Comprehensive medication guide to Rifampin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic rifampin on most commercial plans; typically Tier 1–2 on most formularies. Medicare Part D covers rifampin with minimal cost-sharing for most plans.
Estimated Cash Pricing
$107–$184 retail for a 30-day supply of generic rifampin capsules; as low as $37–$50 with GoodRx or SingleCare coupons. Rifampin injection is in active shortage in 2026.
Medfinder Findability Score
62/100
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Rifampin (brand name Rifadin; also known internationally as rifampicin) is a prescription antibiotic in the rifamycin class. It is classified as an antimycobacterial agent and is FDA-approved to treat and prevent tuberculosis (TB), eliminate meningococcal bacteria from carriers, provide Haemophilus influenzae type B prophylaxis, and treat leprosy. It is also used off-label for MRSA infections and other bacterial conditions.
Rifampin has been a cornerstone of global tuberculosis treatment for decades, recognized by the World Health Organization as an essential medicine. It is available as 150 mg and 300 mg oral capsules, as an IV injection (currently in shortage), and can be compounded into oral suspension for patients who cannot swallow capsules.
Rifampin is not a controlled substance and carries no DEA schedule. Any licensed prescriber — physician, nurse practitioner, or physician assistant — can prescribe it.
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Rifampin exerts bactericidal effects by binding tightly to the beta subunit of bacterial DNA-dependent RNA polymerase (RNAP). This enzyme is the bacterial cell's construction foreman — it reads the DNA blueprint and directs the production of messenger RNA (mRNA), which cells need to make proteins. By blocking or disrupting RNAP, rifampin halts RNA synthesis, which starves the bacterium of the proteins it needs to survive and replicate.
Rifampin selectively targets bacterial RNAP and does not inhibit the equivalent enzyme in human cells, which is why it can kill bacteria without directly harming the patient. It is highly lipophilic (fat-soluble), allowing it to penetrate the waxy outer coat of Mycobacterium tuberculosis and enter macrophages where the bacterium hides.
A critical side effect of rifampin's mechanism is that it is also the most potent inducer of hepatic cytochrome P450 enzymes (especially CYP3A4, CYP2C9, CYP2C19) known in clinical medicine. This dramatically increases the metabolism of many other medications, often reducing their blood levels by 50–90%. This is why rifampin has an unusually long list of drug interactions — more than almost any other antibiotic.
150 mg — capsule
Oral capsule; two 150 mg capsules = one standard 300 mg dose
300 mg — capsule
Oral capsule; most common strength for adult TB treatment (two capsules = 600 mg daily dose for 60 kg patient)
600 mg/10 mL — injection
IV infusion; administered over 30 minutes; in active shortage as of 2026
As of June 2026, rifampin availability depends heavily on the formulation. Oral capsules (150 mg and 300 mg) are not in a formal FDA shortage and are generally stocked by most major retail pharmacy chains including CVS, Walgreens, Walmart, and Kroger. However, local stock-outs occur, especially in areas with high TB prevalence.
Rifampin injection (600 mg/10 mL IV) is in active shortage. Sanofi's Rifadin IV has been permanently discontinued, and the Viatris/Mylan injectable product is experiencing shipping delays. This shortage has been ongoing since 2021 and represents a persistent structural vulnerability in the U.S. injectable antibiotic supply chain.
If you're having trouble locating rifampin at your pharmacy, medfinder contacts pharmacies near you on your behalf to find which ones have your prescription in stock, and texts you the results — saving you hours of phone calls and reducing the risk of a dangerous treatment gap.
Rifampin is not a controlled substance, so any licensed healthcare professional with prescribing authority can prescribe it without special DEA registration. The following specialties and settings commonly prescribe rifampin:
Public health TB clinic providers and TB nurses (most common for active TB and LTBI)
Infectious disease specialists (for complex TB, drug-resistant TB, HIV/TB co-infection)
Pulmonologists (pulmonary TB)
Primary care physicians (PCPs) — for straightforward LTBI and meningococcal prophylaxis
Pediatricians and pediatric infectious disease specialists (for Hib prophylaxis and pediatric TB)
Nurse practitioners (NPs) and physician assistants (PAs) in primary care and ID settings
Telemedicine providers can prescribe rifampin in most states for appropriate indications (particularly LTBI), since no in-person DEA verification is required. However, active tuberculosis management should involve in-person care, sputum testing, and potentially directly observed therapy.
No. Rifampin is not classified as a controlled substance by the U.S. Drug Enforcement Administration (DEA) and carries no DEA schedule. This means there are no special restrictions on prescribing, filling, or refilling rifampin based on controlled substance regulations.
Any licensed healthcare provider with prescribing authority — including physicians, nurse practitioners, and physician assistants — can prescribe rifampin in all 50 states without a DEA registration or special waiver. Telemedicine providers can also prescribe rifampin for appropriate indications. Patients may fill rifampin at any retail pharmacy and can receive a 90-day supply in most cases.
The most distinctive and common side effect of rifampin is harmless orange-red discoloration of body fluids. Other common side effects include:
Orange-red discoloration of urine, sweat, tears, and saliva (benign; can stain soft contact lenses permanently)
Nausea, vomiting, diarrhea, abdominal cramping
Skin flushing and rash
Headache and dizziness
False-positive urine opioid drug screen
Hepatotoxicity (liver damage): Signs include jaundice, dark brown urine, upper right abdominal pain, fatigue, and clay-colored stools. Most serious adverse effect; requires baseline and periodic LFTs.
DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms): Rare but life-threatening multi-organ reaction; stop drug and seek emergency care immediately
Thrombocytopenia: Low platelet count; signs include unusual bruising, petechiae, prolonged bleeding
Acute renal failure: Decreased urine output, leg/foot swelling; more common with intermittent high-dose regimens
Flu-like syndrome: Fever, chills, bone pain, wheezing; occurs with missed doses or intermittent regimens
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Rifabutin (Mycobutin)
Same rifamycin class; preferred over rifampin for HIV/TB co-infected patients on protease inhibitors due to fewer drug interactions; also used for MAC prophylaxis
Rifapentine (Priftin)
Long-acting rifamycin; once-weekly dosing for latent TB (3HP regimen) or once-daily for 1 month (1HP); not currently in shortage
Isoniazid (INH)
First-line anti-TB agent; used in combination with rifampin for active TB; 9-month monotherapy alternative for LTBI when rifamycins are contraindicated
Ethambutol (Myambutol)
Bacteriostatic anti-TB agent used in combination regimens; requires monitoring for optic neuritis; partner drug in standard TB regimen
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Warfarin
majorRifampin dramatically reduces warfarin anticoagulant effect by inducing CYP2C9; warfarin dose increase and frequent INR monitoring required
HIV Protease Inhibitors (saquinavir, atazanavir, darunavir, tipranavir)
majorRifampin reduces PI levels by up to 90% via CYP3A4 induction; complete loss of antiviral efficacy; use rifabutin instead for HIV/TB co-infection
Hormonal Contraceptives
majorRifampin significantly reduces efficacy of all hormonal birth control; unintended pregnancies have been reported; use barrier method throughout treatment and for 1 month after
Apixaban (Eliquis), Rivaroxaban (Xarelto)
majorRifampin reduces DOAC levels by 50–90% via CYP3A4 and P-gp induction; may render anticoagulation ineffective; warfarin preferred if anticoagulation needed
Azole Antifungals (fluconazole, itraconazole, voriconazole)
majorRifampin substantially reduces antifungal levels; may require significant dose adjustments or alternative agents
Statins (atorvastatin, simvastatin)
moderateRifampin reduces statin levels; dose increase or switch to less CYP3A4-dependent statin may be needed
Cyclosporine, Tacrolimus
majorRifampin reduces transplant immunosuppressant levels by 70–80%; risk of organ rejection; frequent drug level monitoring and dose adjustment required
Amiodarone
majorRifampin reduces amiodarone levels; may cause loss of antiarrhythmic control; avoid combination if possible
Isoniazid
moderateCombined use increases risk of hepatotoxicity; baseline and frequent liver function tests required
Praziquantel
majorRifampin dramatically reduces praziquantel levels; contraindicated; wait at least 4 weeks after stopping rifampin before starting praziquantel
Rifampin is one of the most clinically significant antibiotics in medicine — a drug that has helped drive TB elimination efforts for over 50 years. Its ability to kill M. tuberculosis inside cells and in dormant states made it a breakthrough when introduced, and it remains irreplaceable in standard TB regimens today. However, its powerful enzyme-inducing properties mean that drug interactions must be proactively managed at every prescription.
The current shortage of rifampin injection (as of 2026) highlights the fragility of the U.S. specialty injectable supply chain. For patients on oral therapy, access is generally good — but local stock-outs can occur. Adherence is absolutely critical: never skip doses and never stop rifampin without medical guidance, as treatment interruptions can lead to drug-resistant TB that is far harder and more expensive to treat.
If you are struggling to fill your rifampin prescription, don't give up — there are resources to help. Your local public health TB clinic can often provide medication at no cost, and medfinder can quickly find which pharmacies near you have rifampin in stock, saving you time and ensuring you don't miss a dose.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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