Main uses in hair loss: folliculitis decalvans (always paired together with another antibiotic such as clindamycin)


What is Rifampin?

  • Rifampin is an antibiotic. 
  • It is well known for its use in treating tuberculosis but can be used in many other situations as well, including certain scarring hair loss conditions such as folliculitis decalvans

How is Rifampin prescribed?

  • Rifampin dosing will be advised by your doctor.
  • Do not take with food
  • You will do a series of blood tests, including liver tests, before starting Rifampin to make sure it’s safe for you to start.  You will also have blood tests every few months if you stay on the rifampin for long periods of time. (liver tests panel and blood counts)

Can I use Rifampin with other treatments?  

  • Rifampin interacts with many drugs.  It is important that you give your doctor a full list of all medications, herbal medications, and over the counter medications you take
  • Women who use an oral contraceptive need to be aware the Rifampin will reduce the effectiveness of the oral contraceptive. Another form of contraception is needed
  • A full list of medications must be given to your prescribing doctor, including whether you take warfarin, birth control, cyclosporine, itraconazole, digoxin, calcium channel blockers, midazoloam, statins for cholesterol, lorazepam (benzodiazepines) , celocoxib, Tylenol, aminophylline, amiodorone, diabetic medications, beta blockers, corticosteroids, digoxin, ketoconazole, morphine, quinidine, sulfones, theophylline, verapamil (calcium channel blockers)

Who should not use Rifampin?

  • You need to let your doctor know if you take any medications. He or she can then tell you if Rifampin is safe or unsafe.
  • You shouldn’t use rifampin if you are were allergic to it in the past

What side effects are possible with Rifampin?

  • Patients taking rifampin may notice a harmless red-orange color to the urine (and to a lesser extent, also sweat and tears) for a few hours after a dose.  In fact, if you don’t notice that your urine is orange, you are probably taking it too close to food
  • Because rifampin stains the tears red, it may permanently stain contact lenses.
  • The most common reactions are fever, nausea, vomiting, diarrhea, gas and rashes

Other side effects include:

  1. immunological reactions
  2. abdominal cramps, diarrhea
  3. flushing, itching of the skin
  4. flu-like symptoms
  5. liver irritation and rarely serious liver irritation
  6. breathing difficulties
  7. rarely can drop blood counts (red cells, white cells)
  8. sore mouth and tongue
  9. headaches, drowsiness, dizziness
  10. kidney problems
  11. muscle weakness and pain and joint pains


What side effects should prompt me to STOP Rifampin and get medical advice?

Stop if you have any symptom that makes you not feel well and seek medical attention including

  • Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
  • Black urine or white stools,  decreased urination
  • fever, chills, or persistent sore throat;
  • general feeling of discomfort;
  • joint pain or swelling;
  • loss of appetite;
  • mental or mood changes;
  • nausea or vomiting; pain, swelling,
  • red, swollen, or blistered skin; severe stomach pain;
  • unusual bruising or bleeding;
  • vision changes;
  • wheezing;
  • yellowing of eyes or skin.

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