[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antituberculosis drugs](https://durgical.com/en/pharmacology/classes/antituberculosis-drugs/) › Rifapentine [Pharmacology](https://durgical.com/en/pharmacology/) · [Antituberculosis drugs](https://durgical.com/en/pharmacology/classes/antituberculosis-drugs/) # Rifapentine A longer-acting rifamycin used in short preventive treatment with isoniazid and in a 4-month regimen for drug-susceptible pulmonary TB. Updated 2026-11-01 - Class: [Antituberculosis drugs](https://durgical.com/en/pharmacology/classes/antituberculosis-drugs/) - Enzyme: DNA-dependent RNA polymerase, β subunit - ATC code: J04AB05 - WHO Model List of Essential Medicines ✂**DNA-dependent RNA polymerase, β subunit**Rifapentine ⓘ The figure shows rifapentine bound to the RNA polymerase of Thermus thermophilus, in the same rifamycin pocket of the β subunit as in M. tuberculosis. **Target in 3D:** DNA-dependent RNA polymerase, β subunit. PDB structure 2A69 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/2A69) · Drag to rotate · pinch to zoom ## Mechanism of action A cyclopentyl rifamycin that blocks bacterial DNA-dependent RNA polymerase and kills intracellular and extracellular M. tuberculosis; its 25-desacetyl metabolite is also active. Its longer half-life allows spaced dosing in preventive regimens. - Rifapentine binds the β subunit of RNA polymerase - Bacterial transcription stops - Its long half-life allows spaced doses ## Pharmacokinetics **Absorption** Food, especially fatty food, increases absorption **Distribution** Highly bound to albumin **Metabolism** Hydrolysis to an active 25-desacetyl metabolite; it induces CYP3A4 and CYP2C8/9 **Half-life** About 13 hours ## Indications - TB infection: short preventive treatment with isoniazid [Tuberculosis →](https://durgical.com/en/conditions/tuberculosis/) - Drug-susceptible pulmonary TB from age 12: 4-month regimen with isoniazid, moxifloxacin and pyrazinamide [Pulmonary tuberculosis →](https://durgical.com/en/conditions/pulmonary-tuberculosis/) ## Adverse effects ### Common - Red-orange colour of body fluids; can stain contact lenses and dentures - Flu-like symptoms - Rise in liver enzymes ### Serious (rare, important) - Hepatotoxicity - Hypersensitivity, including anaphylaxis and bronchospasm - Severe skin reactions (SJS, DRESS) - Clostridioides difficile diarrhoea ## Contraindications - Hypersensitivity to any rifamycin - Porphyria (avoided) - Rifampicin-resistant tuberculosis (it would not work) ## Key interactions **HIV protease inhibitors and some reverse transcriptase inhibitors** Their levels can fall markedly **Hormonal contraceptives** Less effective: a non-hormonal or barrier method is used **Warfarin, azole antifungals, methadone, immunosuppressants** Faster breakdown; induction lasts about two weeks after stopping ## What is monitored - Liver tests at baseline and during treatment in people with liver disease - Symptoms of hepatitis and hypersensitivity - Adherence to every scheduled dose ## Administration and safety - By mouth with food - Tablets can be crushed into semi-solid food - Preventive regimens are often directly observed - Look-alike names: rifapentine is not rifampicin or rifabutin ## Nursing care - Warn about orange-red body fluids and stained lenses or dentures - Teach flu-like or allergic symptoms to report - Review antiretrovirals and contraceptives - Track each dose in the preventive schedule ## Pregnancy and breastfeeding Human data are limited; use in the last weeks of pregnancy may increase bleeding in mother and newborn, so vitamin K may be indicated. ## Memory aid Rifa-PENT-ine: the rifamycin that stays longer, so doses can be spread out. ## Test yourself Think of the answer, then tap the question to see it. ## With which drug is rifapentine combined for short preventive treatment? Isoniazid. ## Which WHO 4-month regimen contains rifapentine? Isoniazid, rifapentine, moxifloxacin and pyrazinamide (2HPMZ/2HPM), from age 12 with drug-susceptible pulmonary TB. ## Does food help or hinder rifapentine? They help: food, especially fatty food, increases its absorption. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/rifapentine/) ## Related drugs - [Rifampicin](https://durgical.com/en/pharmacology/rifampicin/) - [Isoniazid](https://durgical.com/en/pharmacology/isoniazid/) - [Rifabutin](https://durgical.com/en/pharmacology/rifabutin/) - [Moxifloxacin](https://durgical.com/en/pharmacology/moxifloxacin/) ## Related conditions - [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/) - [Pulmonary tuberculosis](https://durgical.com/en/conditions/pulmonary-tuberculosis/) [← Back to the class: Antituberculosis drugs](https://durgical.com/en/pharmacology/classes/antituberculosis-drugs/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [DailyMed - RIFAPENTINE tablet, film coated](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f95d726e-5a09-48dd-b719-e4400fb91c8f) (DailyMed (U.S. National Library of Medicine), 2026); [WHO consolidated guidelines on tuberculosis: module 4: treatment and care](https://www.who.int/publications/i/item/9789240107243) (World Health Organization (WHO), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J04AB05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 65 (McGraw Hill, 2023). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/rifapentine/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/rifapentine/