Drug interactions -summary-

Indinavir-
rifapentine should be used with extreme caution if at all, in patients who are taking
protease inhibitors

Cytochrome P450-
rifapentene is an inducer of cytochromes P450 3A4 P450 2C8/9. Rifapentene may increase
the metabolism of other coadministred drugs that are metabolised by these enzymes. 

Pulmonary tuberculosis

Adverse reactions-

Dermatologic - urticaria, skin discoloration,

GI - constipation, esophagitis, gastritis, pancreatitis

Hematologic - thrombocytopenia, neutropenia, leukocytosis, purpura, hematoma

Hepatic- bilirubinemia, hepatitis

Metabolic- /nutritional  - hyperkalemia, hypervolemia, alkaline phosphatase increased,
LDH increased

Musculoskeletal -  gout, arthiritis

Miscellaneous- aggressive reaction, peripheral edema, fatigue 

Hypersensitivity

Special Precautions-
Compliance - compliance with full course of therapy must be emphasised and the importance of
not missing must be stressed

Psuedomonous colitis- if pseudomonous colitis is suspected rifapentine should be stopped
 immediately and patient should be treated with supportive and specific treatment without
delay

Red discoloration body fluids- rifapentine may produce a predominantly red-orange dscoloration
of body tissues and fluidseg skin, teeth, tongue, feces, urine, sputum, sweat, cerebrospinal fluid
Contact lens and dentures may become permanently stained

Porphryia- rifapentine should not be used in patients with porphyria

Hepatic function impairment - patients with abnormal hepatic function should be given refapentine
only under medical supervision. Necessary caution should be excercised

Pregnancy- rifapentine should be used during pregnancy only if needed.

Lactation-  since rifapentine may produce a orange red discoloration of body fluids, there is
a potential for discoloration of breast milk.

Children-  safety and effctiveness of riapentine not established

Elderly- elderly patients should be cautious, usually starting with a low dose and monitor
progress during therapy

Indication-

Pulmonary tuberculosis

Dosage-
Intentive short trem therapy- which is continue for 2 months, 600mg ( four 150mg tablets ) of
rifapentine oral should be given twice weekly with an interval of not less than 3 days (72hours )
between doses.

For those patients with propensity for vomting or gastro-intestinal upset , administration
with food will be useful.
 

1. Take with food if vomiting or GI upset occurs

2,.Patients should be told that rifapentine  Red discoloration body of body tissues and fluids
   eg.skin, teeth, tongue, feces, urine, sputum, sweat, cerebrospinal fluid
    Contact lens and dentures may become permanently stained

3.patients hould be instructed to notify their physician if they experience , fever, loss of
   appetite, malaise, nausea, vomiting, darkened urine, yellowish discolroation of skin
  and eyes and pain or swelling of the joints.

4. Compliance of full course of therapy must be emphasised and the importance of not
    missing any doses of the daily administered in the intensive phase must be stressed.

Take with food if vomiting or GI upset occurs

Pregnancy-
Rifapentine should be used during pregnancy only if needed.

Lactation- 
Since rifapentine may produce a orange red discoloration of body fluids, there is
a potential for discoloration of breast milk.

Children- 
Safety and effctiveness of riapentine not established

Elderly-
Elderly patients should be cautious, usually starting with a low dose and monitor
progress during therapy