[Rifampicin, pregnancy, hormonal contraception, menopause and aging]

Rev Tuberc Pneumol (Paris). 1971 Nov;35(7):695-712.
[Article in French]

Abstract

PIP: Rifampicin (usually 600 mg per day, with ethambutol 1 gm or isoniazide) was given to 106 patients with tuberculosis: 6 during pregnancy, 4 of whom were taking estrogen and progestagens for hormonal imbalance , 14 women taking oral contraceptives or steroids, 25 women with increased estrogen levels, and 5 elderly women taking testosterone. Particular attention was paid to liver function considering reports of jaundice in pregnancy, oral contraception, and use of rifampicin with isoniazide. The 6 pregnancies resulted in 5 normal infants (1 with meconium staining) and 1 fetal death at 6 months. During pregnancy there were 3 incidents of elevated serum glutamic-pyruvate transaminase (SGPT) 30-150 units, and 1 of liver toxicity. The authors' concluded that there was no proof that rifampicin caused the hormonal imbalance or fetal death, and it can be prescribed safely, especially after the first 3 months. In 12 progestagen and estrogen users, there were 1 jaundice treated by stopping rifampicin but not the pill, and 4 incidents of elevated SGPT of 35-90 units. The authors recommended following those taking pills and rifampicin with regular SGPT tests. 5 patients received cyclofenil, 400 or 800 mg per day, in addition to rifampicin to induce ovulation or treat menopausal symptoms: this resulted in 1 case of hepatic toxicity. Cyclofenil is preferred over estrogen for treating menopausal symstoms in patients on rifampicin. 5 postmenopausal women received methyl-testosterone and ethinyl estradiol without any change in SGPT.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use
  • Chemical and Drug Induced Liver Injury / chemically induced*
  • Contraceptives, Oral / pharmacology*
  • Cystitis / drug therapy
  • Drug Resistance, Microbial
  • Female
  • Fetus / drug effects*
  • Humans
  • Infant
  • Infant, Newborn
  • Liver / drug effects
  • Male
  • Menopause*
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Rifampin / therapeutic use*
  • Tuberculosis, Pulmonary / drug therapy*

Substances

  • Antitubercular Agents
  • Contraceptives, Oral
  • Rifampin