II. Indications
- Prophylaxis of Mycobacterium Avium Complex Infection in AIDS
- Treatment of Mycobacterium Avium Complex Infection in AIDS
- See other references for multi-drug treatment regimens that include Rifabutin
III. Mechanism
- Semisynthetic Rifamycin derivative active against Mycobacteria
- Rifamycin is produced by Streptomyces mediterranei
-
Rifamycins inhibit Bacterial DNA-dependent RNA Polymerase, blocking Bacterial RNA formation and transcription
- Increased activity against Mycobacterium Avium Complex compared with other Rifamycins
IV. Dosing: Prophylaxis Mycobacterium Avium Complex Infection in AIDS
- Adult (and age >6 years)
- Take 300 mg orally daily OR
- Take 150 mg orally twice daily (if gi irritation with 300 mg dose)
- Child (age < 6 years, off label)
- Give 5 mg/kg (up to 300 mg) orally daily
- Indications to decrease dosing (e.g. 50% reduction)
- Hepatic dysfunction
- eGFR <30 ml/min
- Toxicity suspected
V. Safety
- Pregnancy Category B
- Considered safe in Lactation
VI. Adverse Effects
-
Uveitis
- Risk increases with higher dose
- Hepatotoxicity
- Thrombocytopenia
- Neutropenia
- Skin Hyperpigmentation
- Body fluid discoloration (orange or brown)
- Urine
- Sweat
- Contact Lenses
VII. Monitoring
- Baseline
- Complete Blood Count with Platelets
- Liver Function Tests (LFTs)
- Periodic lab monitoring indications
- Abnormal baseline Liver Function Test
- History suggestive of Possible liver disorder or Chronic Liver Disease
- Human Immunodeficiency Virus (HIV)
- Pregnancy
VIII. Drug Interactions
-
CYP3A4 Inducer and CYP3A4 Substrate
- Oral Contraceptives (decreased efficacy)
- Imidazole Antifungal
- Clarithromycin
IX. Resources
X. References
- (2012) Med Lett Drugs Ther 10(116): 29-36
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Related Studies
rifabutin (on 5/17/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
RIFABUTIN 150 MG CAPSULE | Generic | $10.76 each |
Ontology: Rifabutin (C0140575)
Definition (NCI_NCI-GLOSS) | A drug used to prevent the spread of a bacterium called in patients with advanced HIV (the virus that causes AIDS) infection. It blocks an enzyme that the bacteria need to grow. It is a type of antibiotic. |
Definition (NCI) | A semisynthetic ansamycin antibiotic with potent antimycobacterial properties. Rifabutin inhibits bacterial DNA-dependent RNA polymerase, thereby suppressing the initiation of RNA formation and leading to inhibition of RNA synthesis and transcription. (NCI04) |
Definition (MSH) | A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIV-positive patients. |
Definition (CSP) | broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIV-positive patients. |
Definition (PDQ) | A semisynthetic ansamycin antibiotic with potent antimycobacterial properties. Rifabutin inhibits bacterial DNA-dependent RNA polymerase, thereby suppressing the initiation of RNA formation and leading to inhibition of RNA synthesis and transcription. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37812&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37812&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1408" NCI Thesaurus) |
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | D017828 |
SnomedCT | 108684009, 386893001 |
LNC | LP14435-9, MTHU006676 |
English | Ansamycin, Rifabutine, Rifamycin XIV, 1',4-didehydro-1-deoxy-1,4-dihydro-5'-(2-methylpropyl)-1-oxo-, rifabutin, rifabutin (medication), Rifabutin [Chemical/Ingredient], ansamycin, rifabutine, RIFABUTIN, Rifabutin, Rifabutin (product), Rifabutin (substance) |
Swedish | Rifabutin |
Czech | rifabutin |
Finnish | Rifabutiini |
Russian | RIFABUTIN, РИФАБУТИН |
Japanese | リファブチン |
Italian | Rifabutina, Ansamicina, Rifabutin |
Polish | Rifabutyna |
Spanish | rifabutina (producto), rifabutina (sustancia), rifabutina, Rifabutina |
French | Rifabutine |
German | Rifabutin |
Portuguese | Rifabutina |