Rifampin
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Rifampin is a rifamycin antibiotic that used against bacterial pathogens. Examples of these pathogens include the Mycobacterium tuberculosis that causes tuberculosis, Hemophilus influenza that causes respiratory symptoms and Neisseria meningitides that cause meningitis and respiratory symptoms.The mechanism of action of rifampin is binding to the beta subunit of the DNA-dependent RNA polymerase in bacteria and therefore arrests RNA production and consequently protein synthesis. It is effective in tuberculosis since it can penetrate the body tissues to reach the bacteria and it is selective for the bacterial polymerase, sparing the human cells.
Sanofi-Aventis is the company that produces rifampin under the brand names Rifadin and Rifadin IV. It is also produced in preparations that target the mycobacteria by taking advantage of combination medication that exerts their effects at different sites or through different mechanisms resulting in synergistic action. Under the brand name rifamate, the company produces rifampin and isoniazid as a combination medication.
The company, Sanofi-Aventis, can be contacted through their website www.sanofi.us. Alternatively, the company can be reached through its address Sanofi-Aventis U.S. LLC, 55 Corporate Drive, Bridgewater, NJ 00807. They can also be reached by phone at (800)981-2491,
Rifampicin is a rifamycin. This group of drugs acts by inhibiting the bacterial protein metabolism at the molecular level.
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They all prevent the synthesis of DNA-dependent RNA polymerase. They have a shared chemical structure of an ansa carbon chain derived from propionate and acetate with a seven-carbon amino acid chain. They therefore also share the mechanisms of action, side effects profile, and the possible adverse effects. Even the list of susceptible organisms is similar between different rifamycins. There are three other drugs in the rifamycin class. These include rifabutin, rifaximin, and rifapentine
Due to their shared structure, the rifamycins are comparable in their pharmacokinetics and pharmacodynamics. Rifampin is the standard for the class. The liver excretes the drug, rifampin, into bile, and a little is cleared by the kidneys in urine. Its excretion is not complicated by many factors and therefore, there is no need for dose adjustments in hepatic failure and renal insufficiency. Its chemical properties allow for it to be widely distributed in body fluids. Adequate levels are achieved regarding its CSF concentrations only in meningeal inflammation. Adverse effects include rashes, nephritis, acute tubular necrosis, and thrombocytopenia.
Rifabutin has a similar profile as rifampin. Notably, the mechanism of resistance is similar for both rifampin and rifabutin. Therefore, rifabutin cannot be used as a substitute where rifampicin fails. Unlike rifampin, rifabutin is a much weaker inducer of cytochrome enzymes. Its effect in combination with other medication may not be as pronounced as wth rifampin. It is a good substitute for rifampin where the patients are on medication that may be rapidly metabolized with rifampin. A case in point is the patient on antiretrovirals which may be less effective with the concomittant administration of rifampin.
Rifapentine is very similar to rifampin in toxicity and efficacy and even shares a side effects profile with rifampin. However, rifapentine has microbiologically active metabolites such as 25-desacetylrifapentine, which prolongs its duration of action. The half-life is 13 hours. It can, therefore, be used for instances where rifamycin action is desirable, yet the dosing does not allow for frequent administration of medication, or where longer durations of action are desirable.
Rifampin is active against Mycobacterium and is most commonly used to treat, manage or prevent tuberculosis. It has more side effects than rifabutin and a shorter duration of action than rifapentine. Rifampin is the most commonly used of the three because it is much more affordable.
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