Clinical pharmacokinetics of rifampicin. 1978

G Acocella

After oral administration on an empty stomach, the absorption of rifampicin (rifampin) is rapid and practically complete. With a single 600mg dose, peak serum concentration of the order of 10microgram/ml generally occur 2 hours after administration. The half-life of rifampicin for this dose level is of the order of 2.5 hours. The amount of rifampicin extracted by the liver during its first passage through the hepatoportal system and transferred to bile is relevance for the time course of distribution of the antibiotic in the blood compartment. With dose of the order of 300 to 450mg, the excretory capacity of the liver for the antibiotic is saturated. As a consequence, increasing the dose of antibiotic results in a more than proportional increase in serum concentrations. On repeated administration, and most likely as a consequence of self-induced (autoinduction) metabolism, the rate of disappearance of rifampicin from the blood compartment increases in the early phase of treatment, the phenomenon affecting mainly the levels following the peak, with a consequent reduction in half-life. Approximately 80% of rifampicin is transported in blood bound to plasma proteins, mainly albumin. Rifampicin is well distributed, although to a different degree, in the various tissues of the human body. Probably in the hepatocyte, rifampicin undergoes a process of desacetylation. The metabolic derivative, desacetylrifampicin, is more polar than the parent compound, and microbiologically active. This metabolite accounts for the majority of the antibacterial activity in the bile Rifampicin is almost equally excreted in the bile and urine, the recovery in the 2 fluids being of the same order of magnitude. Administration of rifampicin to newborn infants and children is followed by blood levels generally lower than those found in adults for the same dose levels. In patients with impaired liver and kidney function the elimination of the antibiotic from the blood compartment is slower than in normal subjects. Rifampicin has been found to compete with bilirubin and other cholefil substances for biliary excretion, giving rise to transient and reversible increased bilirubin and BSP retention values. A kinetic model study on the transfer constants between various body compartments has indicated that rifampicin is rapidly absorbed from the intestine and that the absorption rate increases with time. Rifampicin as such is transferred into urine at a rate 3 times higher than the rate of transfer into bile. Desacetylrifampicin, the more polar metabolic derivative of rifampicin, behaves in the opposite way since its rate of transfer into bile is 4 times higher than that into urine. The rate of biotransformation of rifampicin into desacetylrifampicin is of the same order of magnitude as than of biotransformation of the latter into a further metabolic derivative, which could be a glucuronide conjugate...

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007408 Intestinal Absorption Uptake of substances through the lining of the INTESTINES. Absorption, Intestinal
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D007674 Kidney Diseases Pathological processes of the KIDNEY or its component tissues. Disease, Kidney,Diseases, Kidney,Kidney Disease
D007700 Kinetics The rate dynamics in chemical or physical systems.
D008107 Liver Diseases Pathological processes of the LIVER. Liver Dysfunction,Disease, Liver,Diseases, Liver,Dysfunction, Liver,Dysfunctions, Liver,Liver Disease,Liver Dysfunctions
D010634 Phenobarbital A barbituric acid derivative that acts as a nonselective central nervous system depressant. It potentiates GAMMA-AMINOBUTYRIC ACID action on GABA-A RECEPTORS, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. Phenemal,Phenobarbitone,Phenylbarbital,Gardenal,Hysteps,Luminal,Phenobarbital Sodium,Phenobarbital, Monosodium Salt,Phenylethylbarbituric Acid,Acid, Phenylethylbarbituric,Monosodium Salt Phenobarbital,Sodium, Phenobarbital
D011485 Protein Binding The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific protein-binding measures are often used as assays in diagnostic assessments. Plasma Protein Binding Capacity,Binding, Protein
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body

Related Publications

G Acocella
February 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
G Acocella
January 1987, Nihon Kyobu Shikkan Gakkai zasshi,
G Acocella
November 1974, Antibiotiki,
G Acocella
January 1995, American journal of therapeutics,
G Acocella
January 1985, Archives of toxicology. Supplement. = Archiv fur Toxikologie. Supplement,
G Acocella
November 1987, Antibiotiki i meditsinskaia biotekhnologiia = Antibiotics and medical biotechnology,
G Acocella
October 1989, Arzneimittel-Forschung,
G Acocella
November 1972, Lille medical : journal de la Faculte de medecine et de pharmacie de l'Universite de Lille,
Copied contents to your clipboard!