Resophine (Rifapentine) for TB Prevention: Uses, Dosing, Side Effects & Precautions

Resophine® (Rifapentine) is a long-acting rifamycin antibiotic used for latent TB infection (LTBI) treatment and active TB (in combination).

Key Indication: 3-Month Weekly Regimen (3HP)

• Dose: Rifapentine 900 mg (15 mg/kg max) + Isoniazid 900 mg (15 mg/kg max) once weekly × 12 weeks (directly observed therapy preferred).
• Alternative: 4-month daily rifampin (4R) or 3-month daily isoniazid+rifampin (3HR).
• Advantage: Higher completion rates vs. 9-month daily INH.

Common Side Effects

• GI: Nausea, vomiting, abdominal pain, anorexia.
• Hepatotoxicity (monitor LFTs baseline & periodically).
• Flu-like syndrome (fever, chills, myalgia) — "rifampin syndrome."
• Orange discoloration of body fluids (tears, urine, sweat) — harmless, stains contacts.
• Drug interactions: Induces CYP450 (reduces OCP, warfarin, ART, many others).

Serious Risks

• Severe hepatitis, thrombocytopenia, anaphylaxis, Stevens-Johnson.

Contraindications / Cautions

• Active liver disease, severe renal impairment.
• Pregnancy (safety not established; 3HP not recommended).
• Concurrent rifampin (same class).
• Porphyria.

Monitoring

• LFTs at baseline, monthly (or if symptoms).
• Symptom review each dose.
• Assess adherence (critical for resistance prevention).

Always coordinate with TB control program; LTBI treatment prevents reactivation (5–10% lifetime risk).