Rifapentine

What is Rifapentine

Rifapentine is a rifamycin derivative. It was originally developed in the 1950s, but was never marketed in the US until 1998.

Rifapentine has a similar profile of microbiological activity to rifampin, but with a longer half-life. Its longer half-life allows for twice weekly dosing which was equivalent to daily dosing of rifampin.

Rifapentine is used for the treatment of active pulmonary tuberculosis (TB) and latent TB infection, but is not a first-line agent for either indication.

In clinical trials comparing rifapentine- and rifampin-containing treatment regimens, rifapentine treatment regimens had a higher relapse rate due to non-compliance with non-rifamycin treatments (e.g., ethambutol, isoniazid, pyrazinamide).

Rifapentine does not appear to be suitable for treating active pulmonary TB in HIV-positive patients due to the development of rifampin-resistant organisms and pharmacokinetic interactions with the protease inhibitors; the drug may be used in HIV-infected patients to prevent progression of latent TB to active disease. Final FDA approval was granted June 22, 1998.

Brand Name

Priftin

Indications

1. Haemophilus influenzae (beta-lactamase negative)
2. Haemophilus influenzae (beta-lactamase positive)
3. Legionella pneumophila
4. Mycobacterium avium
5. Mycobacterium bovis
6. Mycobacterium fortuitum
7. Mycobacterium intracellulare
8. Mycobacterium kansasii
9. Mycobacterium leprae
10. Mycobacterium marinum
11. Mycobacterium tuberculosis
12. Neisseria meningitidis
13. Staphylococcus aureus (MSSA)
14. tuberculosis infection
15. tuberculosis prophylaxis

Side Effects

1. abdominal pain
2. acne vulgaris
3. agitation
4. alopecia
5. anemia
6. angioedema
7. anorexia
8. anxiety
9. arthralgia
10. asthenia
11. back pain
12. bone fractures
13. bronchospasm
14. cheilitis
15. chest pain (unspecified)
16. confusion
17. conjunctivitis
18. constipation
19. contact lens discoloration
20. cough
21. cystitis
22. diabetes mellitus
23. diaphoresis
24. diarrhea
25. dizziness
26. drowsiness
27. dyspepsia
28. dysphonia
29. dyspnea
30. dysuria
31. eczema vaccinatum
32. elevated hepatic enzymes
33. epistaxis
34. erythema
35. esophagitis
36. fatigue
37. fever
38. furunculosis
39. gout
40. headache
41. hematoma
42. hematuria
43. hemoptysis
44. hemorrhoids
45. hepatitis
46. hepatomegaly
47. hyperbilirubinemia
48. hypercalcemia
49. hyperglycemia
50. hyperkalemia
51. hyperphosphatemia
52. hypertension
53. hypertonia
54. hyperuricemia
55. hypoesthesia
56. hypoglycemia
57. hypophosphatemia
58. hyporeflexia
59. hypovolemia
60. infection
61. influenza
62. insomnia
63. jaundice
64. laryngeal edema
65. laryngitis
66. leukocytosis
67. leukopenia
68. leukorrhea
69. lymphadenopathy
70. lymphocytosis
71. lymphopenia
72. maculopapular rash
73. malaise
74. migraine
75. myalgia
76. nausea
77. neutropenia
78. ocular pain
79. orthostatic hypotension
80. otalgia
81. palpitations
82. pancreatitis
83. pericarditis
84. peripheral edema
85. peripheral vasodilation
86. pharyngitis
87. phlebitis
88. pleural effusion
89. pneumonitis
90. pneumothorax
91. polycythemia
92. porphyria
93. proctitis
94. proteinuria
95. pruritus
96. pseudomembranous colitis
97. pulmonary fibrosis
98. purpura
99. pyuria
100. rash
101. rhinitis
102. seizures
103. sinus tachycardia
104. sinusitis
105. skin discoloration
106. skin ulcer
107. superinfection
108. syncope
109. tenesmus
110. thrombocytopenia
111. thrombocytosis
112. thrombosis
113. torticollis
114. tremor
115. urinary incontinence
116. urine discoloration
117. urticaria
118. vaginal bleeding
119. vaginitis
120. vomiting
121. weakness
122. weight gain
123. weight loss
124. xerosis
125. xerostomia

Monitoring Parameters

• CBC
• LFTs

Contraindications

• breast-feeding
• children
• colitis
• contact lenses
• diarrhea
• geriatric
• GI disease
• hepatic disease
• human immunodeficiency virus (HIV) infection
• infants
• inflammatory bowel disease
• neonates
• porphyria
• pregnancy
• pseudomembranous colitis
• rifamycin hypersensitivity
• ulcerative colitis
• viral infection

Interactions

• Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
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