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