Has your doctor ever prescribed you a red, orange capsule? You may be familiar with this medicine, especially if you are treating a bacterial infection like tuberculosis. This medicine is called Rifampin. It is a very important, powerful antibiotic. So today we will talk about this medicine, the things to be careful about while using it, and the possible side effects.
What is Rifampin?
Simply put, Rifampin is a type of antibiotic. This means that this medicine helps to kill harmful bacteria that enter our body and cure infections. It is especially a main medicine given for Tuberculosis (TB) . Doctors also recommend it for a number of other bacterial infections.
But one thing to remember is that this only works on bacteria. This medicine will not cure viral infections like the common cold and flu.
Things you need to tell your doctor before starting medication
Before you start taking rifampin, be sure to tell your doctor the following information, as special care should be taken when using rifampin with these conditions.
| Do you have these conditions? | Why is it important? |
|---|---|
| Diabetes | Rifampin may change the way diabetes medications work. |
| Liver disease | This medicine can mainly affect the liver, so it is very important if you have liver disease. |
| HIV or AIDS status | Rifampin may interact with some medications used to treat HIV. |
| If you are a frequent drinker | Combining alcohol and rifampin can increase liver damage. |
| If you wear contact lenses | Rifampin can discolor your tears and permanently stain your contact lenses. |
| If you are pregnant or expecting a baby | It is essential to seek medical advice about the use of medication during pregnancy. |
| If you are a breastfeeding mother | This medicine can pass to the baby through breast milk, so talk to your doctor. |
| If you have allergies to other medications | It is important to inform your doctor if you have any allergies to rifampin or any other medicine or food. |
How exactly do you use this medicine?
- Follow your doctor's instructions: Take this medicine with a glass of water, exactly as prescribed by your doctor, at the same time every day.
- Complete the course: Even if you feel better, continue taking the medication until your doctor tells you to stop. Otherwise, the infection may come back.
- How to take it with antacids: If you are taking antacids for gastritis, take them at least one hour after taking rifampin. Do not take them together.
- What if you miss a dose? If you forget to take your medicine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at the same time.
- If you overdose: If you think you have taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other medications that may interact with Rifampin
Rifampin can interact with many other medications, so it is very important to tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
Special warning: About birth control pills!
If you are a woman using birth control pills, the effectiveness of those pills may be significantly reduced while you are taking rifampin. This means that there is a risk of pregnancy. Therefore, be sure to talk to your doctor about using another form of birth control, such as condoms, while taking this medication and for a while after you stop taking it.
In addition, rifampin may interact with the following medications:
- Some medications taken for HIV or hepatitis
- Medications to prevent blood clots (e.g. Warfarin)
- Some medications for blood pressure and heart disease
- Some medications for diabetes
- Antifungal medications (e.g. ketoconazole, fluconazole)
- Some medications for mental illness
- Acetaminophen (Paracetamol)
This list is not complete, so please inform your doctor about all medications you are taking.
Things to be careful about while taking the medicine
- Pay attention to symptoms: If your symptoms do not improve, or if they get worse, tell your doctor immediately.
- Diarrhea: If your diarrhea is severe and lasts more than two days, do not take medication from the pharmacy and call your doctor.
- Severe skin reactions: Sometimes severe skin reactions can occur weeks after starting the medication. If you experience symptoms such as fever, body aches, red/purple blisters on the skin, peeling skin, or swelling of the face, lips, or hives on the neck or armpits, seek medical advice immediately.
- Vitamins: It's a good idea to make sure you're getting enough vitamin B6 and vitamin D while taking rifampin. Talk to your doctor about this as well.
What are the possible side effects?
Like any medicine, rifampin can cause side effects. Some are minor, while others require immediate attention.
| Serious side effects that should be reported to your doctor immediately | |
|---|---|
| Symptoms of liver damage | Pain in the upper right side of the stomach, loss of appetite, nausea, yellowing of the eyes or skin, dark yellow/brown urine, and feeling lethargic. |
| Severe allergies | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Symptoms of bleeding | Black or bloody stools, vomit that looks like coffee grounds, red/dark brown urine, small red/purple spots on the skin, and unexplained bruising. |
| Skin blisters or peeling | Redness, blistering, or peeling of the skin, including around the mouth. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Change in color of body fluids | Urine, sweat, tears, and saliva may turn a reddish-orange color. This is normal and nothing to worry about. |
| Other minor ailments | Headache , dizziness , drowsiness, nausea, vomiting, loss of appetite, heartburn. |
Take-Home Message
- Rifampin is a powerful antibiotic that must be taken for the full duration prescribed by your doctor.
- Be sure to tell your doctor about all other medications you are taking, especially birth control pills.
- It is normal for your urine, sweat, and tears to turn a reddish-orange color while taking this medicine. Don't worry about that. However, if you wear contact lenses, they may become permanently stained.
- Seek immediate medical attention if you experience signs of liver damage (yellowing of the skin/eyes, stomach pain) or severe skin allergies (blisters, skin rash).
- Avoid drinking alcohol. It can increase liver damage.
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