In the treatment of rifampicin, disorders of the function of the gastrointestinal tract (decreased appetite, nausea, vomiting, diarrhea) are possible. These phenomena usually pass independently in 2-3 days without drug withdrawal.
Rifampicin can have a hepatoxic effect (an increase in the content of transaminases and bilirubin in the serum, jaundice). For the timely detection andprevention of hepatotoxicity, treatment with rifampicin should begin after a study of liver function (determining the level of bilirubin and aminotransferases in the blood, timol test), and in the treatment process carried out monthly. In patients who have had past hepatitis or who suffer from cirrhosis of the liver, these studies should be conducted every 2 weeks. Moderate dysfunctions of the liver usually have a transient nature and can disappear without drug discontinuation in the appointment of allochol, methionine, pyridoxine, vitamin B12. With increasing phenomena of violations of liver function, rifampicin should be discontinued.
In the treatment of rifampicin may develop leukopenia and thrombocytopenia, allergic reactions. The latter manifest themselves in the form of skin eruptions, eosinophilia, rarely - bronchospasm and Quincke's edema. With intermittent treatment, irregular drug intake, or with the resumption of treatment with rifampicin after a break, severe allergic reactions may occur in the form of urticaria, influenza-like fever, acute renal-hepatic insufficiency, thrombopenic purpura.These complications are sometimes preceded by signs of drug sensitization (rise in temperature after taking the drug, increasing eosinophilia, bronchospasm, interstitial nephritis, induction of porphyria, etc.).
To prevent these phenomena, the drug should be administered in small doses (150 mg per day). In cases when signs of sensitization to rifampicin have been observed at the previous stage of treatment, it is used under control, temperature changes after taking the drug (within 3 hours at 2-3 day intervals). With good tolerability, the dose of antibiotic can be increased to the usual therapeutic dose.
When allergic reactions occur
rifampicin abolish and conduct desensitizing therapy (antihistamines, calcium preparations, glucocorticosteroid hormones). In cases of severe allergic reactions, it is necessary to administer parenterally large doses of glucocorticosteroid hormones, antihistamines, intravenous haemodes, isotonic sodium chloride solution, diuretics, etc.
In patients using the drug, urine, tear fluid, sputum becomes orange-red.