Rifapentine

Rifapentine is used with other medications to treat active tuberculosis (TB; a serious infection that affects the lungs and sometimes other parts of the body) in adults and children 12 years of age and older. Rifapentine is also used with isoniazid (Laniazid) to treat adults and children 2 years of age and older with latent (resting or nongrowing) TB, including those in close contact with people who have active TB, a positive tuberculin skin test, human immunodeficiency virus (HIV), or those with pulmonary fibrosis (scarring of the lungs with an unknown cause). Rifapentine is in a class of medications called antimycobacterials. It works by killing the bacteria that cause infection.

Antibiotics such as rifapentine will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Rifapentine comes as a tablet to take by mouth. When rifapentine is used to treat active TB, it is usually taken with food twice weekly, with doses at least 3 days apart, for the first 2 months and then once weekly for 4 months. When rifapentine is used to treat latent TB infection, it should be with food taken once every week. Take rifapentine at around the same time every scheduled day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rifapentine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are unable to swallow the tablets, you can crush them and mix the medication in a small amount of semisolid food such as pudding or applesauce. Swallow the mixture right away; do not store it for later use.

Continue to take rifapentine until you finish the prescription even if you feel better, and be careful not to miss doses. If you stop taking rifapentine too soon, your infection may not be completely treated and the bacteria may become resistant to antibiotics. If you miss doses of rifapentine, you may develop uncomfortable or serious symptoms when you begin to take the medication again.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking rifapentine,

• tell your doctor and pharmacist if you are allergic to rifapentine, rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), rifaximin (Xifaxan), any other medications, or any of the ingredients in rifapentine tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antibiotics medications such as chloramphenicol, ciprofloxacin (Cipro), clarithromycin (Biaxin, in Prevpac), dapsone, and doxycycline (Doryx, Monodox, Vibramycin, others); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), and ketoconazole; calcium channel blockers such as diltiazem (Cardizem, Taztia, Tiazac, others), nifedipine (Adalat, Afeditab, Procardia), and verapamil (Calan, Covera, Verelan); clofibrate (Atromid-S; no longer available in U.S.); cyclosporine (Gengraf, Neoral, Sandimmune); diazepam (Valium); digoxin (Lanoxin); disopyramide (Norpace); glyburide (Diabeta, Glynase); glipizide (Glucotrol); haloperidol (Haldol); HIV medications; levothyroxine (Levoxyl, Synthroid, Tirosint); methadone (Dolophine, Methadose); mexiletine, phenobarbital; phenytoin (Dilantin, Phenytek); prednisone (Rayos); propranolol (Hemangeol, Inderal, InnoPran); quinidine (in Nuedexta), quinine (Qualaquin); sildenafil (Revatio, Viagra); tacrolimus (Astagraf, Envarsus, Prograf); theophylline (Elixophyllin, Theochron, Uniphyl); tocainide (Tonocard; no longer available in U.S.); and tricyclic antidepressants such as amitriptyline and nortriptyline (Pamelor). Many other medications may interact with rifapentine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you are taking or using hormonal contraceptives (birth control pills, patches, rings, implants, and injections). Rifapentine can decrease the effectiveness of hormonal contraceptives. You should use another method of birth control while taking this medication. Talk to your doctor about birth control while taking rifapentine.

• tell your doctor if you have active TB or if you were unresponsive to other TB medications or if you have or have ever had porphyria (condition in which certain natural substances build up in the body and may cause stomach pain, changes in thinking and behavior, or other symptoms), HIV infection, or liver disease.

• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking rifapentine, call your doctor.

• do not breastfeed while taking rifapentine. Rifapentine may cause breast milk to turn reddish-orange.

• tell your doctor if you wear soft contact lenses or dentures. Rifapentine may cause permanent red stains on your contact lenses or dentures.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

• Rifapentine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • temporary discoloration (yellow, reddish-orange, or brown color) of your skin, teeth, saliva, urine, stool, sweat, and tears

  • dizziness

  • fainting

  • increased sweating

• Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • diarrhea (up to 2 months after your treatment)

  • rash

  • itching

  • hives

  • cough with wheezing

  • difficulty breathing

  • red, itchy, or irritated eyes

  • fever

  • blisters

  • changes in thinking and behavior

  • swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs

  • fast or irregular heartbeat

  • nausea

  • vomiting

  • chest pain

  • flu-like symptoms such as fever, chills, muscle aches, muscle pain, tiredness, and headache

  • stomach pain

  • loss of appetite

  • dark urine

  • joint pain or swelling

  • yellowing of the skin or eyes

• Rifapentine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

• If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• blood in urine

• itching

• body pain or stiffness

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to rifapentine.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking rifapentine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.