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Overview: Rifampin is used to treat tuberculosis and to get rid of meningitis-causing bacteria in your nose or throat. Common side effects include nausea, vomiting, diarrhea, and upset stomach. Rifampin can cause your body fluids, like your urine (pee), saliva, tears, and sweat, to turn a red-orange color. This color change is normal and not harmful, but it can stain contact lenses or dentures permanently. It is important to complete your prescribed course of rifampin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to rifampin or other similar medicines.

Uses

What is rifampin used for?

Rifampin is commonly used to treat tuberculosis (in combination with other medicine). Rifampin can also be used to help get rid of meningitis-causing bacteria from your nose and throat, but it is not for treating meningitis. 

Rifampin may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to rifampin, which will make it not work as well.

Rifampin may also be used for other conditions as determined by your health care provider.

How does rifampin work (mechanism of action)?

Rifampin helps stop certain bacteria from multiplying in your body. This makes it easier for your body to fight off the infection and get rid of the bacteria.

How is rifampin supplied (dosage forms)?

Brands and other names

  • Rifadin
  • Rimactane

Dosage forms and strengths

  • 150 mg oral capsules
  • 300 mg oral capsules

Rifampin is also available in injectable forms.

How should I store rifampin?

Oral Capsule. Rifampin capsules should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from moisture and light. 

Injection Liquid. Rifampin injection liquid is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of rifampin?

The most common side effects of rifampin are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea, vomiting, and diarrhea
  • Upset stomach
  • Headache
  • Fever and chills
  • Dizziness
  • Confusion
  • Muscle weakness
  • Trouble with balance or coordination
  • Feeling tired
  • Rash

There may be other side effects of rifampin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of rifampin?

While less common, the most serious side effects of rifampin are described below, along with what to do if they happen.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking rifampin. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Rifampin can cause severe skin reactions, called Stevens-Johnson Syndrome (SJS), acute generalized exanthematous pustulosis (AGEP), and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop rifampin and call your health care provider right away. Get emergency help if you have any of the following symptoms.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Increased Bleeding Risk. People taking rifampin may have an increased risk of bleeding. Keep all medical appointments, including those for lab work, while you are taking rifampin. Tell your health care provider if you notice any changes in how easily you bruise or bleed.

Lung Inflammation. Rifampin can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Stop taking rifampin and get emergency help if you have trouble breathing. You may also have a cough, fever, or chest pain.

Thrombotic Thrombocytopenic Purpura (TTP). Rifampin can lead to a serious problem with blood clotting, called TTP. TTP is when blood clots form in some parts of your bloodstream, which causes a loss of platelets in the rest of the blood (thrombocytopenia). TTP needs to be treated right away in the hospital or it can lead to death. Stop taking rifampin and get emergency help if you have any of the following symptoms without another explanation.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
  • Changes in your vision
  • Unusual weakness or tiredness
  • Headache, confusion, or slurred speech
  • Fast heartbeat
  • Purplish spots (purpura) on the skin or in the mouth due to bleeding under the skin
  • Low amount of pee or pee that is pink or has blood in it

Severe Allergic Reactions. Rifampin may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Shortness of breath, trouble swallowing, or throat tightness
  • Swelling in your feet, ankles, or legs
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee

Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Warnings & Precautions

Who should not use rifampin?

Allergies to Ingredients. People who are allergic to any of the following should not take rifampin.

  • Rifadin
  • Rifampin
  • Rimactane
  • Any other medicine known as a rifamycin
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific rifampin products they stock.

Drug Interactions. Rifampin should not be taken while you are using certain other medicines. Before taking rifampin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about rifampin before using it?

Do not take rifampin unless it has been prescribed to you by a health care provider. Take it as prescribed.

Take each dose of rifampin one hour before or two hours after a meal with a full glass of water.

Taking antacids with rifampin can make it not work as well. Talk with your health care provider about the best way to take antacids while taking rifampin.

Do not share rifampin with other people, even if they have the same condition as you. It may harm them.

Keep rifampin out of the reach of children.

Your health care provider will likely do blood work before starting this medicine and while you are taking it to monitor the health of your liver and monitor for blood disorders. It is important to keep all appointments for blood work.

It is important to complete your prescribed course of rifampin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to rifampin or other similar medicines.

Rifampin can cause your body fluids, like your urine (pee), saliva, tears, and sweat, to turn a red-orange color. This color change is normal and not harmful, but it can stain contact lenses or dentures permanently.

Rifampin may cause a false-positive urine drug test for opioids. If you have a urine drug test while you are taking rifampin, tell the person doing the test that you are taking rifampin. 

If you use a birth control method that has hormones in it, rifampin may make it not work as well. You should use another method (non-hormonal) of birth control while taking rifampin to prevent pregnancy. Talk to your health care provider about your birth control options and any concerns.

What should I tell my health care provider before using rifampin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if rifampin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • History of taking medicine to treat tuberculosis
  • Blood disorders
  • Liver problems
  • Kidney problems
  • Diabetes

Pregnancy. It is not known if or how rifampin could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant. Your health care provider will advise you if you should take rifampin while you are pregnant or trying to get pregnant.

Breastfeeding. Rifampin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should stop breastfeeding or stop rifampin. 

Interactions

Does rifampin interact with foods or drinks?

There are no known interactions between rifampin and foods or drinks.

It is unknown if drinking alcohol will affect rifampin. The risk of liver damage may be increased if you drink alcohol while taking rifampin. It is best to avoid drinking alcohol while taking rifampin.

Does rifampin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using rifampin.

  • Praziquantel (Biltricide), a medicine for parasite infections
  • A medicine for HIV, AIDS, or hepatitis
  • A medicine used to treat tuberculosis 
  • A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD)
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • A medicine used to control your heart rate or rhythm 
  • A medicine used to treat cancer 
  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • A medicine for mental health conditions
  • A medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • A medicine for bacterial infections
  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), or ketoconazole, which is a medicine used for fungal infections
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • A medicine for diabetes
  • A medicine for blood pressure 
  • A corticosteroid, which is a medicine for certain inflammatory conditions,
  • A statin, such as simvastatin (Zocor), which is a medicine to lower cholesterol
  • Ondansetron, which is a medicine for nausea
  • A thyroid medicine, such as levothyroxine, which is used to raise thyroid hormone levels
  • Theophylline (Elixophyllin, Theo-24), which is a medicine for asthma or certain other breathing problems
  • An antacid or supplement or laxative containing calcium, aluminum, magnesium, or iron

Many other medicines may alter the blood levels of rifampin, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with rifampin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much rifampin?

If you or someone else has used too much rifampin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of rifampin?

It is important to complete your prescribed course of rifampin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to rifampin or other similar medicines.

Oral Tablets. If you miss a rifampin tablet dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. 

Injection Liquid. Rifampin injection liquid is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving rifampin as scheduled. If you miss an appointment to get your rifampin dose, call to make another appointment as soon as possible.