Rifabutin

Definition
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Indication
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Tuberculosis, infections by atypical mycobacteria (MAI), prophylaxis of MAI infection in HIV patients with < 200 CD4 cells/μl.

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Dermatology

Coarse, reddish-brownishknot in the contact area of the violin at the transition from the lower j...

Geiger knot

Special form of the acne mechanica on the left side of the neck for violinists and viola players.

Limited indication
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Pregnancy, lactation, children < 14 years, severe liver and kidney failure.

Dosage and method of use
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Tuberculosis (combination therapy): 150 mg/day p.o., in case of immunosuppression 300 mg/day p.o.

MAI: 300 mg/day p.o. for up to 6 months after achieving negative cultures; in combination with clarithromycin, other macrolides or triazole antifungals 300 mg/day. In combination with indinavir: 150 mg/day p.o.

MAI prophylaxis: 300 mg/day p.o.

Reminder. Patients with soft contact lenses must be informed about the possibility of permanent discolouration of the lenses!

Undesirable effects
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Allergic reactions, skin discoloration and discoloration of body excretions after red-orange, headaches, sleep disorders, uveitis, chest pain, anemia, eosinophilia, leukopenia, neutropenia, thrombopenia, abdominal pain, myalgias.

Interactions
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See Table 1.

Contraindication
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Rifamycin hypersensitivity, acute hepatitis or cirrhosis of the liver, occlusive scterus, thrombocytopenia.

Preparations
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Mycobutin

Tables
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Major interactions of rifabutin

Quinidine	Quinidine effect ↓
Clarithromycin	Rifabutin toxicity (plasma levels around 80% ↑, possibly dose reduction).
Cotrimoxazole	Cotrimoxazole effect ↓
Coumarins	Coumarin effect ↓
Dapsone	Dapsone effect ↓
Didanosine	Palpitations, tachycardia
Fluconazole	Rifabutin levels around 80% ↑, possible dose adjustment.
Glucocorticoids	Glucocorticoid effect ↓
Cardiac glycosides	Cardiac glycoside effect ↓
Contraceptives, oral	contraceptive effect ↓
L-methadone	L-methadone effect ↓
Opioids	Opioid effect ↓
Phenytoin	Phenytoin effect ↓
Sulfonylureas	Sulfonylurea effect ↓