- AFARIS FC 150/75
- AFARIS FC 300/150
- AFARIS PAED 75/50
- AFARIS PAED ODT 60/60
- AKURIT CO KID 75/50/150/ODT
- CO-AFARIS PAED 75/50/150 TABLETS
- RIFAMPICIN+INH+ETHAMBUTOL 150MG/75MG/275MG TABLET
- RIFAMPICIN+ISONIAZID_DT 75/50MG DISPERSIBLE TABLET
- RIFAMPICIN/INH/PYRAZ./ETHAMB 150MG/75MG/400MG/275MG TABLET
- RIFAMPICIN/ISONIAZID 150MG, 75MG TABLET
- RIFAMPICIN/ISONIAZID 150MG/75MG TABLET
- RIFAMPICIN150/INH COMBINATION PRODUCT TABLET
- ETHAMBUTOL; ISONIAZID; PYRAZINAMIDE; RIFAMPICIN · Macleods Pharmaceuticals
- ISONIAZID; PYRAZINAMIDE; RIFAMPICIN · Macleods Pharmaceuticals
- ISONIAZID; RIFAMPICIN · Lupin
- NONE · Lupin Limited
- RIFAMPICIN · Datlabs
- RIFAMPICIN AND ISONIAZID · Lupin
- EPSYLAM DT 100 · Aurobindo Pharma
- QUITIDE 200 · Aurobindo Pharma
- QUITIDE 300 · Aurobindo Pharma
- RH Com · Macleods Pharmaceuticals
- Rifampicin + Isoniazid + Pyrazinamide · Macleods Pharmaceuticals
- Rifampicin 150 mg + Isoniazid 75 mg + Ethambutol 275 mg + Pyrazinamide 400 mg · Lupin
- Rifampicin 150 mg, Isoniazid 75mg Tablets · Macleods Pharmaceuticals
- Rifampicin 150mg + Isoniazid 75mg + Ethambutol 275mg + Pyrazinamide 400mg Tablets · Lupin
- Rifampicin 150mg + Isoniazid 75mg + Ethambutol 275mg Tablets · Lupin
- Rifampicin 150mg + Isoniazid 75mg Tablets · Lupin
- Rifampicin 75 mg Isoniazid 50 mg and Pyrazinamide 150 mg Dispersible Tablets · Macleods Pharmaceuticals
- Rifampicin 75mg + Isoniazid 50mg Dispersible Tablets · Lupin
- AKURIT-KID TABLETS · Lupin
- RIFAMPICIN · Macleods Pharmaceuticals
- RIFAMPICIN & ISONIAZID · Macleods Pharmaceuticals
- RIFAMPICIN 150 MG, ISONIAZID 75 MG & ETHAMBUTOL HCL 275 MG · Macleods Pharmaceuticals
- RIFAMPICIN, ISONIAZID, PYRAZINAMIDE & ETHAMBUTOL · Macleods Pharmaceuticals
- RIFAMPIN 150MG, ISONIAZID 75 MG, PYRAZINAMIDE 400 AND ETHAMBUTOL HYDROCHLORIDE 275 MG TABLET USP · Lupin