rifabutin


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rifabutin

 [rif″ah-bu´tin]
an antibacterial used for the prevention of disseminated Mycobacterium aviumcomplex disease in patients with advanced HIV infection; administered orally.

rifabutin

Pharmacologic class: Rifamycin derivative

Therapeutic class: Antimycobacterial

Pregnancy risk category B

Action

Inhibits RNA synthesis by blocking RNA transcription in susceptible organisms (mycobacteria and some gram-positive and gram-negative bacteria)

Availability

Capsules: 150 mg

Indications and dosages

To prevent disseminated Mycobacterium avium intracellulare complex in patients with advanced human immunodeficiency virus (HIV) infection

Adults: 300 mg P.O. daily as a single dose or in two divided doses

Off-label uses

• Tuberculosis
• Prophylaxis and treatment of M. avium intracellulare in children

Contraindications

• Hypersensitivity to drug
• Active tuberculosis

Precautions

Use cautiously in:
• severe hepatic disease
• pregnant or breastfeeding patients.

Administration

• Give in divided doses twice daily with food to reduce GI upset.

Adverse reactions

CNS: headache, asthenia, weakness

CV: pressure sensation in chest

EENT: uveitis; discolored tears, saliva, or sputum

GI: nausea, vomiting, diarrhea, dyspepsia, abdominal pain, eructation, flatulence, discolored feces, anorexia

GU: discolored urine

Hematologic: eosinophilia, neutropenia, leukopenia, thrombocytopenia Musculoskeletal: joint pain, myalgia

Respiratory: dyspnea

Skin: rash, discolored skin or sweat

Other: abnormal taste, fever, flulike symptoms

Interactions

Drug-drug.Clarithromycin, itraconazole, saquinavir: reduced blood levels and efficacy of these drugs

Delavirdine: decreased delavirdine blood level, increased rifabutin blood level

Drugs metabolized by liver (such as zidovudine): altered blood levels of these drugs

Hormonal contraceptives: decreased contraceptive efficacy

Indinavir, nelfinavir, ritonavir: increased rifabutin blood level

Drug-diagnostic tests.Alanine aminotransferase, aspartate aminotransferase, eosinophils: increased levels

Neutrophils, platelets, white blood cells: decreased counts

Drug-food.High-fat foods: delayed drug absorption

Patient monitoring

• Monitor CBC with white cell differential. Watch for signs and symptoms of blood dyscrasias.
• Assess nutritional status.
• Closely monitor vital signs and temperature. Stay alert for dyspnea and flulike symptoms.

Patient teaching

• Advise patient to take twice daily with food (but not high-fat food) if GI upset occurs. To further minimize GI upset, teach him to eat small, frequent servings of healthy food and drink plenty of fluids.
• Instruct patient to take exactly as prescribed, even after symptoms subside.

Tell patient to immediately report easy bruising or bleeding.
• Tell patient drug may turn tears, urine, and other body fluids reddish or brownish orange. Instruct him not to wear contact lenses during therapy because drug may stain them permanently.
• Inform patient that drug occasionally causes eye inflammation. Instruct him to report symptoms promptly.
• Caution patient to avoid driving and other hazardous activities until effects of drug are known.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

rifabutin

/rif·a·bu·tin/ (rif″ah-bu´tin) an antibacterial used for the prevention of disseminated complex (MAC) disease in patients with advanced HIV infection.

rifabutin

[rif′ah-bu′tin]
an antibacterial used for the prevention of disseminated Mycobacterium avium complex disease in patients with advanced HIV infection. It is administered orally.

rifabutin

Mycobutin® AIDS A semisynthetic rifamycin used to prevent MAC in AIDS Pts with < 75 T4 cell/mm3, or combined with other drugs to treat MAC; it ↓ anemia, fatigue, fever, hospitalization, Karnovsky performance score, prevents ↑ alk phos seen in advanced AIDS Side effects Kidney and liver damage, BM suppression, rash, fever, GI stress. See AIDS, Mycobacterium avium-intercellulare complex.

rifabutin

A drug used to treat tuberculosis of the lungs and to prevent the development of lung TB in AIDS patients. A brand name is Mycobutin.

rifabutin, (rif´əbūt´ən),

n brand name: Mycobutin;
drug class: antimycobacterial agent;
action: inhibits deoxyribonucleic acid dependent ribonucleic acid (RNA) polymerase synthesis of bacterial RNA;
uses: prevention of disseminated
Mycobacterium avium complex (MAC) disease with advanced HIV infection.

rifabutin

a rifamycin antibiotic with activity against mycobacteria.
References in periodicals archive ?
Possible drug regimens involve a combination of rifabutin, ethambutol, and clarithromycin, with moxifloxacin/levofloxacin, sulfamethoxazole, pyrazinamide, and clofazimine also potentially being useful.
Despite the possible drug interactions and side effects of rifamycins, a 3-drug regimen containing clarithromycin, ethambutol and rifabutin has been associated with fewer relapses and better survival compared to 2-drug regimens containing clarithromycin and ethambutol or clarithromycin and rifabutin.
Cytochrome P450 hepatic enzyme inducers such as rifampin, rifabutin, phenytoin, carbamazepine, and phenobarbital increase the metabolic elimination of T4 and T3 by 20%.
If DILI developed on PI-based regimen with double-dose LOP/r, then the preferred approach is to replace RIF with 150 mg rifabutin on alternate days and use this with atazanavir/ritonavir (or a standard dose of LOP/r).
Rifabutin (this is an effective drug but is very expensive for developing countries, so it not included in WHO list).
The tuberculosis treatment rifabutin, for example, should not be used with the protease inhibitor saquinavir for this reason.
Since 2005, CDC has received reports of difficulty obtaining each of the following SLDs: streptomycin, cycloserine, ethionamide, rifabutin, amikacin, capreomycin, and kanamycin.
A fourth - line therapy with rifabutin in patients with three H.
The third-line drugs for treating TB include rifabutin, linezolid, thioidazine, arginine, Vitamin D, macrolides (e.
Drugs for the treatment of TB are usually supplied by the National TB Programme free of charge to the healthcare facility but rifabutin is not available through this programme if required for a patient on a PI-based regime.
In this Dutch multicenter trial, 100 affected children were randomized to surgical excision or at least 12 weeks of antibiotic therapy with clarithromycin plus rifabutin (Clin.