rifapentine


Also found in: Wikipedia.

rifapentine

 [-pen´tēn]
a synthetic rifamycin antibiotic used in treatment of pulmonary tuberculosis, administered orally.

rifapentine

Pharmacologic class: Rifamycin derivative

Therapeutic class: Antitubercular

Pregnancy risk category C

Action

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

Availability

Tablets: 150 mg

Indications and dosages

Pulmonary tuberculosis (TB)

Adults:Intensive-phase treatment-600 mg P.O. twice weekly for 2 months, with doses spaced 72 hours apart; must be given with at least one other antitubercular. Continuation-phase treatment-600 mg P.O. once weekly for 4 months, given with another antitubercular.

Off-label uses

Mycobacterium avium intracellulare complex infection

Contraindications

• Hypersensitivity to drug or other rifamycin derivatives

Precautions

Use cautiously in:
• hepatic disorders, porphyria
• concurrent protease inhibitor therapy for human immunodeficiency virus infection
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 12.

Administration

• Know that drug is given with at least one other antitubercular.
• Expect to give drug with pyridoxine to adolescents, malnourished patients, and patients at risk for neuropathy.

Adverse reactions

CNS: headache, fatigue, anxiety, dizziness, aggressive behavior

CV: hypertension, peripheral edema

EENT: visual disturbances; discolored tears, sputum, and saliva

GI: nausea, vomiting, diarrhea, dyspepsia, esophagitis, gastritis, discolored feces, anorexia, pancreatitis

GU: hematuria, pyuria, proteinuria, urinary casts, discolored urine

Hematologic: anemia, thrombocytosis, hematoma, purpura, eosinophilia, neutropenia, leukopenia

Hepatic: hepatitis

Metabolic: hyperuricemia, hypovolemia, hyperkalemia

Musculoskeletal: gout, arthritis, joint pain

Skin: rash, pruritus, acne, urticaria, discolored skin and sweat

Other: edema

Interactions

Drug-drug.Amitriptyline, anticoagulants, barbiturates, beta-adrenergic blockers, chloramphenicol, clofibrate, cortico-steroids, cyclosporine, dapsone, delavirdine, diazepam, digoxin, diltiazem, disopyramide, doxycycline, fentanyl, fluconazole, fluoroquinolones, haloperidol, hormonal contraceptives, indinavir, itraconazole, ketoconazole, methadone, mexiletine, nelfinavir, nifedipine, nortriptyline, oral hypoglycemics, phenothiazines, progestin, quinidine, quinine, ritonavir, saquinavir, sildenafil, tacrolimus, theophylline, thyroid preparations, tocainide, verapamil, warfarin, zidovudine: decreased actions of these drugs

Antiretroviral drugs: decreased efficacy of these drugs

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, eosinophils, lactate dehydrogenase, potassium, uric acid: increased levels

Folate, vitamin B12 assays: interference with standard assays

Hemoglobin, neutrophils, platelets, white blood cells: decreased values

Patient monitoring

• Monitor CBC, uric acid level, and liver function tests. Watch for signs and symptoms of blood dyscrasias and hepatitis.
• Assess vital signs and fluid intake and output. Stay alert for hypertension and edema.
• Closely monitor nutritional status and hydration.

Patient teaching

Instruct patient to immediately report fever, malaise, appetite loss, nausea, vomiting, or yellowing of skin or eyes.
• Emphasize importance of taking with companion drugs, as prescribed, to prevent growth of resistant TB strains.
• Tell patient drug may color 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.
• Advise patient to take with meals and to minimize GI upset by eating small, frequent servings of healthy food and drinking plenty of fluids.
• Tell patient to monitor his weight and report sudden gains. Also tell him to report swelling.

Instruct patient to immediately report rash or unusual bleeding or bruising.

Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, vision, and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

rifapentine

/rif·a·pen·tine/ (-pen´tēn) a synthetic rifamycin antibiotic used in the treatment of pulmonary tuberculosis.

rifapentine

an antitubercular.
indications Rifapentine is used to treat pulmonary tuberculosis. It must be used in combination with at least one other antitubercular.
contraindication Known hypersensitivity to rifamycin prohibits its use.
adverse effects Life-threatening effects include pancreatitis, hematuria, proteinuria, thrombocytopenia, leukopenia, neutropenia, lymphopenia, and leukocytosis. Other adverse effects include rash, pruritus, urticaria, acne, visual disturbances, gout, arthrosis, edema, aggressive reaction, bilirubinemia, hepatitis, increased AST/ALT, pyuria, urinary casts, headache, fatigue, anxiety, dizziness, anemia, purpura, and hematoma. Common side effects include nausea, vomiting, anorexia, diarrhea, and heartburn.

rifapentine

Priftin® Infectious disease An agent used for pulmonary TB and MAC with other agents–INH, pyrazinamide, ethambutol, streptomycin. See AIDS, Tuberculosis.
References in periodicals archive ?
Today, we have a better prophylaxis regimen - giving Rifapentine with Isoniazid once a week for 3 months.
With LTBI there are now 4 treatment options for patients and physicians to consider: (9) isoniazid given daily or twice weekly for either 6 or 9 months; isoniazid and rifapentine given once weekly for 3 months; or rifampin given daily for 4 months.
Antituberculosis therapy (300 mg/d of isoniazid, 750 mg/d of ethambutol, and 450 mg rifapentine twice a week) was administered to her, owing to the positive PPD result.
As a result, JCDHE developed a policy and procedure to allow persons who met eligibility requirements to complete 12 weekly doses of isoniazid and rifapentine treatment using video directly observed therapy (VDOT) rather than traditional in-person directly observed therapy (DOT).
Three months of rifapentine and isoniazid for latent tuberculosis infection.
He mentioned that since the standard MDT has only 1 bactericidal drug, Rifampicin; the alternative regimens have focused on incorporating the newer bactericidal agents like Rifapentine, Moxifloxacin, Sparfloxacin, Ofloxacin, Minocycline, Clarithromycin, etc.
Since 2012, New Mexico has been utilizing a "new" 12 week treatment regimen of Isoniazid (INH) and Rifapentine given by directly observed therapy as the primary treatment for TB infection.
SAN DIEGO--Health care workers with latent tuberculosis infection were significantly more likely to continue a shorter course of weekly rifapentine plus isoniazid than daily INH monotherapy, researchers reported at an annual scientific meeting on infectious diseases.
Comparative antimycobacterial activities of rifampin rifapentine and KRM1648 against a collection of rifampinresistant Mycobacterium tuberculosis isolates with known rpoB mutations.
A novel regimen of intermittent high-dose isoniazid and rifapentine given weekly for 3 months has recently been evaluated in low and high TB burden settings.
Recently, treatment based on weekly doses of INH and rifapentine (RPT) for three months has shown promising results: 82% completion rate, efficacy comparable to nine months of INH treatment, and similar toxicity profile.