Classes
DEA Class; Rx
Common Brand Names; Priftin
- Antitubercular Agents
Description
Oral cyclopentyl rifamycin antimycobacterial drug
Used for treatment of active pulmonary tuberculosis (TB) in combination with 1 or more anti-TB drugs and treatment of latent TB infection in patients at high risk of progression to TB disease
Hepatotoxicity and drug-drug interactions may limit use
Indications
Limitations of use
- Active TB disease should be ruled out before initiating
- Must always be used in combination with isoniazid as a 12-wk once-weekly regimen
- Rifapentine in combination with isoniazid is not recommended for rifamycin or isoniazid resistant M tuberculosis
Treatment of Mycobacterium avium complex (MAC) in patients with AIDS
Contraindications
Hypersensitivity to rifamycins
Adverse Effects
- Hyperuricemia (most likely d/t pyrazinamide from initial phase combo Tx)
- Hypertension
- Headache
- Dizziness
- Rash
- Pruritus
- Acne
- Anorexia
- Nausea/vomiting
- Dyspepsia
- Diarrhea
- Neutropenia
- Lymphopenia
- Anemia
- Leukopenia
- Thrombocytosis
- Increased ALT/AST
- Arthralgia
- Pain
- Pyuria
- Proteinuria
- Hematuria
- Urinary casts
- Hemoptysis
Warnings
Severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS) and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome have been reported in association with treatment regimens in patients with active and latent tuberculosis; discontinue therapy at first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity
May increase liver enzymes; initiation in patients with existing abnormal liver tests and/or liver disease only in cases of necessity and under strict medical supervision; monitor LFTs every 2-4 week and discontinue if evidence of liver injury occurs
Hypersensitivity or anaphylaxis reported including hypotension, urticaria, angioedema, acute bronchospasm, conjunctivitis, thrombocytopenia, neutropenia, or flu-like syndrome
Not for use as initial phase treatment in HIV-infected individuals with active pulmonary TB
Higher relapse rate may occur in patients with cavitary pulmonary lesions and/or positive sputum cultures after the initial phase of active TB treatment, and in patients with bilateral pulmonary disease
Induces CYP450 isoenzymes; coadministration with drugs metabolized by these enzymes (eg, protease inhibitors, certain NRTIs, hormonal contraception) may result in significant decreased plasma concentrations and loss of therapeutic effect
May produce a red-orange discoloration of body tissues/fluids (eg, skin, teeth, tongue, urine, feces, saliva, sputum, tears, sweat, CSF); contact lenses or dentures may become permanently stained
Pregnancy and Lactation
No adequate and well-controlled studies have been performed in pregnant women
There are limited pregnancy outcome data reported from women enrolled in clinical trials of various rifapentine treatment regimens for active tuberculosis and latent tuberculosis infection
Unknown if excreted in human milk
May produce a red-orange discoloration of body fluids; potential for discoloration of breast milk
Maximum Dosage
600 mg PO twice weekly is the FDA-approved maximum dosage for active tuberculosis infection treatment. Maximum dosages are delineated by weight for latent tuberculosis infection.
Weighing 50 kg or more: 900 mg/dose PO.
Weighing 32.1 to 49.9 kg: 750 mg/dose PO.
600 mg PO twice weekly is the FDA-approved maximum dosage for active tuberculosis infection treatment. Maximum dosages are delineated by weight for latent tuberculosis infection.
Weighing 50 kg or more: 900 mg/dose PO.
Weighing 32.1 to 49.9 kg: 750 mg/dose PO.
600 mg PO twice weekly is the FDA-approved maximum dosage for active tuberculosis infection treatment. Maximum dosages are delineated by weight for latent tuberculosis infection.
Weighing 50 kg or more: 900 mg/dose PO.
Weighing 32.1 to 49.9 kg: 750 mg/dose PO.
Weighing 25.1 to 32 kg: 600 mg/dose PO.
Maximum dosages are delineated by weight for latent tuberculosis infection.
2 to 12 years weighing 50 kg or more: 900 mg/dose PO.
2 to 12 years weighing 32.1 to 49.9 kg: 750 mg/dose PO.
2 to 12 years weighing 25.1 to 32 kg: 600 mg/dose PO.
2 to 12 years weighing 14.1 to 25 kg: 450 mg/dose PO.
2 to 12 years weighing 10 to 14 kg: 300 mg/dose PO.
2 to 12 years weighing less than 10 kg: Safety and efficacy have not been established.
1 year: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Rifapentine
tablet
- 150mg
