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Overview: Rifabutin is used to prevent certain infections in people with HIV. Common side effects include rash and upset stomach. Rifabutin can cause your body fluids, like your urine (pee), saliva (spit), 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 rifabutin, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to rifabutin or other similar medicines.

Uses

What is rifabutin used for?

Rifabutin is commonly used to prevent Mycobacterium avium complex (MAC), a bacterial infection, in people with human immunodeficiency virus (HIV).

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

Rifabutin 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 rifabutin, which will make it not work as well.

How does rifabutin work (mechanism of action)?

People with HIV have a virus that spreads in their body and damages the immune system, making it easier for them to get very sick from other infections. Rifabutin helps stop certain bacteria from multiplying in your body. This makes it easier for your body to fight off the infection.

How is rifabutin supplied (dosage forms)?

Brands and other names

  • Mycobutin

Dosage forms and strengths

  • 150 mg oral capsules

How should I store rifabutin?

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

Side Effects

What are the most common side effects of rifabutin?

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

  • Rash
  • Upset stomach
  • Low white blood cell levels
  • Color change to urine 
  • Nausea and vomiting

There may be other side effects of rifabutin 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 rifabutin?

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

Eye Inflammation. Rifabutin may cause uveitis, an inflammation of the eye. Tell your health care provider right away if you have any of the following symptoms.

  • Eye redness or pain
  • Blurry or lessened vision and sensitivity to light
  • Floaters, those tiny dots or specks in your vision

Severe Skin Reactions. Rifabutin 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 rifabutin 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

Antibiotic-Associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut with many types of antibiotics, including rifabutin. This can cause a condition known as antibiotic-associated diarrhea and can happen even up to two months after stopping the antibiotic. Call your health care provider right away if you have any of the following symptoms of this condition.

  • Watery diarrhea
  • Diarrhea that does not go away
  • Blood in your stool (poop)
  • Severe stomach cramps
  • Fever that starts after you start or finish the medicine

Severe Allergic Reactions. Rifabutin 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 rifabutin?

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

  • Mycobutin
  • Rifabutin
  • 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 rifabutin products they stock.

What should I know about rifabutin before using it?

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

Taking rifabutin with food may help reduce the risk for an upset stomach. 

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

Keep rifabutin 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 for blood disorders. It is important to keep all appointments for blood work.

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

Rifabutin 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.

People with HIV are at a higher risk for infections, including tuberculosis. This is important because if you have tuberculosis, taking rifabutin alone is not enough to treat the infection and could cause the infection to become resistant to treatment. Tell your health care provider right away if you have any of the following symptoms of tuberculosis.

  • Persistent cough or coughing up blood
  • Chest pain
  • Feeling tired all the time
  • Fever, chills, or night sweats
  • Loss of appetite

If you use a birth control method that has hormones in it, rifabutin may make it not work as well. You should use another method (non-hormonal) of birth control while taking rifabutin 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 rifabutin?

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 rifabutin 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
  • Eye problems
  • Blood disorders
  • Liver problems
  • Kidney problems

Other Medicines and Supplements. Rifabutin may interact with other medicines and supplements. Before taking rifabutin, 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.

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

Breastfeeding. It is not known if rifabutin 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 rifabutin. There may be risks if you breastfeed with HIV.

Interactions

Does rifabutin interact with foods or drinks?

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

It is unknown if drinking alcohol will affect rifabutin.

Does rifabutin 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 rifabutin.

  • Any other antibiotic, which is a medicine used for bacterial infections
  • A medicine for HIV or AIDS
  • Itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are used for fungal infections
  • Isoniazid, rifampin (Rifadin), or rifapentine (Priftin), which are  commonly used to treat tuberculosis
  • A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD)
  • Methadone, which is an opioid medicine used to treat pain or opioid use disorder
  • Theophylline (Elixophyllin, Theo-24,), which is a medicine for asthma or certain other breathing problems

Many other medicines may alter the blood levels of rifabutin, 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 rifabutin. 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 rifabutin?

If you or someone else has used too much rifabutin, 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 rifabutin?

If you miss a 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. 

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