What Is Rifampin Used For? (Plus 5 More Pharmacist-Backed Tips for Taking It)

When it comes to antibiotics, many people are familiar with the ones that are commonly prescribed, such as amoxicillin (Amoxil) and azithromycin (Z-pak). But certain antibiotics aren’t used as often. Rifampin (Rifadin) is a good example. It’s only prescribed for certain infections,  and chances are you may not know much about it. So, what are the approved rifampin uses? And what else should you know before you take it?

1. What are the most common rifampin uses?

Rifampin is an antibiotic that treats bacterial infections. But it’s not something you’ll be prescribed for common infections, such as an ear infection or strep throat. Instead, it’s most often used for two different types of infections: tuberculosis (TB) and bacterial meningitis. 

Tuberculosis (TB)

Rifampin is a first-choice option for treating active and latent forms of TB. 

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Active TB is a serious infection that affects the lungs. Symptoms include a persistent cough, weight loss, and a low-grade fever. You may also have night sweats or cough up blood. And it’s very easy to spread active TB to other people. 

Rifampin is commonly prescribed for active TB. But you won’t take it on its own — you’ll usually take at least two other antibiotics along with rifampin to treat active TB.

You can also test positive for TB even if you don’t have any symptoms. This is called a latent TB infection. You can’t spread latent TB to other people, but it’s still best to treat it so it won’t turn into active TB in the future. Rifampin treats latent TB as well.

Bacterial meningitis

Rifampin can also be used to prevent bacterial meningitis in people who have been exposed to it. Meningitis is an infection of the lining of the brain and spinal cord. Bacterial meningitis is becoming less common thanks to the development of vaccines against it. But if a meningitis infection happens, it’s very contagious, so it’s best to receive antibiotics within 24 hours of being exposed to help prevent you from getting sick. You’ll take rifampin twice a day for 2 days in this case.

Keep in mind: There are other rifampin uses, including leprosy, bone infections, and implant infections. But it’s not commonly prescribed for infections other than TB or bacterial meningitis.

2. Rifampin works by stopping bacteria from spreading

Rifampin kills bacteria by stopping them from making a part of their genetic material called RNA. This blocks the bacteria’s ability to make copies of itself, which helps stop an infection. But rifampin doesn’t affect the RNA in human cells — just bacteria. This helps lower the chance of side effects when you take it.

As mentioned, rifampin only works on certain types of bacteria. It does not treat infections caused by viruses, such as the common cold or the flu. And it’s common for certain bacteria to build resistance to it. This means that rifampin will no longer work against the bacteria. This is why rifampin is typically only used to treat specific bacterial infections.

3. It’s best to take rifampin on an empty stomach

You should take rifampin on an empty stomach with a full glass of water. An empty stomach means either 1 hour before or 2 hours after a meal. And you shouldn’t take an antacid within 1 hour of taking rifampin. These steps help make sure your body can absorb the dose properly.

Rifampin has a large number of drug interactions. So be sure to show your provider an updated medication list before you start taking it. They can check for any possible interactions or changes that should be made to your medications. You should also ask your provider before starting any new medications or supplements while you’re taking rifampin. 

Good to know: Rifampin may reduce the effectiveness of hormonal birth control pills. If you’re taking them for pregnancy prevention, discuss backup birth control methods with your provider.

4. Rifampin stays in your system for about a day and can turn your body fluids orange

You absorb rifampin very quickly after you take it. From there, your body will gradually get rid of it, mostly in your urine and your poop. You may also get rid of some of it in your tears, saliva, and sweat.

You may find that your urine and body fluids turn orange during this time. This is normal and just means your body is getting rid of the medication. But you may want to take steps to protect your clothing while taking rifampin since the orange color in your sweat can cause stains.

Rifampin stays in your system for about 15 hours after your last dose if you’ve been taking it for a while. If you just take a dose or two, such as to prevent meningitis, it could take closer to a full day for your body to clear it.

5. You may need to take rifampin for several months

How long you need to take rifampin depends on what type of infection you’re taking it for. 

To prevent bacterial meningitis, you’ll just take rifampin for 2 days in most cases. But for active TB, you may need to take rifampin for up to 6 to 9 months. If you have a latent TB infection, you’ll likely need 3 to 4 months of treatment.

Your healthcare provider will let you know how long your rifampin treatment will last. Missing doses can lead to resistance, so make sure you understand your provider’s instructions. And don’t hesitate to use a medication reminder app or other tools to help you remember to take it.

6. Rifampin is considered safe, but there are side effects to be aware of

Most people can take rifampin without any serious issues. Common rifampin side effects include nausea, heartburn, and diarrhea. And as mentioned, it can turn your urine and body fluids orange while you’re taking it.

Serious side effects are less common with rifampin, but are still possible. These include mental changes, liver damage, and blood disorders. Severe skin reactions are also possible — especially if you’ve been taking rifampin for a long time or if you miss doses often. Symptoms can include hives, itching, and blisters. You may also have flu-like symptoms. Seek emergency care if you notice signs of an allergic reaction while taking rifampin.

Your healthcare provider will likely keep an eye on your liver function if you’re taking rifampin for a long period of time. If you notice signs of liver problems, such as stomach pain, itchy skin, or yellowing of the eyes (jaundice), be sure to let your provider know. It’s best to avoid alcohol while taking rifampin to help protect your liver.

How to save on rifampin

Rifampin is a lower-cost generic medication. GoodRx can help you save over 85% off the average retail price. You can pay as little as $45.92 for a 30-day supply of rifampin at certain pharmacies with a free GoodRx discount.

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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