Rifapentine

Rifapentine is an anti-mycobacterial drug that was approved in the United States as a treatment for tuberculosis in 1998. Rifapentine should be taken in combination with other anti-tuberculosis drugs.

It is manufactured by Hoechst Marion Rousel.

Rifapentine is taken intensively for the first two months of treatment, and then is taken once a week for four months.

The effectiveness of rifapentine as a treatment for tuberculosis has not been proven in people with HIV. There is evidence that rifapentine may be an inferior treatment option for people with HIV due to an increased chance of resistance to the rifamycins, including rifapentine and the related drug rifampicin (Rifadin / Rimactane). A randomised trial comparing rifapentine with rifampicin, both in combination with isoniazid in 71 HIV-positive people with tuberculosis found that four people on rifapentine developed drug resistance compared with none of the rifampicin group. The authors recommended the once weekly rifapentine and isoniazid should not be used among people with HIV.1

People who are on protease inhibitors should not take rifapentine due to drug interactions.

References

  1. Vernon A et al. Acquired rifamycin monoresistance in patients with HIV-related tuberculosis treated with once-weekly rifapentine and isoniazid. Lancet 353: 1843, 1999

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