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

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