Rifampin — what it does and why people take it

Rifampin (also called rifampicin) is a powerful antibiotic most often used to treat tuberculosis and other serious infections. Doctors usually give it as part of a combination of antibiotics for active TB so bacteria don’t become resistant. You may also see rifampin used for some types of staph infections or to prevent meningococcal disease in close contacts — but that’s decided case-by-case by a clinician.

How rifampin works and common dosing notes

Rifampin kills bacteria by blocking their ability to make RNA. That’s why it’s usually combined with other drugs rather than used alone. A common adult dose for TB treatment is 600 mg once daily, but exact dosing and length of therapy depend on the infection and your doctor’s plan. Rifampin is best taken on an empty stomach — at least one hour before or two hours after a meal — because food can lower how much drug your body absorbs.

Side effects, key interactions, and simple safety tips

Expect orange or red discoloration of urine, sweat, saliva, and even contact lenses — it’s harmless but can be surprising. The most serious concern is liver damage: your provider will usually check liver function before and during treatment. Call your doctor right away if you get yellow skin or eyes, dark urine, persistent nausea, or stomach pain.

Rifampin is a very strong enzyme inducer. That means it can lower blood levels of many other drugs, sometimes making them ineffective. Big examples include hormonal birth control, warfarin, certain HIV medicines, some antifungals, and many statins. If you take any regular meds, tell your prescriber and pharmacist so they can adjust doses or offer alternatives. If you rely on oral contraceptives, use a reliable backup method while on rifampin and for a short time after stopping it.

Don’t stop rifampin suddenly without talking to your clinician. Skipping doses or stopping early can let bacteria survive and become resistant. If you miss one dose, follow your prescriber’s advice — often you take it as soon as you remember unless it’s nearly time for the next dose.

Simple day-to-day tips: store pills in a cool, dry place; avoid heavy alcohol while taking rifampin because both can stress the liver; bring your medication list to every appointment so drug interactions aren’t missed. If you wear soft contact lenses, consider switching to glasses while on treatment to avoid staining.

Rifampin is an important drug when used correctly. Ask questions, get baseline labs if recommended, and stay in touch with your healthcare team while you take it — that’s the best way to stay safe and make the treatment work.