Rifampicin-induced elevation of serum bile acids in man

Abstract

Fasting and postprandial serum bile acid concentrations were determined by gas-liquid chromatography in 20 consecutive individuals (14 normal subjects, 6 cirrhotics) before and after administration of rifampicin in a single dose of 900 mg, using each individual as his own control. In the normal subjects the 2-hr postprandial level was 2.9±0.2 μM (mean±1sem) prior to drug administration. Following rifampicin, it was 7.7±0.5 μM (P<0.0005). In the patients with liver cirrhosis the 2-hr postprandial level increased from 30.2±3.5 before, to 105.0±27.7 μM after rifampicin (P<0.025). Twelve hours after drug administration the levels of serum bile acids were not significantly different with respect to the control values. Total serum bilirubin also showed a transient and parallel increase. These findings are compatible with the hypothesis that rifampicin inhibits the hepatic transport of bile acids.