A semisynthetic anti-infection delivered from Streptomyces mediterranei. It has a wide antibacterial range, including movement against a few types of Mycobacterium. In defenseless living beings it restrains DNA-subordinate RNA polymerase action by shaping a steady mind boggling with the catalyst. It accordingly smothers the commencement of RNA union. Rifampin is bactericidal, and follows up on both intracellular and extracellular living beings.
Rifampicin which is otherwise called rifampin which is a semisynthetic anti-microbial and came about because of streptomycin mediterranei.It can act against various sorts of mycobacterium and has likewise an impact like wide antibacterial range. It hinders DNA-subordinate RNA polymerase action which is in the powerless life forms and at last shape a steady intricate with this sort of compound. It restrains the commencement of RNA synthesis.Rifampicin is bactericidal and follows up on both intracellular and extracellular life forms.
Mechanism of action: Rifampicin explicitly hinders bacterial RNA polymerase, the catalyst in charge of DNA translation, by forming a steady drug enzyme complex with a binding constant. Inhibiting bacterial DNA –dependent RNA polymerase which is responsible for suppress the bacterial DNA-dependent RNA synthesis. By physically blocking elongation, RNA synthesis prevented by the inhibitor and which is then prevent the synthesis of proteins of host bacteria.
Resistance to rifampicin
There are some safeguard instrument develop in microscopic organisms to rifampicin.The following are –
• Mutation: through transformation repo B quality (target site for rifampicin) mycobacteria diminish the fondness for the medication.
• Normalobstruction: by producing beta lactamase gram (-) microorganisms keep the entrance of medication to target sites.
• single treatment : utilizing rifampicin alone opposition grow rapidly than blend treatment
Rifampicin which is utilized in the treatment of tuberculosis. It is additionally connected in atypical mycobacterial infection. It works viably even there is a rifampicin resistance.As they are bactericidal and which ultimately acts on intra and extracellular.
Pharmacokinetics studies the ADME. It means absorption, distribution, metabolism and excretion.
Distribution: The distribution of drug is very elevated throughout our body.In body fluid and organs it contributes and effective concentration including CSF. About 60-90% of this drug which as properties to bound with plasma protein. Because of its high lipophilicity, it exhibits high tendency for distribution and tissue uptake.
Biotransformation:The metabolism is occurred by deacylation. But metabolite which is active antimicrobial. As it is a potent CYP450 inducer, which is also known as great inducer in clinical practice. The drug by which the metabolism is stimulated by the drug into inactive metabolite.
Absorption: Rifampicin is retain well from gut and GIT which is then generally circulated Excretion: Bile is the main way to continue the excretion process is continued about.
Rifampicin mainly use to treated bacteriological infection like-
• Common cold
• Flu like syndrome
? Rifampicin + Warfarin: Warfarin is an oral enemy of coagulant sedate. Rifampicin is a strong cytochrome P450 chemical inducer. At the point when organization this two medications in themeantime the movement of warfarin is lost. Since Rifampicin expands the digestion of Warfarin rapidly.
? Rifampicin + Saquinavir: Saquinavir is an enemy of viral medication. It is utilized uniquely in HIV infection. At the point when organization this two medications in the meantime, the movement of Saquinavir is lost. Since Rifampicin is an intense hepatic chemical inducer. So builds the digestion of saquinavir is rapidly, and the viral contamination not to be fix.
? Rifampicin +Propranolol, Digoxin, Morphine: Propranolol is an original non– specific beta blocker. Rifampicin is a powerful Cytochrome P450 chemical inducer. At the point when directed this medications in the meantime, diminished bioavailability of this specialists.
The most serious condition but in rare case arise when taken rifampicin such as-
• Respiratory syndrome
• Kidney failure
• Flu like syndrome
Combination therapy of Rifampicin
o Combination treatment is the synchronous organization of at least two prescription to treat a solitary medication which is a measurement from that contains in excess of one dynamic fixing.
o The blend treatment of Rifampicinwith isoniazid is utilized to treat TB tolerant. At the point when the TB causing microorganisms don’t reaction with that blend treatment as like Rifampicin with isoniazid with pyrazinamide.
o Blend treatment is vital in battle against medication opposition sedate obstruction is the procedure of decrease of adequacy of a prescription.
o Furthermore the it is likewise used to lessen the long term of time as like Rifampicin with isoniazid need to take 09 months whereas Rifampicin with isoniazid with pyrazinamide need to take 3 months.
o At last it likewise help to prevent ending up sick from the dynamic from of TB.
o The prescription is utilized in void stomach 30 minutes before meat or 2 hours after dinner.
Available Brand Name
Brand name DOSAGE STRENGTH DOSAGE FORM COMPANY PRICE
Rimactane 450mg Tablet Novartis(BD)Ltd. Price not available
G Rifampicin 450mg Capsule Gonoshasthaya pharma Ltd. Tk.6.09(unit price)
Firifam 150mg Tablet Sanofi bd Ltd. Price not available
Rifampicin 450mg Capsule Essential Drugs Ltd. Tk.9.28 (unit price)
Rifatan 100mg/5ml syrup Syrup Gaco laboratories Ltd. 60 ml bot.29.39 MRP
Rifcin 100mg/5ml syrup Syrup Pharmadesh laboratories Ltd. 60 ml bot.40.00 MRP
Overall we can say that rifampicin attach to the beta subunit of DNA dependent RNA polymerase in bacteria which forms possible mutations. RNA polymerase in human does not attach to rifampicin. Rifampicin is the most effective and potent drug among all antitubercular drugs.Dosage adjustment for renal or hepatic insuffiency is not important. After administrated orally it is absorbed very well and eliminated through the bile and liver. Rifampicin is distributed extensively in body fluids and other tissues. Rifampicin is extremely bound to protein and achieved enough cerebrospinal fluid concentration.So it proves that rifampicin is very good against tuberculosis with potential and effective antitubercular requirements.
• Baysarowich J, Koteva K, Hughes DW, Ejim L, Griffiths E, Zhang K, Junop M, Wright GD: Rifamycin antibiotic resistance by ADP-ribosylation: Structure and diversity of Arr. Proc Natl Acad Sci U S A. 2008 Mar 25;105(12):4886-91. doi: 10.1073/pnas.0711939105. Epub 2008 Mar 18. PubMed:18349144
• Essential of Medical Pharmacology , Sixth edition Author : KD Tripathi Page number :554 Chapter : 53 Sec: 12
• New England Journal of Medicine. (2018). Four Months of Rifampin or Nine Months of Isoniazid for Latent Tuberculosis in Adults | NEJM. online Available at: https://www.nejm.org/doi/full/10.1056/NEJMoa1714283 Accessed 25 Nov. 2018.
• PubFacts. (2018). Resistance to rifampicin: a review.. online Available at: https://www.pubfacts.com/detail/25118103/Resistance-to-rifampicin-a-review Accessed 25 Nov. 2018.
• Rifampicin/isoniazid/pyrazinamide/ethambutol and Isoniazid/rifampicin. (2017). Reactions Weekly, 1678(1), pp.155-155.
• vin, M. and Hatfull, G. (1993). Mycobacterium smegmatis RNA polymerase: DNA supercoiling, action of rifampicin and mechanism of rifampicin resistance. Molecular Microbiology, 8(2), pp.277-285