Peringatan Keamanan

In safety studies with rifamycin, it was reported a potential of hepatotoxicity due to the depletion of glutathione and the generation of reactive oxygen species in liver microsomes. It is important to mention that this effect is mainly observed in the intravenous administration as the oral dosage does not have a significant systemic absorption.A33279

Rifamycin is not genotoxic in bacterial mutation assays, mouse cell mutation assay or mouse bone marrow micronucleus assay. There is no current information about the effects on fertility, overdosage or carcinogenesis.FDA label

Rifamycin

DB11753

small molecule approved investigational

Deskripsi

Rifamycin is the prime member of the rifamycin family which are represented by drugs that are a product of fermentation from the gram-positive bacterium Amycolatopsis mediterranei, also known as Streptomyces mediterranei. The parent compound of rifamycin was rifamycin B which was originally obtained as a main product in the presence of diethylbarburitic acid. Some small modifications where performed in this inactive compound and with the creation of rifamycin SV there was the first antibiotic used intravenously for the treatment of tuberculosis.A39990

Rifamycin has had several direct derivative products such as rifamycin SV, rifaximin, rifampin and rifamycin CV. All of the derivatives have slight different physicochemical properties when compared to the parent structure.A39986

Rifamycin was further developed by Cosmo Technologies Ltd and approved in November 16, 2018 by the FDA as a prescription drug after being granted the designation of Qualified Infectious Disease Product which allowed it to have a status a priority review.L4800 This drug was also sent for review to the EMA in 2015 by Dr. Falk Pharma Gmbh and it was granted a waiver for the tested conditions.L4801

Struktur Molekul 2D

Berat 697.778
Wujud solid

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) The reported half-life when a dose of 250 mg of rifamycin was administered is 3 h.[A39998]
Volume Distribusi The reported volume of distribution after measured after a dosage of 250 mg of rifamycin is 101.8 L.[A39998]
Klirens (Clearance) The reported clearance when a dose of 250 mg of rifamycin was administered is 23.3 L/h.[A39998]

Absorpsi

Rifamycin has a very poor absorptionA39996 and thus, the generation of an oral modified-release formulation using the technology of the multi-matrix structure was required for the generation of the FDA approved product. This preparation allows the delivery of the active ingredient in the distal small bowel and colon without interfering with the flora in the upper gastrointestinal tract.A39997 The multi-matrix is made by a lipophiic matrix surrounded in a hydrophilic matrix which allows for the protection of the active ingredient from dissolution in the intestinal aqueous fluids before it arrives in the cecum. All this matrix is surrounded by a gastro-resistant polymer that only desintegrate in a pH lower than 7.A39998 All this administration-customed formulation allows for a bioavailability of <0.1% and the plasma concentrations are reported to be of <2 ng/ml in patients receiving a dose of 400 mg. This confirms that the site of action of rifamycin stays in the small intestine and colon which prevents the need for dose adjustments in special populations as well as systemic drug interactions.A39998 The reported Cmax, tmax, AUC and mean residence time after a dosage of 250 mg of rifamycin is 36 mg/L, 5 min, 11.84 mg.h/L and 0.49 h respectively.A39998

Metabolisme

When absorbed, rifamycin is mainly metabolzied in hepatocytes and intestinal microsomes to a 25-deacetyl metabolite.A39998

Rute Eliminasi

From the administered dose, 18%, 50% and 21% is recovered in feces during the first 24, 48 and 72h after administration. This will represent about 90% of the administered dose eliminated by the feces while the urinary secretion is negligible.A39998

Interaksi Makanan

3 Data
  • 1. Avoid alcohol.
  • 2. Take with a full glass of water.
  • 3. Take with or without food.

Interaksi Obat

95 Data
Clopidogrel The therapeutic efficacy of Clopidogrel can be increased when used in combination with Rifamycin.
Isoniazid Rifamycin may increase the hepatotoxic activities of Isoniazid.
Warfarin The risk or severity of bleeding can be increased when Rifamycin is combined with Warfarin.
Acenocoumarol The risk or severity of bleeding can be increased when Rifamycin is combined with Acenocoumarol.
(R)-warfarin The risk or severity of bleeding can be increased when Rifamycin is combined with (R)-warfarin.
(S)-Warfarin The risk or severity of bleeding can be increased when Rifamycin is combined with (S)-Warfarin.
Mycophenolate mofetil The serum concentration of Mycophenolate mofetil can be decreased when it is combined with Rifamycin.
Mycophenolic acid The serum concentration of Mycophenolic acid can be decreased when it is combined with Rifamycin.
Picosulfuric acid The therapeutic efficacy of Picosulfuric acid can be decreased when used in combination with Rifamycin.
BCG vaccine The therapeutic efficacy of BCG vaccine can be decreased when used in combination with Rifamycin.
Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Rifamycin.
Esmolol The metabolism of Esmolol can be increased when combined with Rifamycin.
Betaxolol The metabolism of Betaxolol can be increased when combined with Rifamycin.
Metoprolol The metabolism of Metoprolol can be increased when combined with Rifamycin.
Atenolol The metabolism of Atenolol can be increased when combined with Rifamycin.
Sotalol The metabolism of Sotalol can be increased when combined with Rifamycin.
Labetalol The metabolism of Labetalol can be increased when combined with Rifamycin.
Bisoprolol The metabolism of Bisoprolol can be increased when combined with Rifamycin.
Alprenolol The metabolism of Alprenolol can be increased when combined with Rifamycin.
Pindolol The metabolism of Pindolol can be increased when combined with Rifamycin.
Carvedilol The metabolism of Carvedilol can be increased when combined with Rifamycin.
Propafenone The metabolism of Propafenone can be increased when combined with Rifamycin.
Acebutolol The metabolism of Acebutolol can be increased when combined with Rifamycin.
Nadolol The metabolism of Nadolol can be increased when combined with Rifamycin.
Bevantolol The metabolism of Bevantolol can be increased when combined with Rifamycin.
Practolol The metabolism of Practolol can be increased when combined with Rifamycin.
Penbutolol The metabolism of Penbutolol can be increased when combined with Rifamycin.
Oxprenolol The metabolism of Oxprenolol can be increased when combined with Rifamycin.
Dexpropranolol The metabolism of Dexpropranolol can be increased when combined with Rifamycin.
Celiprolol The metabolism of Celiprolol can be increased when combined with Rifamycin.
Nebivolol The metabolism of Nebivolol can be increased when combined with Rifamycin.
Bufuralol The metabolism of Bufuralol can be increased when combined with Rifamycin.
Bopindolol The metabolism of Bopindolol can be increased when combined with Rifamycin.
Bupranolol The metabolism of Bupranolol can be increased when combined with Rifamycin.
Indenolol The metabolism of Indenolol can be increased when combined with Rifamycin.
Arotinolol The metabolism of Arotinolol can be increased when combined with Rifamycin.
Levobetaxolol The metabolism of Levobetaxolol can be increased when combined with Rifamycin.
Talinolol The metabolism of Talinolol can be increased when combined with Rifamycin.
Anisodamine The metabolism of Anisodamine can be increased when combined with Rifamycin.
Bucindolol The metabolism of Bucindolol can be increased when combined with Rifamycin.
Esatenolol The metabolism of Esatenolol can be increased when combined with Rifamycin.
Cloranolol The metabolism of Cloranolol can be increased when combined with Rifamycin.
Mepindolol The metabolism of Mepindolol can be increased when combined with Rifamycin.
Epanolol The metabolism of Epanolol can be increased when combined with Rifamycin.
Tertatolol The metabolism of Tertatolol can be increased when combined with Rifamycin.
Landiolol The metabolism of Landiolol can be increased when combined with Rifamycin.
Phenindione The risk or severity of bleeding can be increased when Rifamycin is combined with Phenindione.
Coumarin The risk or severity of bleeding can be increased when Rifamycin is combined with Coumarin.
Tioclomarol The risk or severity of bleeding can be increased when Rifamycin is combined with Tioclomarol.
4-hydroxycoumarin The risk or severity of bleeding can be increased when Rifamycin is combined with 4-hydroxycoumarin.
Clorindione The risk or severity of bleeding can be increased when Rifamycin is combined with Clorindione.
Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Benzyl alcohol.
Benzocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Benzocaine.
Capsaicin The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Capsaicin.
Levobupivacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Levobupivacaine.
Diphenhydramine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Diphenhydramine.
Fluindione The risk or severity of bleeding can be increased when Rifamycin is combined with Fluindione.
Dicoumarol The risk or severity of bleeding can be increased when Rifamycin is combined with Dicoumarol.
Lactulose The therapeutic efficacy of Lactulose can be decreased when used in combination with Rifamycin.
Timolol The metabolism of Timolol can be increased when combined with Rifamycin.
Propranolol The metabolism of Propranolol can be increased when combined with Rifamycin.
Vibrio cholerae CVD 103-HgR strain live antigen The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Rifamycin.
Estetrol The therapeutic efficacy of Estetrol can be decreased when used in combination with Rifamycin.
Ropivacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Ropivacaine.
Meloxicam The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Meloxicam.
Ethyl biscoumacetate The risk or severity of bleeding can be increased when Rifamycin is combined with Ethyl biscoumacetate.
Diphenadione The risk or severity of bleeding can be increased when Rifamycin is combined with Diphenadione.
Bupivacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Bupivacaine.
Ambroxol The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Ambroxol.
Phenprocoumon The risk or severity of bleeding can be increased when Rifamycin is combined with Phenprocoumon.
Cinchocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Cinchocaine.
Dyclonine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Dyclonine.
Procaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Procaine.
Prilocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Prilocaine.
Proparacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Proparacaine.
Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Oxybuprocaine.
Cocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Cocaine.
Mepivacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Mepivacaine.
Chloroprocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Chloroprocaine.
Phenol The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Phenol.
Tetrodotoxin The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Tetrodotoxin.
Etidocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Etidocaine.
Articaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Articaine.
Tetracaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Tetracaine.
Propoxycaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Propoxycaine.
Pramocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Pramocaine.
Butamben The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Butamben.
Butacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Butacaine.
Oxetacaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Oxetacaine.
Ethyl chloride The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Ethyl chloride.
Butanilicaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Butanilicaine.
Metabutethamine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Metabutethamine.
Quinisocaine The risk or severity of methemoglobinemia can be increased when Rifamycin is combined with Quinisocaine.
Cisatracurium Rifamycin may increase the neuromuscular blocking activities of Cisatracurium.
Fecal microbiota The therapeutic efficacy of Fecal microbiota can be decreased when used in combination with Rifamycin.

Target Protein

DNA-directed RNA polymerase subunit beta rpoB
DNA-directed RNA polymerase subunit beta' rpoC
DNA-directed RNA polymerase subunit beta rpoB
DNA-directed RNA polymerase subunit alpha rpoA
DNA-directed RNA polymerase subunit beta' rpoC

Referensi & Sumber

Artikel (PubMed)
  • PMID: 28697313
    Lin SW, Lin CJ, Yang JC: Rifamycin SV MMX for the treatment of traveler's diarrhea. Expert Opin Pharmacother. 2017 Aug;18(12):1269-1277. doi: 10.1080/14656566.2017.1353079. Epub 2017 Jul 27.
  • PMID: 6635432
    Sensi P: History of the development of rifampin. Rev Infect Dis. 1983 Jul-Aug;5 Suppl 3:S402-6.
  • PMID: 27094342
    Barrett J, Brown M: Travellers' diarrhoea. BMJ. 2016 Apr 19;353:i1937. doi: 10.1136/bmj.i1937.
  • PMID: 23656647
    Ross AG, Olds GR, Cripps AW, Farrar JJ, McManus DP: Enteropathogens and chronic illness in returning travelers. N Engl J Med. 2013 May 9;368(19):1817-25. doi: 10.1056/NEJMra1207777.
  • PMID: 23756321
    Rosette C, Buendia-Laysa F Jr, Patkar S, Moro L, Celasco G, Bozzella R, Ajani M, Gerloni M: Anti-inflammatory and immunomodulatory activities of rifamycin SV. Int J Antimicrob Agents. 2013 Aug;42(2):182-6. doi: 10.1016/j.ijantimicag.2013.04.020. Epub 2013 Jun 5.
  • PMID: 21402860
    Di Stefano AF, Rusca A, Loprete L, Droge MJ, Moro L, Assandri A: Systemic absorption of rifamycin SV MMX administered as modified-release tablets in healthy volunteers. Antimicrob Agents Chemother. 2011 May;55(5):2122-8. doi: 10.1128/AAC.01504-10. Epub 2011 Mar 14.
  • PMID: 20236863
    Aristoff PA, Garcia GA, Kirchhoff PD, Showalter HD: Rifamycins--obstacles and opportunities. Tuberculosis (Edinb). 2010 Mar;90(2):94-118. doi: 10.1016/j.tube.2010.02.001. Epub 2010 Mar 16.
  • PMID: 15700959
    Floss HG, Yu TW: Rifamycin-mode of action, resistance, and biosynthesis. Chem Rev. 2005 Feb;105(2):621-32. doi: 10.1021/cr030112j.
Textbook
  • Kerr P. (2013). Fighting multidrug resistance with herbal extracts, essential oils and their components. Academic Press.

Contoh Produk & Brand

Produk: 3 • International brands: 0
Produk
  • Aemcolo
    Tablet, delayed release • 194 mg/1 • Oral • US • Approved
  • Aemcolo
    Tablet, delayed release • 194 mg/1 • Oral • US • Approved
  • Aemcolo
    Tablet, delayed release • 194 mg/1 • Oral • US • Approved

Sekuens Gen/Protein (FASTA)

Sekuens dimuat saat dibutuhkan agar halaman tetap ringan.
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