KEY POINTS
- Rifabutin (Mycobutin) is a rifamycin antibiotic that works on susceptible bacteria by inhibiting DNA-dependent RNA polymerase at the beta subunit, preventing chain elongation
- May be used for Mycobacterium tuberculosis, Mycobacterium avium complex (MAC) or other Mycobacterium
- Available oral only
- Common dose is 300mg once daily
- Reduce dose by 50% for CrCl < 30mL/min
- No dose adjustment recommended by package insert for hepatic dysfunction
- A drug to look to in place of rifampin, when rifampin drug-drug interactions are an issue
- Commonly used for patients on antiretroviral therapy when a rifamycin is needed
- Beware drug-drug interactions between rifabutin and other drugs
- More common adverse reactions are: skin rash, discoloration of urine to a reddish / orange color, neutropenia and leukopenia
RESOURCES
- Rifabutin Package Insert
- AIDS Info Opportunistic Infection Treatment Guideline
- Rifabutin, Where Do We Stand In 2016? (JAC, 2016)
- Critical Review: What Dose Of Rifabutin Is Recommended With Antiretroviral Therapy? (JAIDS, 2016)
- Drug Induced Lupus Associated With Rifabutin: A Literature Review (JIAPC, 2013)
