Rifampicin Oral: Dosing and Interactions
Rifampicin guidance for tuberculosis, latent tuberculosis, leprosy, and brucellosis, with major interaction precautions.
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Source reviewed
June 2021
Guide category
Oral drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Antibacterial, first-line antituberculosis antibacterial with sterilising and bactericidal activity, and antileprotic antibacterial with bactericidal activity.
Indications
- Tuberculosis, in combination with other antituberculosis antibacterials.
- Paucibacillary and multibacillary leprosy, in combination with dapsone and clofazimine.
- Brucellosis, in combination with another antibacterial.
- Latent tuberculosis, as monotherapy or in combination with isoniazid.
Forms and strengths
- 150 mg tablet.
- 300 mg capsule.
Dose
Do not exceed 600 mg daily.
In patients with hepatic impairment, do not exceed 8 mg/kg/day when treatment is administered daily.
Tuberculosis, latent tuberculosis, as monotherapy or in combination with isoniazid
- Child under 30 kg: 15 mg/kg once daily, on an empty stomach.
- Child 30 kg and over and adult: 10 mg/kg once daily, on an empty stomach.
Paucibacillary and multibacillary leprosy
- Child under 10 years: 10 mg/kg once monthly, on an empty stomach.
- Child from 10 to 14 years: 450 mg once monthly, on an empty stomach.
- Child 15 years and over and adult: 600 mg once monthly, on an empty stomach.
Brucellosis
- Child: 15 to 20 mg/kg once daily on an empty stomach, maximum 600 mg daily.
- Adult: 600 to 900 mg once daily on an empty stomach.
Duration
- Tuberculosis: according to protocol.
- Latent tuberculosis as monotherapy: 4 months.
- Latent tuberculosis in combination with isoniazid: 3 months.
- Paucibacillary leprosy: 6 months.
- Multibacillary leprosy: 12 months.
- Brucellosis: 6 weeks.
Contra-indications, adverse effects, precautions
- Do not administer to patients with jaundice, hypersensitivity to rifamycins, or history of severe haematological disorders during a previous treatment with rifamycins.
- Avoid or administer with caution to patients with hepatic disorders.
- May cause harmless orange-red discoloration of body secretions, gastrointestinal disturbances, headache, drowsiness, hepatotoxicity, influenza-like symptoms, thrombocytopenia, and hypersensitivity reactions.
- If signs of hepatotoxicity develop, rifampicin should be discontinued until symptoms resolve.
- Rifampicin reduces the effect of many drugs including antimicrobials, some antiretrovirals, some hormones, antidiabetics, corticosteroids, phenytoin, direct-acting antivirals for chronic hepatitis C, and warfarin.
- In patients taking nevirapine, lopinavir/ritonavir, or atazanavir/ritonavir, use rifabutin in place of rifampicin.
- In women using contraception, use injectable medroxyprogesterone or an intrauterine device.
- With concomitant fluconazole, administer each drug 12 hours apart.
- Pregnancy: no contra-indication. When the mother receives rifampicin in late pregnancy, administer phytomenadione to the mother and the neonate to reduce the risk of bleeding disorders.
- Breast-feeding: no contra-indication.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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