Rifabutin for Non-Mycobacterial Infections  (PDF Version)


Antibiotic Class:



Antimicrobial Spectrum:


Mechanism of Action:

Rifamycins bind to and inhibit DNA-dependant RNA polymerase



Most likely concentration dependent killing (peak:MIC)



Cmax: 0.2-0.6mg/L; Tmax: 2.5-4 hours; Bioavailability: 20%; Protein binding: 71-85%; Table 3


Adverse Effects:

Hepatic: hepatotoxicity, jaundice, hepatitis

Hematologic: Thrombocytopenia, hemolytic anemia

Musculo-skeletal: Arthralgias

Skin: Rash

GI: Nausea, vomiting, loss of appetite

Kidneys: Acute renal failure, interstitial nephritis,

Other: shock, flu-like syndrome (at least with related rifampin), body fluid discoloration (tears, sweat may be orange colored)





Precautions: Hepatic impairment


Drug Interactions:

Due to its known induction of P450 liver isoenzymes, caution should be exercised when administering this agent with other drugs metabolized in the liver. Please see the the “Drug Interactions” section in the text/website for a complete list of relevant interactions. Heparin may negate the action of rifabutin.



Category B: No evidence of risk in humans but studies inadequate


Monitoring Requirements:

Toxic: baseline liver function tests, bilirubin, serum creatinine, complete blood count and platelet count.


Brand names/Manufacturer:

Rifabutin (Various manufacturers worldwide)

Alfacid - Grunenthal, Germany

Ansamycin - Adria Laboratories

Ansatipine - Pharmacia, France

Ansatipin - Kenfarma, Spain, Finland

Mycobutin - Pharmacia , USA, Greece, Canada, Netherlands, Portugal, Switzerland, Australia, Austria, Belgium, Czech Republic, Germany, Hong Kong, Israel, Italy, New Zealand, South Africa, United Kingdom, Greece