From the FDA Drug Label
Treatment Intensive support measures should be instituted and individual symptoms treated as they arise... Since nausea and vomiting are likely to be present, gastric lavage within the first 2 to 3 hours after ingestion is probably preferable to induction of emesis... Antiemetic medication may be required to control severe nausea and vomiting. The treatment for nausea and vomiting associated with taking Rifampin (rifampicin) includes:
- Gastric lavage within the first 2 to 3 hours after ingestion
- Antiemetic medication to control severe nausea and vomiting 1
From the Research
To treat nausea and vomiting associated with taking Rifampin, ondansetron (Zondran) 4-8 mg every 8 hours is the most effective antiemetic option, as it has been shown to be highly effective in treating chemotherapy-induced nausea and vomiting, and its use is supported by recent evidence 2. When taking rifampin, it is essential to take the medication with food rather than on an empty stomach to minimize gastrointestinal side effects.
- Start with small, frequent meals throughout the day instead of large meals.
- Stay well-hydrated by drinking clear fluids like water, ginger ale, or clear broth. Some patients may find relief from over-the-counter medications such as:
- Dimenhydrinate (Dramamine) 50-100 mg every 4-6 hours
- Meclizine (Bonine) 25 mg every 24 hours Natural relief options include:
- Ginger supplements (250 mg four times daily)
- Peppermint tea If symptoms persist or are severe, contact your healthcare provider, who may prescribe antiemetics like metoclopramide (Reglan) 10 mg before meals, although ondansetron is generally preferred due to its efficacy and safety profile, as shown in a study comparing the antiemetic effects of ondansetron and metoclopramide 3. It's crucial to continue taking rifampin despite these side effects, as stopping tuberculosis or other infection treatment prematurely can lead to treatment failure or antibiotic resistance, and these side effects typically improve after the first few weeks of treatment as your body adjusts to the medication.