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rifampin

Generic Rifadin
Used for Skin Infection, Tuberculosis
Used for Skin Infection, Tuberculosis

Rifampin (Rifadin) is an antibiotic used to treat active and latent tuberculosis (TB). It also helps prevent the spread of meningococcal infections by people who carriers of the bacteria, but aren't showing symptoms. Rifampin (Rifadin) is taken by mouth once or twice daily, depending on your medical conditions. If you're taking it for TB, your provider might prescribe other medications as well, like isoniazid. One side effect of rifampin (Rifadin) is that it can temporarily change the color of your teeth, body fluids, and even urine as a side effect.

Reviewed by:
reviewer
Aileen Chu, PharmD, BCPS
reviewer
Allison Gourley, PharmD
Last reviewed on June 14, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Rifampin (Rifadin)?

What is Rifampin (Rifadin) used for?

  • Tuberculosis (TB)

  • Meningococcal carriers (when there's bacteria living in the nose and/or throat, but not causing infection)

How Rifampin (Rifadin) works

Rifampin (Rifadin) is a rifamycin antibiotic. It blocks an enzyme (protein) the bacteria need to eventually make proteins, so the bacteria can't grow and spread.

Are you looking for information on Xifaxan (rifaximin) or rifabutin (Mycobutin) instead?

Drug Facts

Common BrandsRifadin
Drug ClassRifamycin antibiotic
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the side effects of Rifampin (Rifadin)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Temporary change in color (orange/yellow) of body fluids and teeth

Other Side Effects

  • Upset stomach
  • Diarrhea
  • Headache
  • Fever
  • Nervous system problems affecting energy, movement, thinking, or behavior
  • Nerve pain or numbness
  • Changes in vision
  • Changes in menstrual cycle
  • Fluid buildup (edema) in the face, arms, and/or legs

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reaction: fever, rash, swelling of your lips or tongue, trouble breathing
  • Serious bleeds: bruising easily, blood in the urine or stool, bleeding that's difficult to stop
  • Liver problems: loss of appetite, nausea or vomiting, dark urine, or yellowing of the eyes or skin

Source: DailyMed

More on Rifampin (Rifadin) side effects

Rifampin: side effects rifampin

8 Rifampin Side Effects You Should Know About

Written by Alex Evans, PharmD, MBA

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Agitation

bleeding gums

blood in the urine or stools

bruising

confusion

cough

coughing or vomiting blood

dark urine

darkening of the skin

decreased frequency or amount of urine

difficulty in breathing and swallowing

dizziness

fainting

fast heartbeat

fever with or without chills

general feeling of tiredness or weakness

headache

hives

hoarseness

hostility

increased blood pressure

increased thirst

irritability

light-colored stools

loss of appetite

lower back or side pain

mental depression

nausea

painful or difficult urination

persistent bleeding or oozing from puncture sites, mouth, or nose

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

skin itching, rash, or redness

sores, ulcers, or white spots on the lips or in the mouth

stomach pain

swelling of the face, ankles, fingers, hands, or lower legs

tightness in the chest

unusual bleeding or bruising

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

vomiting

weight gain

yellow eyes or skin

Incidence not known

Bleeding under the skin

blistering, peeling, or loosening of the skin

bloating

bloody, severe, or watery diarrhea

bone pain

chest pain

chills

cold, clammy skin

difficulty with speaking

double vision

fast, weak pulse

inability to move the arms, legs, or facial muscles

inability to speak

increased menstrual flow or vaginal bleeding

joint or muscle pain

lightheadedness

nosebleeds

pale skin

paralysis

pinpoint red spots on the skin

prolonged bleeding from cuts

red or black, tarry stools

red or dark brown urine

red skin lesions, often with a purple center

red, irritated eyes

slow speech

sores, welts, blisters

sweating

swollen glands

unpleasant breath odor

unusual weight loss

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blurred vision

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast, pounding, or irregular heartbeat or pulse

feeling of fullness in the upper abdomen or stomach

low blood pressure or slow pulse

pain in the upper abdomen or stomach

reddish-orange to reddish-brown color of the urine, stool, saliva, sputum, sweat, and tears

seizures

swelling around the eyes or face

unconsciousness

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

Feeling that others are watching you or controlling your behavior

feeling that others can hear your thoughts

feeling, seeing, or hearing things that are not there

muscle tenderness, wasting, or weakness

severe mood or mental changes

unusual behavior

Incidence not known

Belching

bloated or full feeling

drowsiness

excess air or gas in the stomach or bowels

indigestion

not able to concentrate

pain or discomfort in the chest, upper stomach, or throat

tooth discoloration

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Rifampin (Rifadin)

thumbs-up

Pros

One of the first-choice antibiotics for treating TB

Taken once daily for TB treatment

For people who carry the meningococcal bacteria, taking rifampin (Rifadin) for just 2 days helps prevent the spread of infection

Can be made into an oral suspension if you or your child has a hard time swallowing capsules

Available in an injectable form if you're in the hospital and can't take medications by mouth

Available as a lower-cost generic

thumbs-down

Cons

Must be used in combination with other anti-TB antibiotics when treating active TB

Can change the color of your teeth and body fluids and stain your contact lenses

Skipping doses can quickly cause drug resistance, making it much harder to treat the infection.

Can cause liver injury, so it's recommended to avoid alcohol

Interacts with many medications, and can lower the medication levels in the body

Not recommended for the treatment of serious meningococcal infections

pharmacist-tips

Pharmacist tips for Rifampin (Rifadin)

pharmacist

  • Take rifampin (Rifadin) 1 hour before or 2 hours after a meal with a full glass of water.

    • Before starting rifampin (Rifadin) for tuberculosis (TB), you'll need to get bloodwork done to check the health of your liver, kidneys, and blood cells. Make sure to follow up with your provider while you are taking rifampin (Rifadin) to make sure the medication is working correctly and not causing side effects.

      • For active TB infections, most people need to take rifampin (Rifadin) in combination with other anti-TB antibiotics such as isoniazid, pyrazinamide, and ethambutol (Myambutol). Some people have latent TB (when you have TB in your body, but you don't have symptoms), which can be treated with just rifampin (Rifadin) by itself. Talk to your provider if you're not sure if you have active or latent TB.

        • A common side effect is body fluids (e.g., urine, sweat, spit, tears) turning yellow, orange, red, or brown. This can lead to staining of clothing, teeth, soft contact lenses, which can be permanent.

          • Rifampin (Rifadin) can cause serious liver injury. It's best to avoid alcohol, herbal supplements, or other medications that can also affect your liver while you are taking rifampin (Rifadin).

            • It's very important not to miss any doses of rifampin (Rifadin) or other anti-TB medications. Skipping doses can make the bacteria resistant to the usual antibiotics, which then makes the infection much harder to treat.

              • Rifampin (Rifadin) interacts with many medications. Usually, it causes other medication levels to be lower making them less effective (not work as well). It's important to tell your provider and pharmacist about all the medications you are taking, including supplements and birth control as they might need to change your dose. Before starting any new medications, make sure your provider knows that you're on rifampin (Rifadin).

                • Since rifampin (Rifadin) can cause hormonal birth control to work less effectively, you should consider other methods of birth control while you are taking rifampin (Rifadin). Some options include condoms, spermicides, and a copper intrauterine device (IUD).

                  More on Rifampin (Rifadin) tips

                  Medication Education: pharmacy tips rifampin

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

                  Written by Alex Evans, PharmD, MBA
                  faqs

                  Frequently asked questions about Rifampin (Rifadin)

                  How long do I take rifampin (Rifadin) for latent TB?
                  If you have latent TB, which is when the TB in your body isn't causing an infection, you can expect to take rifampin (Rifadin) for 3 or 4 months. It's important to take rifampin (Rifadin) exactly as prescribed. Don't stop taking it unless instructed by your provider.
                  How long after taking rifampin (Rifadin) can I eat?
                  You're recommended to take rifampin (Rifadin) 1 hour before meals or 2 hours after eating. Taking rifampin (Rifadin) with food can lower the amount of medication absorbed, which can lead to lower medication levels and resistant bacteria.
                  How long after taking rifampin (Rifadin) can I drink alcohol?
                  Be careful about drinking alcohol while you are taking rifampin (Rifadin). Rifampin (Rifadin) can cause liver injury, and drinking alcohol at the same time can raise your risk. You should avoid alcohol during your months of treatment. If this is difficult, talk to your provider about your options for drinking responsibly.
                  Does rifampin (Rifadin) turn urine orange?
                  Yes, rifampin (Rifadin) can turn urine red-orange. It can also do the same for other bodily fluids, like sweat and tears, as well as your teeth orange. This side effect is harmless and temporary. But the color might stain things like soft contact lenses or clothing permanently.
                  How long does rifampin (Rifadin) side effects last?
                  How long side effects of rifampin (Rifadin) last depends on what side effects you're experiencing. For example, some common side effects of rifampin (Rifadin) include changes in urine color and stomach upset. These side effects will typically start to fade once you stop rifampin (Rifadin) treatment. But this medication can also cause more serious side effects, such as liver damage, which might take longer to recover from. Studies show that people typically experience minor side effects from rifampin (Rifadin). Talk with your provider if you've concerned about the side effects of this medication.
                  Does rifampin (Rifadin) cause hair loss?
                  Hair loss (alopecia) isn't a side effect reported by people who took rifampin (Rifadin) during clinical trials. There have been a few reports of other TB medications, such as isoniazid, causing hair loss. You might experience some hair loss if you take those other medications along with rifampin (Rifadin). If you're concerned about rifampin (Rifadin) and hair loss, talk with your provider.
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                  What are the risks and warnings for Rifampin (Rifadin)?

                  Rifampin (Rifadin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Liver injury

                  • Risk factors: Drinking alcohol | Taking other medications that cause liver injury | Liver problems

                    Rifampin (Rifadin) can cause liver problems, which can be serious and life-threatening. You'll need regular blood tests to make sure that your liver is healthy, especially if you need to take rifampin (Rifadin) for a long time. While you're taking rifampin (Rifadin), avoid alcohol and other medications that might harm your liver. Before starting this medication, talk to your provider if you have a history of liver problems since taking rifampin (Rifadin) can make those problems worse. If you've a loss of appetite, nausea or vomiting, dark urine, or yellowing of the eyes or skin, talk to your provider right away because you might need to stop this medication.

                    risk-warning

                    Not for treating meningococcal infection

                    Rifampin (Rifadin) isn't meant to treat an active meningococcal infection. It's only meant to treat meningococcal bacteria if you're a carrier of the bacteria, but not showing any symptoms. Take this medication only for a short amount of time (usually recommended for 2 days) to prevent antibiotic resistance.

                    risk-warning

                    Allergic reactions

                    Rifampin (Rifadin) can cause various types of allergic reactions. You might experience allergy symptoms like rash, swelling, or difficulty breathing. Skin reactions can be severe or even life-threatening, especially if they affect large parts of the body or mucous membranes, like your eyes and mouth. Allergic reactions can also be less typical, such as abnormal blood counts, liver injury, or flu-like symptoms (weakness, vomiting, aches, and chills). If you feel unwell after starting rifampin (Rifadin), even if you don't see a rash, it's best to check with your provider to make sure you're not experiencing a severe allergic reaction. When taking rifampin (Rifadin) daily for tuberculosis, be careful not to miss doses, since stopping and starting the medication can cause kidney problems.

                    risk-warning

                    Higher risk for bleeding

                    • Risk factors: Liver problems | Poor nutrition | Taking antibiotics or blood thinners for a long time

                      Rifampin (Rifadin) can cause bleeding problems, especially in people at risk for having low vitamin K. You might need regular blood tests to monitor your risk of bleeding. Your provider might prescribe vitamin K supplements which can help your clotting factors work better. If you notice abnormal bleeding or bruising while on rifampin (Rifadin), call your provider right away.

                      risk-warning

                      Caution in diabetes

                      Rifampin (Rifadin) can make it harder to control your blood sugar if you have diabetes. Before starting this medication, talk to your provider about your diabetes management plan.

                      risk-warning

                      More side effects if not taken once a day

                      For treatment of tuberculosis, it's best to take rifampin (Rifadin) once a day and no more than 600 mg per day. If you find that it's hard to take rifampin (Rifadin) every day, your provider may recommend a different dose strategy such as taking it twice a week. Taking higher doses less frequently can help some people stay on track with the medication, but also raises the risk of side effects such as flu-like symptoms, abnormal blood counts, upset stomach, liver or kidney injury, or allergic reaction including anaphylaxis.

                      risk-warning

                      Effects on hormones and vitamin D levels

                      Rifampin (Rifadin) raises the activity of some enzymes in the body. This can lead to faster breakdown of certain hormones (adrenal and thyroid) and vitamin D. Lower vitamin D in the body can lead to low calcium and phosphate, as well as high parathyroid hormone.

                      dosage

                      Rifampin (Rifadin) dosage forms

                      The average cost for 60 capsules of 300mg of Rifampin (Rifadin) is $45.92 with a free GoodRx coupon. This is 75.56% off the average retail price of $187.90.
                      capsule
                      Capsule
                      DosageQuantityPrice as low asPrice per unit
                      150mg60 capsules$33.34$0.56
                      300mg60 capsules$45.92$0.77
                      vial
                      Vial
                      DosageQuantityPrice as low asPrice per unit
                      600mg30 vials$52.15$1.74

                      Typical dosing for Rifampin (Rifadin)

                      Tuberculosis

                      Your provider will calculate the dose of rifampin (Rifadin) based on your age and body weight. They'll also prescribe other tuberculosis medications to take along with rifampin (Rifadin). Your provider will let you know how long your treatment will last, but it'll usually take 4 months or longer.

                      • Adults: The typical dose is 10 mg/kg (up to 600 mg) once a day.

                      • Children: The typical dose is 10 mg/kg to 20 mg/kg (up to 600 mg) once a day.

                      Meningococcal bacteria in the nose and/or throat

                      • Adults: The recommended dose is 600 mg by mouth twice daily for 2 days.

                      • Children: The recommended dose ranges from 5 mg/kg to 10 mg/kg (up to 600 mg per dose), depending on your child's age. They'll take this medication by mouth every 12 hours for 2 days.

                      Rifampin (Rifadin) is also available as an infusion through the veins given by a healthcare provider in the hospital setting.

                      interactions

                      Interactions between Rifampin (Rifadin) and other drugs

                      Rifampin (Rifadin) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Rifampin (Rifadin). Please note that only the generic name of each medication is listed below.

                      Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                      Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                      Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                      drug-cost

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                      contraindications-icon

                      Rifampin (Rifadin) contraindications

                      Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Rifampin (Rifadin) will not be safe for you to take.
                      alternatives

                      What are alternatives to Rifampin (Rifadin)?

                      There are a number of medications that your doctor can prescribe in place of Rifampin (Rifadin). Compare a few possible alternatives below.
                      Rifampin (Rifadin)
                      Used for:

                      • Tuberculosis (TB)

                      • Meningococcal carriers (when there's bacteria living in the nose and/or throat, but not causing infection)

                      $33.34 Lowest GoodRx priceView Prices
                      Rifabutin (Mycobutin)
                      Used for:

                      • Prevention of Mycobacterium avium complex (MAC) disease in people with severe HIV infection

                      $114.81 Lowest GoodRx priceView Prices
                      Priftin (rifapentine)
                      Used for:
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                      latest news

                      What is the latest news about Rifampin (Rifadin)?

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                      The most common rifampin (Rifadin) side effects are nausea, heartburn, and diarrhea. But there are several other side effects to look out for.

                      9 Rifampin Side Effects You Should Know About

                      The most common rifampin (Rifadin) side effects are nausea, heartburn, and diarrhea. But there are several other side effects to look out for.
                      Rifampin is an antibiotic medication. It’s often used to treat bacterial infections, including tuberculosis and certain types of meningitis.

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

                      Rifampin is an antibiotic medication. It’s often used to treat bacterial infections, including tuberculosis and certain types of meningitis.
                      Antibiotics, antiepileptics, antiretrovirals, and St. John’s wort are the most likely medications to interact with hormonal birth control. If you are about to start taking one of these medications, you may need to talk to your provider about alternative contraceptives. Learn more, with GoodRx.

                      How Do Antibiotics and Other Medications Interfere With Birth Control?

                      Antibiotics, antiepileptics, antiretrovirals, and St. John’s wort are the most likely medications to interact with hormonal birth control. If you are about to start taking one of these medications, you may need to talk to your provider about alternative contraceptives. Learn more, with GoodRx.
                      Many medications can lower vitamin D levels and lead to deficiency — like blood pressure medications, antibiotics, and steroids. Learn what may be contributing to your low vitamin D levels.

                      Low on Vitamin D? Your Medications Could Be to Blame

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                      Meningitis is an infection of the outer lining of the brain and spinal cord. It can be caused by viruses or bacteria. If untreated, it can be a serious infection that leads to permanent disability or even death. Learn about the causes of meningitis, symptoms, treatment, and prevention options.

                      What You Need to Know About Meningitis

                      Meningitis is an infection of the outer lining of the brain and spinal cord. It can be caused by viruses or bacteria. If untreated, it can be a serious infection that leads to permanent disability or even death. Learn about the causes of meningitis, symptoms, treatment, and prevention options.
                      images

                      Rifampin (Rifadin) images

                      Red Logo Lannett 1315 - Rifampin 300mg Capsule
                      This medicine is Red Capsule Imprinted With "Logo Lannett 1315".Red Logo Lannett 1315 - Rifampin 300mg Capsule
                      Red E799 E799 - Rifampin 300mg Capsule
                      This medicine is Red Capsule Imprinted With "E799 E799".Red E799 E799 - Rifampin 300mg Capsule
                      Red And Maroon Ce 186 - Rifampin 300mg Capsule
                      This medicine is Red And Maroon Capsule Imprinted With "Ce 186".Red And Maroon Ce 186 - Rifampin 300mg Capsule
                      Red Lu E02 - Rifampin 300mg Capsule
                      This medicine is Red Capsule Imprinted With "Lu E02".Red Lu E02 - Rifampin 300mg Capsule

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                      References

                      Best studies we found

                      Centers for Disease Control and Prevention. (2020). Latent TB infection and TB disease.

                      Centers for Disease Control and Prevention. (2020). Treatment regimens for latent TB infection.

                      Centers for Disease Control and Prevention. (2022). Causes and how it spreads.

                      View All References (6)

                      Centers for Disease Control and Prevention. (2022). Meningococcal disease.

                      Chartwell RX, LLC. (2023). Rifampin capsule [package insert]. DailyMed.

                      Diallo, T., et al. (2018). Safety and side effects of rifampin versus isoniazid in children. The New England Journal of Medicine.

                      Eden, R. E., et al. (2023). Vitamin K deficiency. StatPearls.

                      Gupta, K. B., et al. (2011). Isoniazid-induced alopecia. Lung India.

                      Mylan Institutional LLC. (2023). Rifampin injection, powder, lyophilized, for solution [package insert]. DailyMed.

                      GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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