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Mycobutin
Mycobutin (generic name: rifabutin) is an antibiotic used to prevent and treat Mycobacterium avium complex (MAC), a type of bacterial infection often seen in individuals with weakened immune systems, particularly those with HIV/AIDS. Rifabutin belongs to the rifamycin class of antibiotics, and it works by inhibiting bacterial RNA synthesis, thereby stopping the growth of the bacteria. It is often used as part of combination therapy in patients at high risk of MAC infection or those already diagnosed with MAC.
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Frequently Asked Questions
How long do I need to take Mycobutin for MAC prevention?
Patients at high risk for MAC, especially those with advanced HIV/AIDS, may need to take Mycobutin long-term or until their immune system improves (e.g., with effective antiretroviral therapy).
Can Mycobutin cause liver problems?
Yes, Mycobutin can affect liver function, especially in patients with pre-existing liver conditions. Routine liver function tests may be recommended during treatment.
What should I do if I miss a dose of Mycobutin?
If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take the next dose at your regular time. Do not take two doses at once.
Will Mycobutin affect the color of my bodily fluids?
Yes, Mycobutin may cause reddish-orange discoloration of your urine, sweat, tears, and other bodily fluids. This is harmless but may stain clothing or contact lenses.
Can I take Mycobutin with other antibiotics?
Yes, Mycobutin is often used in combination with other antibiotics like azithromycin or clarithromycin for treating MAC infections. Your healthcare provider will adjust doses accordingly to prevent drug interactions.
Comprehensive Drug Guide
How Does Mycobutin Work?
Mycobutin works by inhibiting RNA polymerase in bacteria, specifically preventing the synthesis of bacterial RNA. This action halts the growth and reproduction of bacteria, effectively reducing the bacterial load in patients with Mycobacterium avium complex (MAC) infections. This mechanism of action is similar to other rifamycin-class antibiotics like rifampin, but Mycobutin is often preferred due to its lower propensity for drug interactions.
Common Dosages
- Mycobutin is available in 150 mg oral capsules, and the dosage may vary depending on the condition being treated.
Typical Dosing
- For MAC prophylaxis in HIV-positive patients: The typical dose is 300 mg once daily.
- For active MAC treatment: The typical dose is 300 mg once daily, but it is usually administered in combination with other antibiotics, such as clarithromycin or azithromycin.
- Dose adjustments may be required for patients with kidney impairment or if drug interactions are present.
Typical Dosing
FDA Approved Indications
- Prevention of Mycobacterium avium complex (MAC) in patients with advanced HIV/AIDS.
- Treatment of Mycobacterium avium complex (MAC) as part of a combination therapy in patients with active MAC infection.
Who Shouldn't Take Mycobutin?
- Known hypersensitivity to rifabutin or other rifamycin-class antibiotics (e.g., rifampin, rifapentine).
- Severe liver impairment, as rifabutin is metabolized in the liver and may exacerbate liver dysfunction.
Advice From The Pharmacist
- Take Mycobutin once daily, preferably at the same time each day. It can be taken with or without food, but taking it with food may reduce the chance of stomach upset.
- Mycobutin may cause your urine, sweat, and tears to turn a reddish-orange color. This is harmless but may cause staining of contact lenses, so wearing glasses may be preferred during treatment.
- If you experience unusual symptoms such as severe fatigue, fever, or unexplained bruising, contact your healthcare provider immediately, as these could be signs of a serious side effect.
- Continue taking Mycobutin for the entire course of treatment as prescribed, even if you start feeling better before finishing the medication. Stopping early can result in bacterial resistance.
- Store Mycobutin at room temperature away from moisture and heat.
Side Effects of Mycobutin
Common Side Effects
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Reddish-orange discoloration of bodily fluids (e.g., urine, sweat, tears)
- Rash
- Muscle or joint pain
Uncommon/Severe Side Effects
- Hematologic abnormalities, such as neutropenia (low white blood cell count), thrombocytopenia (low platelet count), or anemia.
- Liver toxicity or jaundice (yellowing of the skin and eyes).
- Severe hypersensitivity reactions, such as rash, itching, or swelling.
Risks and Warnings of Mycobutin
- Hematologic Effects: Mycobutin can cause changes in blood cell counts, including neutropenia or thrombocytopenia. Routine blood tests may be required to monitor for these side effects, especially in patients on long-term therapy.
- Liver Toxicity: Mycobutin is metabolized in the liver and can lead to liver dysfunction or worsening liver disease in patients with pre-existing liver conditions. Liver function tests may be recommended during treatment.
- Drug Interactions: Mycobutin can interact with several medications, including antiretrovirals, antifungals, and antibiotics. Dose adjustments may be necessary when used in combination with these drugs.
- Eye Discoloration: Rifabutin may cause a harmless reddish-orange discoloration of bodily fluids, including tears. Contact lens wearers should be aware of potential staining.
Interactions with Mycobutin
Common Drug Interactions
- Antiretroviral drugs (e.g., protease inhibitors, NNRTIs): Mycobutin can reduce the efficacy of certain antiretroviral drugs used to treat HIV, requiring dose adjustments.
- Clarithromycin: When used in combination with clarithromycin for MAC treatment, a lower dose of Mycobutin is often needed due to increased rifabutin levels.
- Fluconazole or itraconazole: These antifungal drugs can increase the blood levels of Mycobutin, leading to a higher risk of side effects.
Alternatives to Mycobutin
- Rifampin: Another rifamycin-class antibiotic that may be used for MAC treatment but has more drug interactions than rifabutin.
- Azithromycin: Commonly used in combination with Mycobutin for treating active MAC infections.
- Clarithromycin: Often used as part of a combination therapy for MAC treatment.
