Rifamycin-based regimens are increasingly used for the management of patients with tuberculosis infection because of lower rates of hepatic adverse drug reactions and higher completion rates than other regimens. When treatment is resumed after stopping because of adverse drug reactions, patients may uncommonly develop hypotension and shock, which generally resolve within 24 hours.[1]-[6] The terminology in the literature is inconsistent; we refer to this severe clinical presentation as rifampin-induced flu-like syndrome with shock. If treatment is temporarily stopped because of flu-like syndrome, patients can uncommonly have a more severe reaction, including shock, after resuming treatment. Patients who develop a mild flu-like syndrome on weekly rifapentine treatment may tolerate a daily rifampin regimen.[1],[2],[5] Patients on daily rifampin treatment who develop mild flu-like symptoms can be treated with over-the-counter anti-pyrectic and analgesic agents. [Extracted from the article]