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Rifampicin Intravenous Infusion for Adults
Who can administer
May be administered by registered competent doctor or nurse/midwife
Important information
- See monitoring requirements - see below
- There are numerous important interactions - check current BNF
- See under 'Dose' for adjustments required in renal impairment
Available preparations
Rifadin 600mg vial
Reconstitution
Solvent provided
- 10mL solvent per 600mg vial
- Swirl vial gently to completely dissolve powder
- The solution is red in colour
Dilute further prior to administration
Infusion fluids
Sodium chloride 0.9% or Glucose 5%
Methods of intravenous administration
Intermittent intravenous infusion
- Add required dose to 500mL infusion fluid and administer over 2 to 3 hours
- Fluid restricted (use a large vein): 600mg in 100mL infusion fluid over 30 minutes (unlicensed). This solution is less stable, watch closely for precipitation (ref 1)
Dose in adults
Tuberculosis, in combination with other anti-tuberculous drugs
- Give 8 to 12mg/kg (to a maximum of 600mg (ref 3)) as a single daily dose
- A reduced dose (e.g. 8mg per kg daily) is recommended in elderly or frail patients
Non-tuberculous infections (for example: Brucellosis, Legionnaires disease, endocarditis and serious staphylococcal infections (in combination with other drugs)
- For patients over 50kg: Give 450mg twice daily, or 300mg three times daily
Hepatic impairment
- A daily dose of 8mg/kg should not be exceeded in patients with impaired liver function
Renal impairment (ref 2)
- If eGFR less than 30mL/min/1.73m2
- Tuberculosis: Usual dose (ref 4)
- Other infections: use 50 to 100% of dose. Use doses >600mg with caution
- There is no increase in half-life in severe renal impairment for doses less than 600mg daily
Monitoring
- Monitor baseline LFTs, FBC and platelets. Monitor Bilirubin, serum creatinine
- Hypersensitivity phenomena may occur (affecting platelets, vascular tissues and renal function)
- Anaphylaxis may occur, especially with intermittent therapy (e.g.two to three times weekly dosing)
- If hepatic impairment, use with caution. Use lower doses and monitor LFTs every two to four weeks during therapy
Further information
- Avoid extravasation during injection; local irritation and inflammation due to extravascular infiltration of the infusion have been observed. If these occur, the infusion should be discontinued and restarted at another site
- May cause red discolouration of urine, sweat, sputum and tears
- Consider IV to oral switch as soon as possible as excellent bioavailability
Storage
- Store below 250C
- The prepared infusion bag must be used within 6 hours
References
SPC September 2024
1. Injectable Medicines Administration Guide Medusa, downloaded 08/05/2025
2. Renal Drug Database accessed online 08/05/2025
3. Martindale- accessed online via Medicines complete 20/05/2025
4. GAPP app- -accessed 20/05/2025
Therapeutic classification
Antibiotic
IV Guide Type