Drug reference

Rifabutin

Antimycobacterial

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

FDA category + note

Top interactionssee all 12 →

AzolesSevereTextbookHarrison 22e · p1742
AbirateroneSevereDatabaseDDInter
AlpelisibSevereDatabaseDDInter
AmiodaroneSevereDatabaseDDInter

Mechanism

The mechanism of action for Rifabutin is not explicitly detailed in the provided text.

Indications

Prophylaxis of Mycobacterium avium complex infections in immunosuppressed patients with low CD4 countTreatment of non-tuberculous mycobacterial disease, in combination with other drugsTreatment of pulmonary tuberculosis, in combination with other drugsHelicobacter pylori eradication (off-label, in combination with other drugs for third-line eradication therapy)tuberculosis disease (as a rifampin replacement to avoid drug interactions)disseminated mycobacterium avium complex in patients with AIDSSubstitute for rifampin to minimize drug interactions in HIV coinfected patients receiving protease inhibitors and/or non-nucleoside reverse transcriptase inhibitorsProphylaxis of MAC infection in HIV-AIDS patients (300 mg/day alone as an alternative to azithromycin/clarithromycin)Treatment of MAC infection in HIV-AIDS patients (combined with 2–3 other anti-MAC drugs)

Dosing

Adult: Prophylaxis of Mycobacterium avium complex infections: 300 mg once daily (also consult product literature). Treatment of non-tuberculous mycobacterial disease: 450–600 mg once daily for up to 6 months after cultures negative. Treatment of pulmonary tuberculosis: 150–450 mg once daily for at least 6 months. Helicobacter pylori eradication (third-line): 150 mg twice daily for 10 days.
Renal adjustment: Dose adjustment not specified beyond general clearance mechanisms.

Pharmacokinetics

Half-life

32–67 h

Bioavailability

20%

Protein binding

71%

Metabolism

Metabolized by hepatic CYPs.

Excretion

Bile and feces (major), urine (minor)

Contraindications

Acute porphyrias
Rifamycin hypersensitivity

Side effects

Common

ArthralgiaBronchospasmChest painDyspnoeaEosinophiliaFeverInfluenza-like illnessMyalgiaNauseaSkin reactionsUrine discolourationVomitingrash (4%, leading to discontinuation)gastrointestinal intolerance (3%, leading to discontinuation)Gastrointestinal intoleranceRashesGranulocytopeniaUveitisElevated aminotransferase levelsRashGastrointestinal events (nausea, vomiting, diarrhea)Orange discoloration of body fluids

Serious

Agranulocytosis
Anaemia
Corneal deposits
Decreased leucocytes
Haemolysis
Hepatic disorders
Neutropenia
Pancytopenia
Thrombocytopenia
Uveitis (more common following high doses or concomitant use with drugs that increase plasma concentration)
neutropenia (2%, leading to discontinuation, 25% in HIV patients)
thrombocytopenia (rare)
flu-like symptoms (rare)
hemolysis (rare)
myositis (rare)
chest pain (rare)
hepatitis (rare)
polymyalgia
pseudojaudice
anterior uveitis (unique, discontinue if visual symptoms occur)
iridocyclitis
hypopyon