Rifabutin Antibiotic: Uses, Dosage, Side Effects & Interactions

Summary of Key Points

Rifabutin is an antibiotic used to treat various bacterial infections, including tuberculosis and infections related to HIV. It works by inhibiting bacterial growth and is often prescribed for individuals with weakened immune systems. Common side effects include nausea, skin rashes, and changes in urine color. Always consult your healthcare provider before starting or adjusting your dose. You can schedule a telemedicine visit with one of our providers for personalized advice.

Names of Medication

US Brand Name: Mycobutin (Rifabutin)

The generic name refers to the active ingredient in the medication, listed in parentheses. It is often more affordable than the brand name but works in the same way.

Pharmacologic Category

Antibiotic, Antitubercular

Rifamycin Derivative

Rifabutin Dosage

Rifabutin is prescribed for a variety of conditions. The dosage, frequency, and duration of treatment depend on the specific condition being treated. Always follow your doctor’s instructions and never adjust your dose without consulting them first. You can schedule a telemedicine appointment with one of our providers to discuss your treatment plan.

Tuberculosis (TB): 300 mg once daily for 6 months to 1 year, depending on the severity of the condition and response to treatment.

Mycobacterium avium complex (MAC) in HIV patients: 300 mg once daily, typically taken as long as the patient remains at risk of infection.

Leprosy: 300 mg once daily, usually combined with other medications, for 6-12 months.

Nontuberculous mycobacterial infections: 300 mg once daily, with the duration based on the infection and response to treatment.

Bacterial infections: 300 mg once daily, with the duration depending on the type and severity of the infection.

HIV-related infections: 300 mg once daily, typically continued as long as the patient remains at risk.

Chronic granulomatous disease: 300 mg once daily, with the duration based on the patient’s condition and response to treatment.

Osteomyelitis (bone infection): 300 mg once daily, usually for 6-12 weeks or longer, depending on the infection.

Endocarditis (heart infection): 300 mg once daily, typically for 4-6 weeks, depending on the infection.

Meningitis: 300 mg once daily, with the duration based on the severity and response to treatment.

Dosage Forms and Strengths

Capsules: 150 mg

Administration Instructions for Rifabutin

Rifabutin can be taken with or without food. If it causes stomach upset, try taking it with a meal. Swallow the capsule whole with a full glass of water. To maintain consistent levels of the medication in your body, take it at the same time each day. Do not stop taking Rifabutin unless instructed by your doctor, even if you start feeling better. Stopping the medication too early may cause the infection to return.

Rifabutin Side Effects and Adverse Reactions

Like all medications, Rifabutin can cause side effects. Some are common, while others are rare but more serious. If you experience any side effects, consult your healthcare provider immediately. You can also schedule a telemedicine visit with one of our providers to discuss any concerns.

Common Side Effects:

1. Nausea: Feeling queasy or sick to your stomach.
2. Rash: Skin irritation or redness.
3. Discoloration of body fluids: Rifabutin can cause urine, sweat, and tears to turn orange or reddish. This is harmless but can be surprising.

Less Common Side Effects:

1. Fever: A temporary rise in body temperature.
2. Muscle pain: Discomfort or soreness in the muscles.
3. Diarrhea: Loose or watery stools.

Serious Side Effects (Rare):

1. Severe allergic reactions: Swelling of the face, lips, or throat, difficulty breathing, or a severe rash. Seek immediate medical attention if these occur.
2. Liver problems: Symptoms such as yellowing of the skin or eyes, dark urine, or severe stomach pain. Contact your doctor immediately if you notice these signs.
3. Blood disorders: Unusual bruising or bleeding, or feeling unusually tired. These may indicate a blood-related issue.

Contraindications for Rifabutin

A contraindication is a specific situation where a medication should not be used because it may cause harm. It is important to be aware of contraindications to avoid serious side effects or complications.

Rifabutin is contraindicated in the following situations:

1. Allergy to Rifabutin or related drugs: If you have had an allergic reaction to Rifabutin or other rifamycin antibiotics (such as rifampin or rifapentine), you should not take Rifabutin. Allergic reactions can be severe and may include symptoms like rash, itching, swelling, or difficulty breathing.
2. Severe liver disease: Rifabutin is processed by the liver, and in people with severe liver disease, the medication may accumulate to toxic levels, leading to further liver damage or failure.
3. Active uveitis: Uveitis is an inflammation of the middle layer of the eye. Rifabutin can increase the risk of developing or worsening uveitis, especially in patients prone to this condition.

If you have any of these conditions, discuss them with your healthcare provider before starting Rifabutin. Our telemedicine providers are available to help you determine if Rifabutin is safe for you.

Rifabutin Drug Interactions

Rifabutin can interact with several other medications, increasing the risk of side effects or reducing the effectiveness of either Rifabutin or the other drugs. Below is a list of common medications that may interact with Rifabutin:

1. Protease inhibitors: Medications such as ritonavir (Norvir), atazanavir (Reyataz), and darunavir (Prezista). Rifabutin can reduce the effectiveness of these drugs, which are commonly used to treat HIV.
2. Oral contraceptives: Rifabutin can reduce the effectiveness of birth control pills, such as ethinyl estradiol/norgestimate (Ortho Tri-Cyclen). Alternative contraception should be used while taking Rifabutin.
3. Antifungal medications: Drugs like fluconazole (Diflucan) and itraconazole (Sporanox) can increase Rifabutin levels in the body, raising the risk of side effects.
4. Warfarin (Coumadin): Rifabutin can decrease the effectiveness of warfarin, a blood thinner, increasing the risk of blood clots.
5. Macrolide antibiotics: Clarithromycin (Biaxin) and azithromycin (Zithromax) can increase the risk of side effects when taken with Rifabutin.

Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. If you are unsure about potential interactions, our telemedicine providers can review your medication list and provide guidance.

Rifabutin in Pregnancy

Is it safe to take Rifabutin when pregnant?

Rifabutin is classified as a Category B drug by the FDA for use during pregnancy. This means that while animal studies have not shown harm to the fetus, there are no well-controlled studies in pregnant women. Rifabutin may be prescribed during pregnancy if the potential benefits outweigh the risks. It is essential to have a thorough discussion with your healthcare provider, who will evaluate your specific situation and determine whether Rifabutin is the best option for you. If you are pregnant or planning to become pregnant, consider scheduling a telemedicine consultation with one of our providers to explore your treatment options.

Rifabutin while Breastfeeding

Is it safe to take Rifabutin while breastfeeding?

There is limited information on whether Rifabutin passes into breast milk. Due to the potential for serious side effects in a nursing infant, it is generally recommended to avoid breastfeeding while taking Rifabutin. If you are breastfeeding or planning to breastfeed, it is important to discuss this with your healthcare provider. They can help you weigh the risks and benefits and explore alternative treatments if necessary. Our telemedicine providers are available to guide you through this decision-making process.

Estimated Cost of Rifabutin Medication

The estimated cost of a 30-day supply of Rifabutin (150 mg capsules) without insurance ranges from $300 to $500, depending on the pharmacy and location. With a GoodRx coupon, the price may drop to around $200 to $350. Prices can vary, so it’s a good idea to check with your pharmacy or use a prescription discount service like GoodRx to find the best available price.

Possible Alternatives to Rifabutin

If Rifabutin is not suitable for you, there may be alternative treatments or lifestyle changes available. Always consult your healthcare provider before making any changes to your treatment plan.

Alternative Medications for Tuberculosis

Alternatives include rifampin, isoniazid, and ethambutol. Additionally, lifestyle changes such as improving nutrition and avoiding smoking may help support your immune system.

Alternatives for Mycobacterium Avium Complex (MAC)

Alternatives include clarithromycin or azithromycin. In some cases, a combination of antibiotics may be necessary. Your healthcare provider can help determine the best treatment plan for your condition.

Leprosy Treatment Alternatives

Dapsone and clofazimine are common alternatives. Early diagnosis and treatment are critical to preventing complications.

Alternatives for Nontuberculous Mycobacterial Infections

Azithromycin, clarithromycin, and ethambutol may be used as alternatives. Treatment often requires a combination of antibiotics for the best results.

Alternative Antibiotics for Bacterial Infections

Depending on the type of infection, other antibiotics such as amoxicillin or ciprofloxacin may be considered as alternatives.

HIV-Related Infections and Rifabutin Alternatives

Antiretroviral therapy (ART) is the cornerstone of HIV treatment. Rifabutin may be used alongside ART for certain infections, but alternatives like rifampin may also be considered depending on the specific case.

Chronic Granulomatous Disease Treatment

Prophylactic antibiotics like trimethoprim-sulfamethoxazole (Bactrim) are commonly used. In some cases, interferon-gamma therapy may also be considered.

Osteomyelitis Treatment Options

Treatment may involve other antibiotics such as vancomycin or ceftriaxone. In some cases, surgery may be necessary to address the infection.

Endocarditis Treatment Alternatives

Depending on the bacteria causing the infection, alternatives may include penicillin, vancomycin, or gentamicin. In severe cases, surgery may be required to repair or replace damaged heart tissue.

Meningitis Treatment Options

Treatment depends on the cause of the infection. Alternatives may include ceftriaxone, vancomycin, or ampicillin, depending on the type of bacteria involved.

It is important to consult with your healthcare provider before making any changes to your treatment. Our telemedicine providers are available to discuss these alternatives and help you find the best option for your condition.

Recent Updates on Rifabutin Research

Recent studies have focused on using Rifabutin in combination with other antibiotics to treat drug-resistant tuberculosis and Mycobacterium avium complex (MAC) infections. Researchers are also exploring the potential of Rifabutin for shorter, more effective tuberculosis treatment regimens, which could improve patient adherence and outcomes.

Additionally, ongoing research is investigating Rifabutin’s use in HIV-positive patients to prevent opportunistic infections like MAC. New studies are examining how Rifabutin interacts with newer antiretroviral therapies to ensure patients receive the most effective and safe treatment combinations.

As research continues, staying informed about the latest developments is essential. If you have questions about how new research might impact your treatment, our telemedicine providers are available to discuss the latest findings and how they apply to your care.

James Kingsley

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