<p>Rifampicin has been shown to produce liver dysfunction. Fatalities associated with&nbsp;jaundice&nbsp;have occurred in patients with&nbsp;liver disease&nbsp;and in patients taking rifampin with other&nbsp;hepatotoxic&nbsp;agents. Patients with impaired liver function should be given rifampin only in cases of necessity and then with caution and under strict medical supervision. In these patients, careful monitoring of liver function, especially&nbsp;SGPT/ALT and SGOT/AST should be carried out prior to therapy and then every 2 to 4 weeks during therapy. If signs of hepatocellular damage occur, rifampin should be withdrawn.<br />
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In some cases, hyperbilirubinemia resulting from competition between rifampin and bilirubin for excretory pathways of the liver at the cell level can occur in the early days of treatment. An isolated report showing a moderate rise in bilirubin and/or transaminase level is not in itself an indication for interrupting treatment; rather, the decision should be made after repeating the tests, noting trends in the levels, and considering them in conjunction with the patient&#39;s clinical condition.<br />
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Rifampin has enzyme-inducing properties, including induction of delta amino levulinic acid synthetase. Isolated reports have associated&nbsp;porphyria&nbsp;exacerbation with rifampin administration.</p>