Rifapentine
Mechanism :
Inhibits DNA-dependent RNA polymerase in susceptible strains of Mycobacterium tuberculosis. Bactericidal against both intracellular and extracellular MTB organisms.
Indication :
- Latent and active tuberculosis treatment.
Contraindications :
Hypersensitivity to rifapentine, other rifamycin’s, or any component of the formulation.
Dosing :
Active TB treatment:
Use in children >12 years
Initial Treatment:
600 mg PO twice weekly for 2 months in combination with other anti-tuberculosis agents.
Continuation Treatment:
600 mg PO once weekly for 4 months in combination with other anti-tuberculosis agents.
Latent TB treatment:
Not recommended in children <2 years and those <10 kg. Give once weekly for 12 weeks (Max: 900 mg/week); administer in combination with
isoniazid.
10 to 14 kg:
300 mg PO.
>14 to 25 kg:
450 mg PO.
>25 to 32 kg:
600 mg PO.
>32 to 50 kg:
750 mg PO.
>50 kg:
900 mg PO.
Adverse Effect :
Hyperuricemia, pyuria, hematuria, UTI, neutropenia, lymphocytopenia, chest pain, edema, diaphoresis, hypo/hyperglycemia, anorexia, nausea, casts in urine, hypersensitivity, leukopenia/leucocytosis, thrombocytosis/thrombocytopenia.
Interaction :
Barbiturates: Rifamycin Derivatives may increase the metabolism of Barbiturates.
Beta-Blockers: Rifamycin Derivatives may decrease the serum concentration of Beta-Blockers.
Calcium Channel Blockers: Rifamycin Derivatives may decrease the serum concentration of Calcium Channel Blockers.
CYP2C9 Substrates: Rifapentine may decrease the serum concentration of CYP2C9 Substrates.
CYP3A4 Substrates: CYP3A4 Inducers (Moderate) may decrease the serum concentration of CYP3A4 Substrates.
Estrogen Derivatives & Progestins: Rifamycin Derivatives may decrease the serum concentration of Estrogen Derivatives and progestins.
Etravirine: Rifamycin Derivatives may decrease the serum concentration of Etravirine.
HMG-CoA Reductase Inhibitors (Statins): Rifamycin Derivatives may decrease the serum concentration of HMG-CoA Reductase Inhibitors.
Hepatic Dose :
No dose adjustment recommended as pharmacokinetic profile of the drug did not vary much with hepatic impairment.