rifampin

Adult Dosing .

Dosage forms:  CAP: 150 mg, 300 mg; INJ: various

tuberculosis, active

[10 mg/kg/dose PO/IV qd for at least 6mo]

Max: 600 mg/dose; Alt: 10 mg/kg/dose PO/IV 2x, 3x, or 5x/wk for at least 6mo if directly observed tx, max 600 mg/dose; Info: part of multi-drug regimen; give on empty stomach; duration varies by infection site/severity

tuberculosis, latent

[monotherapy]

Dose: 10 mg/kg/dose PO/IV qd x4mo; Max: 600 mg/day; Info: for HIV-negative pts; 1st-line tx; give on empty stomach

[combo tx (off-label)]

Dose: 10 mg/kg/dose PO/IV qd x3mo; Max: 600 mg/day; Info: give w/ isoniazid; 1st-line tx; give on empty stomach

meningococcal prophylaxis

[10 mg/kg/dose PO bid x2 days]

Max: 600 mg/dose; Info: for close contacts of pts w/ invasive meningococcal dz; give on empty stomach

endocarditis, staphylococcal prosthetic valve (off-label)

[300 mg PO/IV q8h for at least 6wk]

Info: give w/ gentamicin gram positive synergy x2wk and nafcillin, cefazolin, or vancomycin; refer to AHA guidelines; give on empty stomach

leprosy (Hansen dz), paucibacillary (off-label)

[600 mg PO qmo x6mo]

Info: part of multi-drug regimen; give on empty stomach; consider 600 mg PO qd x6mo if unsupervised; may continue tx beyond 6mo in refractory cases

leprosy (Hansen dz), multibacillary (off-label)

[600 mg PO qmo x12mo]

Info: part of multi-drug regimen; give on empty stomach; consider 600 mg PO qd x12mo if unsupervised; may continue tx beyond 12mo in refractory cases

anthrax, systemic (off-label)

[600 mg IV q12h for at least 2wk]

Info: not 1st-line agent; part of multi-drug regimen; switch to PO abx for post-exposure prophylaxis total if inhalational exposure

brucellosis (off-label)

[600 mg PO qd x6wk]

Info: part of multi-drug regimen

renal dosing

[see below]

CrCl <50: decr. usual dose by 0-50%

HD: decr. usual dose by 0-50%; no supplement after dialysis; PD: decr. usual dose by 0-50%; no supplement

hepatic dosing

[see below]

hepatic impairment: avoid use; Info: use w/ caution if medically necessary

Peds Dosing .

Dosage forms:  CAP: 150 mg, 300 mg; INJ: various

tuberculosis, active

[<15 yo]

Dose: 10-20 mg/kg/dose PO/IV qd for at least 6mo; Max: 600 mg/dose; Alt: 10-20 mg/kg/dose PO/IV 2x or 5x/wk for at least 6mo if directly observed tx, max 600 mg/dose; Info: part of multi-drug regimen; give on empty stomach; duration varies by infection site/severity

[15 yo and older]

Dose: 10 mg/kg/dose PO/IV qd for at least 6mo; Max: 600 mg/dose; Alt: 10 mg/kg/dose PO/IV 2x, 3x, or 5x/wk for at least 6mo if directly observed tx, max 600 mg/dose; Info: part of multi-drug regimen; give on empty stomach; duration varies by infection site/severity

tuberculosis, latent

[monotherapy, <3 yo (off-label)]

Dose: 20-30 mg/kg/dose PO/IV qd x4mo; Max: 600 mg/day; Info: for HIV-negative pts; 1st-line tx; give on empty stomach

[monotherapy, 3 yo and older]

Dose: 15-20 mg/kg/dose PO/IV qd x4mo; Max: 600 mg/day; Info: for HIV-negative pts; 1st-line tx; give on empty stomach

[combo tx, <3 yo (off-label)]

Dose: 20-30 mg/kg/dose PO/IV qd x3mo; Max: 600 mg/day; Info: give w/ isoniazid; 1st-line tx; give on empty stomach

[combo tx, 3 yo and older]

Dose: 15-20 mg/kg/dose PO/IV qd x3mo; Max: 600 mg/day; Info: give w/ isoniazid; 1st-line tx; give on empty stomach

H. influenzae prophylaxis

[<1 mo]

Dose: 10 mg/kg/dose PO/IV q24h x4 days; Info: give on empty stomach

[1 mo and older]

Dose: 20 mg/kg/dose PO/IV q24h x4 days: Max: 600 mg/day; Info: give on empty stomach

meningococcal prophylaxis

[<1 mo]

Dose: 5 mg/kg/dose PO/IV q12h x2 days; Info: for close contacts of pts w/ invasive meningococcal dz; give on empty stomach

[1 mo and older]

Dose: 10 mg/kg/dose PO/IV q12h x2 days; Max: 600 mg/dose; Info: for close contacts of pts w/ invasive meningococcal dz; give on empty stomach

endocarditis, staphylococcal prosthetic valve (off-label)

[20 mg/kg/day PO/IV divided q8h for at least 6wk]

Max: 900 mg/day; Info: give w/ gentamicin gram positive synergy x2wk and nafcillin, cefazolin, or vancomycin; refer to AHA guidelines; give on empty stomach

leprosy (Hansen dz), paucibacillary (off-label)

[<10 yo]

Dose: 10 mg/kg/dose PO qmo x6mo; Max: 450 mg/dose; Info: part of multi-drug regimen; give on empty stomach; may continue tx beyond 6mo in refractory cases

[10-14 yo]

Dose: 450 mg PO qmo x6mo; Info: part of multi-drug regimen; give on empty stomach; may continue tx beyond 6mo in refractory cases

[15 yo and older]

Dose: 600 mg PO qmo x6mo; Info: part of multi-drug regimen; give on empty stomach; consider 600 mg PO qd x6mo if unsupervised; may continue tx beyond 6mo in refractory cases

leprosy (Hansen dz), multibacillary (off-label)

[<10 yo]

Dose: 10 mg/kg/dose PO qmo x12mo; Max: 450 mg/dose; Info: part of multi-drug regimen; give on empty stomach; may continue tx beyond 12mo in refractory cases

[10-14 yo]

Dose: 450 mg PO qmo x12mo; Info: part of multi-drug regimen; give on empty stomach; may continue tx beyond 12mo in refractory cases

[15 yo and older]

Dose: 600 mg PO qmo x12mo; Info: part of multi-drug regimen; give on empty stomach; consider 600 mg PO qd x12mo if unsupervised; may continue tx beyond 12mo in refractory cases

anthrax, systemic (off-label)

[neonates >32 wk gestation]

Dose: 10-20 mg/kg/day IV divided q12-24h for at least 2wk; Info: dose, frequency depend on infection site, gestational and post-natal age; not 1st-line agent; part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure

[1 mo and older]

Dose: 20 mg/kg/day IV divided q12h for at least 2wk; Max: 300 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure

brucellosis (off-label)

[1 mo and older]

Dose: 15-20 mg/kg/day PO divided q12-24h x6wk; Max: 600 mg/day; Info: part of multi-drug regimen

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[see below]

hepatic impairment: avoid use; Info: use w/ caution if medically necessary