NEODOSE

INDICATIONS

• Anthrax: meningitis or disseminated infection and meningitis cannot be ruled out.
• Anthrax: Systemic Anthrax (meningitis or disseminated infection and meningitis cannot be ruled out) (IV)
• H influenzae type b; Prophylaxis
• N meningitidis; Prophylaxis
• Infective Endocarditis The following recommendations are based on a consensus of experts:
• 
• Staphylococcal infections (persistent): in combination with vancomycin or aminoglycosides

CONTRAINDICATIONS

Contraindicated in patients receiving ritonavir-boosted saquinavir; in patients receiving atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir; and concomitant use with praziquantel or within 4 weeks prior to praziquantel use (may restart rifampin 1 day after end of praziquantel treatment)

PRECAUTIONS

• Administration:
  • Doses greater than 600 mg once or twice weekly; increased risk of serious adverse effects, including shortness of breath, shock, anaphylaxis, and renal failure.
  • Rifadin® IV is for intravenous infusion only.
• Concomitant use:
  • Concomitant use of cefazolin and rifampin in patients at increased risk for bleeding, avoid use; prolongation of prothrombin time may occur and lead to severe, lifethreatening or fatal, vitamin K-dependent coagulation disorder. If no other option available, close monitoring required .
  • Concomitant use with halothane should be avoided.
• Dermatologic: Local irritation and inflammation due to extravascular infiltration has been observed
• Endocrine & Metabolic: Diabetes mellitus; diabetes management may be more difficult.
• Hematologic: Coagulation disorders that are vitamin K-dependent may occur; monitoring recommended in patients at risk of vitamin K deficiency (eg, chronic liver disease, poor nutritional status, on prolonged antibacterial drugs or anticoagulants) and consider discontinuation if abnormal coagulation tests and/or bleeding occurs.
• Hepatic: Hepatotoxicity of hepatocellular, cholestatic, and mixed patterns have been reported with severity ranging from asymptomatic elevations in liver enzymes, isolated jaundice/hyperbilirubinemia, symptomatic self-limited hepatitis to fulminant liver failure anddeath. Severe hepatic dysfunction, including fatalities, have been reported in patients with liver dysfunction and concomitant hepatotoxic agents; monitoring is recommended and discontinuation may be necessary.
• Immunologic: Systemic hypersensitivity reactions have been reported and may manifest as fever, lymphadenopathy, or laboratory abnormalities (including eosinophilia, liver abnormalities) with or without rash; monitoring recommended and discontinue therapy if signs or symptoms occur
• Renal: Renal hypersensitivity reactions have been reported upon resuming therapy after intentional or accidental interruption of daily regimen

ADVERSE EFFECTS

May cause rgb(250, 250, 152)/orange/red/greenyellow discoloration of sweat, urine, tears, sputum, or teeth . Extravasation may cause local irritation and inflammation. RifAMPin in a potent inducer of several cytochrome P450 enzymes. If administered concomitantly, the following drugs may have decreased pharmacologic effects due to increased metabolism: aminophylline, amiodarone, cimetidine, corticosteroids, digoxin, enalapril, fluconazole, midazolam, morphine, phenobarbital, phenytoin, propranolol, and zidovudine.

ADMINISTRATION

Intravenous: Administer by intermittent IV infusion over 30 minutes to 3 hours at a concentration not exceeding 6 mg/mL. Avoid extravasation during infusion.

MONITORING

Monitor hepatic transaminases and bilirubin. Periodic CBC for thrombocytopenia. Observe IV site for signs of extravasation.