Rifabutin

Rifabutin helps to prevent or slow the spread of Mycobacterium avium complex disease (MAC; a bacterial infection that may cause serious symptoms) in patients with human immunodeficiency virus (HIV) infection. Rifabutin is in a class of medications called antimycobacterials. It works by killing the bacteria that cause infection.

Antibiotics such as rifabutin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Rifabutin comes as a capsule to take by mouth. Rifabutin usually is taken once a day with or without food. If you have nausea or vomiting when you take your medication, your doctor may tell you to take rifabutin at a lower dose twice a day with food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rifabutin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are having difficulty swallowing the capsule, you may empty the contents of the capsule and mix with applesauce.

Rifabutin is also sometimes used in combination with other medications to treat MAC disease that has already spread throughout the body. It is also sometimes used in combination with other medications to treat active tuberculosis (TB; a serious lung infection). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking rifabutin,

• tell your doctor and pharmacist if you are allergic to rifabutin, rifampin (Rifadin, Rimactane, in Rifamate, Rifater), rifapentine (Priftin), rifaximin (Xifaxan), any other medications, or any of the ingredients in rifabutin capsules. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking delavirdine (Rescriptor) or voriconazole (Vfend). Your doctor will probably tell you not to take rifabutin if you are taking one or more of these medications.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: clarithromycin (Biaxin, in Prevpac); fluconazole (Diflucan); HIV protease inhibitors such as atazanavir (Reyataz, in Evotaz), darunavir (Prezista, in Prezcobix), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, Technivie, Viekira Pak), saquinavir (Invirase), and tipranavir (Aptivus); itraconazole (Sporanox, Onmel); and posaconazole (Noxafil). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with rifabutin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever liver or kidney disease .
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking rifabutin, call your doctor.
• tell your doctor if you are taking or using hormonal contraceptives (birth control pills, patches, rings, implants, and injections) to prevent pregnancy. Rifabutin may interfere with the action of hormonal contraceptives. Talk to your doctor about other methods of birth control that will work for you.
• tell your doctor if you wear soft contact lenses. Rifabutin may cause permanent brown-orange stains on your contact lenses.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Rifabutin may cause side effects. Skin, tears, saliva, sweat, urine, and stools may turn brown-orange; this side effect is normal and will stop when you finish taking this medication. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• heartburn
• burping
• gas
• diarrhea
• abdominal pain
• altered sense of taste
• rash
• muscle pain

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

• watery or bloody stools, stomach cramps, or fever during treatment or for up to two or more months after stopping treatment
• rash, hives, difficulty breathing or swallowing,swelling of the face, throat, tongue, lips, or eyes,hoarseness, pink eye, or flu like symptoms
• eye redness, pain, blurred vision or other vision changes
• cough that lasts a long time, coughing up blood, chest pain, unexplained weight loss, extreme tiredness, fever, night sweats, chills, and loss of appetite.
• unusual bruising or bleeding

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to rifabutin.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Mycobutin^®