Rifabutin(continued)
▶Efavirenzslightly decreases the exposure torifabutin. Adjust
dose.rStudy
▶Rifabutinis predicted to decrease the efficacy ofetonogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Rifabutindecreases the exposure toetravirine.oStudy
▶HIV-protease inhibitors(atazanavir, darunavir, fosamprenavir,
lopinavir, saquinavir, tipranavir)(boosted with ritonavir)
increase the exposure torifabutin. Monitor and adjust dose.
rStudy
▶HIV-protease inhibitors(ritonavir)markedly increase the
exposure torifabutin. Avoid or adjust dose.rStudy
▶Rifabutinis predicted to decrease the effects ofhormone
replacement therapy.oAnecdotal
▶Rifabutinis predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, seeContraceptives,
interactionsp. 497.rTheoretical
▶Lumacaftoris predicted to decrease the exposure torifabutin.
Adjust dose.oTheoretical
▶Macrolides(azithromycin)increase the risk of neutropenia
when given withrifabutin.rStudy
▶Macrolides(clarithromycin)increase the risk of uveitis when
given withrifabutin. Adjust dose.rStudy
▶Macrolides(erythromycin)are predicted to increase the risk of
uveitis when given withrifabutin. Adjust dose.r
Theoretical
▶Rifabutinis predicted to decrease the efficacy of
norethisterone. For FSRH guidance, seeContraceptives,
interactionsp. 497.rAnecdotal
▶Rifabutinslightly decreases the exposure torilpivirine. Adjust
dose.rStudy
▶Rifabutinis predicted to decrease the exposure torolapitant.
Avoid.oTheoretical
▶Rifabutinis predicted to decrease the exposure tosimeprevir.
Avoid.oTheoretical
▶Rifabutinis predicted to decrease the exposure totenofovir
alafenamide. Avoid.oTheoretical
▶Rifabutindecreases the efficacy ofulipristal. For FSRH
guidance, seeContraceptives, interactionsp. 497.r
Anecdotal
▶Rifabutinis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
Rifampicin
▶Rifampicinis predicted to decrease the exposure to
abiraterone. Avoid.rTheoretical
▶Rifampicinis predicted to decrease the exposure toafatinib.
oStudy
▶Rifampicinis predicted to decrease the exposure to
agomelatine.oTheoretical
▶Rifampicinis predicted to decrease the exposure toaldosterone
antagonists(eplerenone). Avoid.oTheoretical
▶Rifampicindecreases the exposure toaliskiren.oStudy
▶Rifampicinis predicted to decrease the exposure to
alprazolam. Adjust dose.oTheoretical
▶Rifampicintransiently increases the exposure toambrisentan.
oStudy
▶Rifampicindecreases the exposure toaminophylline. Adjust
dose.oStudy
▶Rifampicinis predicted to decrease the exposure to
anaesthetics, local(ropivacaine).oTheoretical
▶Antacidsdecrease the absorption ofrifampicin.Rifampicin
should be taken 1 hour beforeantacids.oStudy
▶Rifampicinis predicted to decrease the exposure to
antiarrhythmics(disopyramide, dronedarone). Avoid.r
Study
▶Rifampicinis predicted to decrease the efficacy of
antiarrhythmics(propafenone).oStudy
▶Rifampicinis predicted to decrease the exposure to
anticholinesterases, centrally acting(donepezil).nStudy
▶Antiepileptics(phenobarbital, primidone)are predicted to
decrease the exposure torifampicinandrifampicinis predicted
to decrease the exposure toantiepileptics(phenobarbital,
primidone). Use with caution and adjust dose.oStudy▶Rifampicinslightly decreases the exposure toantiepileptics
(brivaracetam). Adjust dose.oStudy
▶Rifampicindecreases the concentration ofantiepileptics
(fosphenytoin, phenytoin). Use with caution and adjust dose.
oStudy
▶Rifampicinmarkedly increases the clearance ofantiepileptics
(lamotrigine). Adjustlamotriginedose,p. 202.oStudy
▶Rifampicinis predicted to decrease the exposure to
antiepileptics(perampanel). Monitor and adjust dose.o
Study
▶Rifampicinslightly decreases the exposure toantifungals, azoles
(fluconazole). Adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure toantifungals,
azoles(isavuconazole). Avoid.rStudy
▶Rifampicinmarkedly decreases the exposure toantifungals,
azoles(itraconazole). Avoid and for 14 days after stopping
rifampicin.oStudy
▶Rifampicinmarkedly decreases the exposure toantifungals,
azoles(ketoconazole)andantifungals, azoles(ketoconazole)
potentially decrease the exposure torifampicin. Avoid.
oStudy
▶Rifampicinis predicted to decrease the exposure toantifungals,
azoles(posaconazole). Avoid.oAnecdotal
▶Rifampicinvery markedly decreases the exposure to
antifungals, azoles(voriconazole). Avoid.oStudy
▶Rifampicinis predicted to decrease the exposure to
antihistamines, non-sedating(bilastine).oTheoretical
▶Rifampicinincreases the clearance ofantihistamines, non-
sedating(fexofenadine).oStudy
▶Rifampicinis predicted to decrease the exposure to
antimalarials(artemether)(with lumafantrine). Avoid.r
Study
▶Rifampicinmoderately decreases the exposure toantimalarials
(atovaquone)andantimalarials(atovaquone)slightly increase
the exposure torifampicin. Avoid.oStudy
▶Rifampicinmoderately decreases the exposure toantimalarials
(mefloquine).rStudy
▶Rifampicinis predicted to decrease the concentration of
antimalarials(piperaquine). Avoid.oTheoretical
▶Rifampicindecreases the exposure toantimalarials(quinine).
rStudy
▶Rifampicinis predicted to moderately decrease the exposure
toapixaban. Use with caution or avoid.rStudy
▶Rifampicinmoderately decreases the exposure toapremilast.
Avoid.rStudy
▶Rifampicinis predicted to markedly decrease the exposure to
aprepitant. Avoid.oStudy
▶Rifampicinis predicted to moderately decrease the exposure
toaripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Rifampicindecreases the exposure toataluren.oStudy
▶Rifampicinis predicted to decrease the exposure toaxitinib.
Avoid or adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure to
bazedoxifene.oTheoretical
▶Rifampicindecreases the exposure tobedaquiline. Avoid.
rStudy
▶Rifampicinmoderately decreases the exposure tobeta blockers,
non-selective(carvedilol).oStudy
▶Rifampicindecreases the exposure tobeta blockers, non-
selective(propranolol). Monitor and adjust dose.oStudy
▶Rifampicinslightly decreases the exposure tobeta blockers,
selective(bisoprolol, metoprolol).nStudy
▶Rifampicinmoderately decreases the exposure tobeta blockers,
selective(celiprolol).oStudy
▶Rifampicinslightly decreases the exposure tobortezomib.
Avoid.rStudy
▶Rifampicinaffects the exposure tobosentan. Avoid.r
Study
▶Rifampicinis predicted to very markedly decrease the
exposure tobosutinib. Avoid.rStudy
▶Rifampicinis predicted to decrease the exposure tobupropion.
oStudy
▶Rifampicinis predicted to decrease the exposure tobuspirone.
Use with caution and adjust dose.rStudy982 Rifabutin—Rifampicin BNFC 2018 – 2019
Interactions|Appendix 1A1