Rifabutin

Indications
 Oral
Prophylaxis of Mycobacterium avium complex infections in immunocompromised patients
Adult: 300 mg once daily.
Child: HIV infected children ≥6 yr: 300 mg once daily.
CrCl (ml/min)Dosage Recommendation
<30Reduce dose by 50%.
Hepatic impairment: Dosage reduction may be necessary in severe impairment.
Oral
Nontuberculous mycobacterial infections
Adult: 450-600 mg daily, given for up to 6 mth after negative cultures are obtained.
Child: 1 mth-12 yr: 5 mg/kg/day, given for up to 6 mth after negative cultures are obtained
CrCl (ml/min)Dosage Recommendation
<30Reduce dose by 50%.
Hepatic impairment: Dosage reduction may be necessary in severe impairment.
Oral
Pulmonary tuberculosis
Adult: 150-450 daily as part of multidrug regimen, given for at least 6 mth. For patients taking macrolide or azole antifungals concurrently, dose should be reduced to 300 mg daily.
Child: HIV infected children: 10-20 mg/kg (up to 300 mg) daily or twice wkly, in combination with other antituberculous agents.
CrCl (ml/min)Dosage Recommendation
<30Reduce dose by 50%.
Hepatic impairment: Dosage reduction may be necessary in severe impairment.

Special Populations: In renal impairment: CrCl <30 mL/min: Reduce dose by 50%. Dose alterations may also be necessary in patients receiving HIV protease inhibitors.
Contraindications
 Hypersensitivity. Not to be admin as a single agent to patients with active tuberculosis.
Warnings / Precautions
 Renal/hepatic impairment; discontinue if AST >500 units/L or total bilirubin is >3 mg/dL; alcoholic. Monitor CBC regularly.
Adverse Reactions
 GI disturbances; blood disorders; headache; rash; reddish coloration of urine and body secretions; chest pain, dyspnoea, uveitis; asymptomatic corneal opacities in prolonged use; syndrome of polyarthralgia arthritis at doses >1 g/day.
Drug Interactions
 May reduce efficacy of oral contraceptives and other cytochrome P450 enzyme metabolised medicines. May decrease serum levels and efficacy of antidiabetics such as tolbutamide, gliclazide and glibenclamide. May decrease serum levels of atovaquone and delavirdine. Serum levels may be increased by azole antifungals. May increase clearance of dapsone. Bioavailability may be increased by protease inhibitors. Absorption may be decreased when given with antacids, anticholinergics and opioids.
See Below for More rifabutin Drug Interactions
Mechanism of Actions
 Rifabutin inhibits DNA-dependent RNA polymerase in susceptible strains of Escherichia coli and Bacillus subtilis.
Absorption: Poorly absorbed from the GI tract.
Distribution: Widely distributed. About 70% bound to plasma proteins.
Metabolism: Hepatic and renal clearance.
Excretion: Terminal half-life: about 45 hr.
Storage Conditions
 Oral: Store at 25°C.
ATC Classification
 J04AB04 - rifabutin ; Belongs to the class of antibiotics. Used in the systemic treatment of tuberculosis.
Storage
 Oral: Store at 25°C.
Available As
  • Rifabutin 150 mg

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