rifabutin at a glance
Medicine class
Rifamycin antimycobacterial antibiotic
Licensed roles
Pulmonary tuberculosis, non-tuberculous mycobacterial infection and MAC prevention in advanced HIV
Food
The capsules may be taken with or without food
Expected colour change
Urine and other body fluids may turn red-orange; soft contact lenses can be permanently stained
What is rifabutin used for?
Licensed indications for the selected capsule product are:
Pulmonary tuberculosis, as part of combination treatment.
Non-tuberculous mycobacterial infections, including infections caused by Mycobacterium avium complex or Mycobacterium xenopi.
Prevention of Mycobacterium avium complex infection in people with HIV disease and a very low CD4 count.
How does rifabutin work?
Rifabutin binds to bacterial DNA-dependent RNA polymerase and blocks transcription, preventing susceptible bacteria from making essential RNA and proteins. Its tissue and intracellular penetration supports activity against mycobacteria that live within cells.
rifabutin preparations and strengths
Capsule
Route: Oral
Strengths: 150 mg
How to take rifabutin
Swallow the capsules by mouth exactly as prescribed. They can be taken with or without food. Do not stop rifabutin without speaking to the treating team.
Take only the capsules prescribed for you.
Tell the prescriber or pharmacist about all medicines, supplements and contraception before starting.
Red-orange urine or body fluids are expected, but report other concerning symptoms.
rifabutin side effects
Common or expected effects
- Low white blood cell count detected on testing
- Anaemia
- Nausea
- Rash
- Muscle pain
- Fever
Get urgent medical advice
- Severe allergic reaction with breathing difficulty or facial or throat swelling
- Severe skin reaction with blistering, peeling, mucosal sores or fever
- Uveitis: eye pain, redness, light sensitivity or impaired vision
- Severe, persistent or bloody diarrhoea
- Jaundice or other signs of liver injury
- Severe infection, unusual bruising or bleeding suggesting a blood disorder
rifabutin in pregnancy
The product information advises against rifabutin during pregnancy because clinical experience is insufficient. Anyone who is pregnant, planning pregnancy or becomes pregnant during treatment should contact the specialist team promptly and should not stop prescribed infection treatment without advice.
rifabutin while breastfeeding
The product information advises against rifabutin while breastfeeding because evidence is insufficient. Discuss feeding options with the specialist team; do not stop necessary treatment without medical advice.
rifabutin interactions
Rifabutin induces CYP3A and has clinically important two-way interactions. A complete medicines review is essential.
Cabotegravir with prolonged-release injectable rilpivirine
Concomitant use is contraindicated because rifabutin can substantially reduce antiretroviral exposure.
Other antiretrovirals
Some protease inhibitors raise rifabutin exposure, while rifabutin can lower medicines including bictegravir, elvitegravir, doravirine and oral rilpivirine, risking toxicity or virological failure.
Sofosbuvir-containing hepatitis C treatments
Rifabutin can lower antiviral exposure and the combination is not recommended.
Common questions about rifabutin
Answers are fully visible for fast scanning and source review.
Is rifabutin the same as rifampicin?
No. Both are rifamycin antibiotics, but they are different active ingredients with different interaction profiles. Resistance may overlap, so susceptibility and treatment decisions require specialist assessment.
Why does rifabutin turn urine orange?
Rifabutin and its pigments can colour urine, sweat, tears and other secretions red-orange. This is expected and is not usually harmful.
Can rifabutin stain contact lenses?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.