RIFASYNT Hard gelatin capsule Ref.[28306] Active ingredients: Rifampicin

Source: Υπουργείο Υγείας (CY)  Revision Year: 2018  Publisher: MEDOCHEMIE LTD, 1-10 Constantinoupoleos street, 3011 Limassol, Cyprus

4.1. Therapeutic indications

  • Tuberculosis: In combination with other active anti-tuberculosis drugs in the treatment of all forms of tuberculosis, including fresh, advanced, chronic and drug-resistant cases. Rifasynt is also effective against most atypical strains of Mycobacteria.
  • Prophylaxis of meningococcal meningitis: For the treatment of asymptomatic carriers of N. Meningitides to eliminate meningococci from the nasopharynx.
  • Leprosy: In combination with at least one other active anti-leprosy drug in the management of multibacillary and paucibacillary leprosy to effect conversion of the infectious state to a non-infectious state.
  • Other Infections: In the treatment of Brucellosis, Legionnaires Disease, and serious staphylococcal infections. To prevent emergence of resistant strains of the infecting organisms, Rifasynt should be used in combination with another antibiotic appropriate for the infection.
  • Haemophilus influenzae: For the treatment of asymptomatic carriers of H.influenzae and as chemoprophylaxis of exposed children, 4 years of age or younger.

4.2. Posology and method of administration

Posology

Tuberculosis

Rifasynt should be given with other effective anti-tuberculosis drugs to prevent the possible emergence of rifampicin-resistant strains of Mycobacteria.

Adults

The recommended single daily dose in tuberculosis is 8-12 mg/kg.

Usual daily dose:

Patients weighing less than 50kg: 450 mg.

Patients weighing 50kg or more: 600mg.

Paediatric population

In children, oral doses of 10-20mg/kg body weight daily are recommended although a total daily dose should not usually exceed 600mg.

Prophylaxis of meningococcal meningitis

Adults

600mg twice daily for 2 days.

Paediatric population

Children 1-12 years – 10mg/kg twice daily for 2 days.

Children 3 months – 1 year: 5 mg/kg twice daily for 2 days.

Leprosy

600 mg doses of rifampicin should be given once per month. Alternatively, a daily regimen may be used. The recommended single daily dose is 10 mg/kg.

Usual daily dose:

Patients weighing less than 50 kg: 450 mg.

Patients weighing 50kg or more: 600 mg.

In the treatment of leprosy, rifampicin should always be used in conjunction with at least one other antileprosy drug.

Brucellosis, Legionnaires Disease or serious staphylococcal infections

Adults

The recommended daily dose is 600-1200 mg given in 2 to 4 divided doses, together with another appropriate antibiotic to prevent the emergence of resistant strains of the infecting organisms.

Prophylaxis of Haemophilus influenzae

Adults

For members of households exposed to H. influenzae B disease when the household contains a child 4 years of age or younger, it is recommended that all members (including the child) receive rifampicin 20 mg/kg once daily (maximum daily dose 600 mg) for 4 days.

Index cases should be treated prior to discharge from hospital.

Neonates (1 month)

10 mg/kg daily for 4 days.

Paediatric population

Children – as for adults.

Impaired liver function

A daily dose of 8mg/kg should not be exceeded in patients with impaired liver function.

Elderly

In elderly patients the renal excretion of rifampicin is decreased proportionally with physiological decrease of renal function; due to compensatory increase of liver excretion, the terminal half-life in serum is similar to that of younger patients. However as increased blood levels have been noted in one study of rifampicin in elderly patients, caution should be exercised in using rifampicin in such patients, especially if there is evidence of impaired liver function.

Method of administration

For oral administration.

The daily dose of Rifasynt, calculated from the patient’s body weight, should preferably be taken at least 30 minutes before a meal or 2 hours after a meal to ensure rapid and complete absorption.

4.9. Overdose

Human Experience

Signs and Symptoms

Nausea, vomiting, abdominal pain, pruritus, headache and increasing lethargy will probably occur within a short time after acute ingestion; unconsciousness may occur when there is severe hepatic disease. Transient increases in liver enzymes and/or bilirubin may occur. Brownish-red or orange colouration of the skin, urine, sweat, saliva, tears and faeces will occur, and its intensity is proportional to the amount ingested. Facial or periorbital oedema has also been reported in paediatric patients. Hypotension, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest were reported in some fatal cases.

The minimum acute lethal or toxic dose is not well established. However, nonfatal acute overdoses in adults have been reported with doses ranging from 9 to 12 g rifampicin. Fatal acute overdoses in adults have been reported with doses ranging from 14-60 g. Alcohol or a history of alcohol abuse was involved in some of the fatal and nonfatal reports.

Nonfatal overdoses in paediatric patients ages 1 to 4 years old of 100 mg/kg for one to two doses have been reported.

Management

Intensive supportive measures should be instituted and individual symptoms treated as they arise. Since nausea and vomiting are likely to be present, gastric lavage is probably preferable to induction of emesis. Following evacuation of the gastric contents, the instillation of activated charcoal slurry into the stomach may help absorb any remaining drug from the gastrointestinal tract. Antiemetic medication may be required to control severe nausea and vomiting. Active diuresis (with measured intake and output) will help promote excretion of the drug. Haemodialysis may be of value in some patients.

6.3. Shelf life

3 years.

6.4. Special precautions for storage

Store below 25°C, in the original package, in order to be protected fromprotected from light.

6.5. Nature and contents of container

Capsules are available packed in aluminium foil – polyvinylchloride film blisters.

Rifasynt 150mg caps: Cartons containing 8, 10 and 100 capsules are available.

Rifasynt 300mg caps: Cartons containing 8, 20, 100 capsules and hospital packs of 1000 capsules are available.

Not all pack sizes may be marketed.

6.6. Special precautions for disposal and other handling

For oral administration only.

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