Applies to rifampin: oral capsule. Other dosage forms:

• intravenous powder for solution

Serious side effects of Rifampin

Along with its needed effects, rifampin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking rifampin:

Rare

• Agitation
• bleeding gums
• blood in the urine or stools
• bruising
• chest tightness
• confusion
• cough
• coughing or vomiting blood
• dark urine
• darkening of the skin
• decreased frequency or amount of urine
• difficulty in breathing and swallowing
• dizziness
• fainting
• fast heartbeat
• fever with or without chills
• general feeling of tiredness or weakness
• headache
• hives
• hoarseness
• hostility
• increased blood pressure
• increased thirst
• irritability
• light-colored stools
• loss of appetite
• lower back or side pain
• mental depression
• nausea
• painful or difficult urination
• persistent bleeding or oozing from puncture sites, mouth, or nose
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• skin itching, rash, or redness
• sores, ulcers, or white spots on the lips or in the mouth
• stomach pain
• swelling of the face, ankles, fingers, hands, or lower legs
• unusual bleeding or bruising
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• vomiting
• weight gain
• yellow eyes or skin

Incidence not known

• Bleeding under the skin
• blistering, peeling, or loosening of the skin
• bloating
• bloody, severe, or watery diarrhea
• bloody nose
• bone pain
• chest pain
• chills
• cold, clammy skin
• diarrhea
• difficulty with speaking
• double vision
• dry cough
• fast, weak pulse
• general feeling of discomfort or illness
• heavier menstrual periods
• inability to move the arms, legs, or facial muscles
• inability to speak
• increased menstrual flow or vaginal bleeding
• joint or muscle pain
• lightheadedness
• muscle aches
• night sweats
• nosebleeds
• pale skin
• paralysis
• pinpoint red spots on the skin
• prolonged bleeding from cuts
• red or black, tarry stools
• red or dark brown urine
• red skin lesions, often with a purple center
• red, irritated eyes
• runny nose
• shivering
• slow speech
• sore throat
• sores, welts, blisters
• sweating
• swelling of the fingers, feet, or lower legs
• swelling or puffiness of the face
• swollen glands
• trouble sleeping
• unpleasant breath odor
• unusual weight loss

Get emergency help immediately if any of the following symptoms of overdose occur while taking rifampin:

Symptoms of overdose

• Blurred vision
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast, pounding, or irregular heartbeat or pulse
• feeling of fullness in the upper abdomen or stomach
• low blood pressure or slow pulse
• pain in the upper abdomen or stomach
• reddish-orange to reddish-brown color of the urine, stool, saliva, sputum, sweat, and tears
• seizures
• swelling around the eyes or face
• unconsciousness
• yellow eyes or skin

Other side effects of Rifampin

Some side effects of rifampin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

• Feeling that others are watching you or controlling your behavior
• feeling that others can hear your thoughts
• feeling, seeing, or hearing things that are not there
• muscle tenderness, wasting, or weakness
• severe mood or mental changes
• unusual behavior

Incidence not known

• Belching
• bloated or full feeling
• excess air or gas in the stomach or bowels
• indigestion
• not able to concentrate
• pain or discomfort in the chest, upper stomach, or throat
• tooth discoloration

For Healthcare Professionals

Applies to rifampin: compounding powder, intravenous powder for injection, oral capsule.

Dermatologic

Uncommon (0.1% to 1%): Serious cutaneous reactions

Frequency not reported: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, erythema multiforme, face edema, itching with/without rash, mild cutaneous reactions, pemphigoid reaction, pruritus, rash, self-limiting cutaneous reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria^[Ref]

Hypersensitivity

Hypersensitivity reactions included acute renal failure, acute tubular necrosis, hematuria, hemoglobinuria, hemolysis, interstitial nephritis, renal insufficiency, and serious cutaneous reactions.^[Ref]

Uncommon (0.1% to 1%): Hypersensitivity reactions

Rare (0.01% to 0.1%): Anaphylaxis^[Ref]

Renal

Acute renal failure, acute tubular necrosis, interstitial necrosis, renal insufficiency were hypersensitivity reactions and usually occurred during intermittent therapy or during the resumption of intentional/accidental interruption of a daily dosage regimen. The effects were usually reversible when treatment was discontinued and appropriate therapy was instituted.^[Ref]

Rare (0.01% to 0.1%): Acute renal failure, acute tubular necrosis, interstitial nephritis, renal insufficiency

Frequency not reported: Blood urea nitrogen elevations^[Ref]

Hematologic

Thrombocytopenia usually occurred with high-dose intermittent therapy, but has occurred with well-supervised daily therapy and after resumption of interrupted treatment; the effect is reversible if treatment is discontinued as soon as purpura occurs.

Hemolysis was a hypersensitivity reaction and usually occurred during intermittent therapy or during the resumption of intentional/accidental interruption of a daily dosage regimen. This effect was usually reversible when treatment was discontinued and appropriate therapy was instituted.^[Ref]

Rare (0.01% to 0.1%): Disseminated intravascular coagulation, hemolysis, thrombocytopenia

Very rare (less than 0.01%): Agranulocytosis

Frequency not reported: Decreased hemoglobin, eosinophilia, hemolytic anemia, leukopenia^[Ref]

Hepatic

Rare (0.01% to 0.1%): Abnormal liver function tests, hepatitis, shock-like syndrome with hepatic involvement

Frequency not reported: Jaundice, transient liver function test abnormalities, serum bilirubin elevations, serum transaminase elevations^[Ref]

Genitourinary

Rare (0.01% to 0.1%): Hematuria, hemoglobinuria

Frequency not reported: Menstrual disturbances^[Ref]

Hematuria and hemoglobinuria were hypersensitivity reactions and usually occurred during intermittent therapy or during the resumption of intentional/accidental interruption of a daily dosage regimen. The effects were usually reversible when treatment was discontinued and appropriate therapy was instituted.^[Ref]

Musculoskeletal

Bone pain was included in flu syndrome, and occurred in patients receiving intermittent regimens; however, this event may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Rare (0.01% to 0.1%): Myopathy

Frequency not reported: Bone pain, extremity pain, muscular weakness^[Ref]

Psychiatric

Rare (0.01% to 0.1%): Psychoses

Frequency not reported: Behavioral changes, mental confusion^[Ref]

Endocrine

Rare (0.01% to 0.1%): Adrenal insufficiency^[Ref]

Adrenal insufficiency occurred in patients with compromised adrenal function.^[Ref]

Gastrointestinal

Frequency not reported: Cramps, diarrhea, epigastric distress, flatulence, heartburn, nausea, pseudomembranous colitis, sore mouth, sore tongue, tooth discoloration/permanent tooth discoloration, vomiting^[Ref]

Nervous system

Cerebral hemorrhage occurred in patients who continued or resumed treatment after the appearance of purpura.

Dizziness and headache were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Frequency not reported: Ataxia, cerebral hemorrhage, dizziness, drowsiness, generalized numbness, headache, inability to concentrate^[Ref]

Cardiovascular

Frequency not reported: Decreased blood pressure, extremity edema, flushing with/without rash, shock, vasculitis^[Ref]

Decreased blood pressure and shock were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Other

Chills and fever were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.

Fatalities occurred in patients who continued or resumed treatment after the appearance of purpura.^[Ref]

Frequency not reported: Chills, fatalities, fatigue, fever^[Ref]

Metabolic

Frequency not reported: Alkaline phosphatase elevations, anorexia, serum uric acid elevations^[Ref]

Ocular

Frequency not reported: Conjunctivitis, visual disturbances^[Ref]

Immunologic

Flu syndrome occurred in patients receiving intermittent regimens, but may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Frequency not reported: Flu syndrome^[Ref]

Respiratory

Shortness of breath and wheezing were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Frequency not reported: Shortness of breath, wheezing^[Ref]