Risk Factor C (Monitor therapy)

Acetaminophen

Isoniazid may enhance the adverse/toxic effect of Acetaminophen.

Apalutamide

CYP3A4 Inducers (Strong) may decrease the serum concentration of Apalutamide.

Ataluren

RifAMPin may decrease the serum concentration of Ataluren.

Barbiturates

Rifamycin Derivatives may increase the metabolism of Barbiturates.

Bazedoxifene

RifAMPin may decrease the serum concentration of Bazedoxifene. This may lead to loss of efficacy or, if bazedoxifene is combined with estrogen therapy, an increased risk of endometrial hyperplasia.

BCG Vaccine (Immunization)

Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization).

Benperidol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Benperidol.

Benzhydrocodone

CYP3A4 Inducers (Strong) may decrease the serum concentration of Benzhydrocodone. Specifically, the serum concentrations of hydrocodone may be reduced.

Beta-Blockers

Rifamycin Derivatives may decrease the serum concentration of Beta-Blockers. Exceptions: Atenolol; Carteolol (Ophthalmic); Levobunolol; Metipranolol; Nadolol.

Bosentan

RifAMPin may decrease the serum concentration of Bosentan. Following the initial several weeks of concurrent rifampin, this effect is most likely. RifAMPin may increase the serum concentration of Bosentan. This effect is most likely to be observed within the initial few weeks of concurrent therapy (and may be greatest immediately following initiation of the combination). Management: Weekly monitoring of liver function tests during the first 4 weeks of concurrent therapy is recommended, with a return to normal recommended monitoring thereafter as appropriate.

Brentuximab Vedotin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Brentuximab Vedotin. Specifically, concentrations of the active monomethyl auristatin E (MMAE) component may be decreased.

Brentuximab Vedotin

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Brentuximab Vedotin. Specifically, concentrations of the active monomethyl auristatin E (MMAE) component may be decreased.

Buprenorphine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Buprenorphine.

Calcifediol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Calcifediol.

Cannabidiol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Cannabidiol.

Cannabidiol

CYP2C19 Inducers (Strong) may decrease the serum concentration of Cannabidiol.

Cannabis

CYP3A4 Inducers (Strong) may decrease the serum concentration of Cannabis. More specifically, tetrahydrocannabinol and cannabidiol serum concentrations may be decreased.

CarBAMazepine

May enhance the hepatotoxic effect of Isoniazid. Isoniazid may increase the serum concentration of CarBAMazepine.

Celiprolol

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Celiprolol.

Chlorzoxazone

Isoniazid may increase the serum concentration of Chlorzoxazone. Isoniazid may decrease the serum concentration of Chlorzoxazone. Specifically, it may decrease chlorzoxazone concentrations below baseline after isoniazid discontinuation.

Citalopram

RifAMPin may decrease the serum concentration of Citalopram.

Cladribine

BCRP/ABCG2 Inducers may decrease the serum concentration of Cladribine.

Cladribine

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Cladribine.

Clopidogrel

CYP2C19 Inducers (Strong) may increase serum concentrations of the active metabolite(s) of Clopidogrel.

Codeine

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Codeine.

Corticosteroids (Systemic)

May decrease the serum concentration of Isoniazid.

CycloSERINE

Isoniazid may enhance the adverse/toxic effect of CycloSERINE. Specifically, CNS toxicity may be enhanced.

CYP2B6 Substrates (High risk with Inducers)

CYP2B6 Inducers (Moderate) may decrease the serum concentration of CYP2B6 Substrates (High risk with Inducers).

CYP2C9 Substrates (High risk with Inducers)

CYP2C9 Inducers (Moderate) may decrease the serum concentration of CYP2C9 Substrates (High risk with Inducers).

CYP2E1 Substrates (High risk with Inhibitors)

Isoniazid may decrease the serum concentration of CYP2E1 Substrates (High risk with Inhibitors). Specifically, it may decrease CYP2E1 substrate serum concentrations below baseline after isoniazid discontinuation. Isoniazid may increase the serum concentration of CYP2E1 Substrates (High risk with Inhibitors).

Dabrafenib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dabrafenib.

Diclofenac (Systemic)

CYP2C9 Inducers (Moderate) may decrease the serum concentration of Diclofenac (Systemic).

Diethylstilbestrol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Diethylstilbestrol.

Disopyramide

RifAMPin may decrease the serum concentration of Disopyramide.

Disulfiram

May enhance the adverse/toxic effect of Isoniazid. Disulfiram may increase the serum concentration of Isoniazid.

Dofetilide

CYP3A4 Inhibitors (Weak) may increase the serum concentration of Dofetilide.

Doxercalciferol

CYP3A4 Inducers (Strong) may increase serum concentrations of the active metabolite(s) of Doxercalciferol.

Doxycycline

RifAMPin may decrease the serum concentration of Doxycycline.

Dronabinol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dronabinol.

Efavirenz

RifAMPin may decrease the serum concentration of Efavirenz.

Eltrombopag

May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates.

Estriol (Systemic)

CYP3A4 Inducers (Strong) may decrease the serum concentration of Estriol (Systemic).

Estriol (Topical)

CYP3A4 Inducers (Strong) may decrease the serum concentration of Estriol (Topical).

Ethionamide

May increase the serum concentration of Isoniazid.

Evogliptin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Evogliptin.

FentaNYL

CYP3A4 Inducers (Strong) may decrease the serum concentration of FentaNYL.

Fexofenadine

RifAMPin may decrease the serum concentration of Fexofenadine. RifAMPin may increase the serum concentration of Fexofenadine.

Gemfibrozil

May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates. See separate drug interaction monographs for agents listed as exceptions.

Gestrinone

RifAMPin may decrease the serum concentration of Gestrinone.

HYDROcodone

CYP3A4 Inducers (Strong) may decrease the serum concentration of HYDROcodone.

Hydrocortisone (Systemic)

CYP3A4 Inducers (Strong) may decrease the serum concentration of Hydrocortisone (Systemic).

Ifosfamide

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Ifosfamide. CYP3A4 Inducers (Strong) may increase serum concentrations of the active metabolite(s) of Ifosfamide.

Isoniazid

Rifamycin Derivatives may enhance the hepatotoxic effect of Isoniazid. Even so, this is a frequently employed combination regimen.

Lactobacillus and Estriol

Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol.

LamoTRIgine

RifAMPin may increase the metabolism of LamoTRIgine.

Leflunomide

RifAMPin may increase serum concentrations of the active metabolite(s) of Leflunomide.

Lesinurad

CYP2C9 Inducers (Moderate) may decrease the serum concentration of Lesinurad.

Levodopa-Containing Products

Isoniazid may diminish the therapeutic effect of LevodopaContaining Products.

Levomethadone

RifAMPin may decrease the serum concentration of Levomethadone.

Lornoxicam

CYP2C9 Inducers (Moderate) may decrease the serum concentration of Lornoxicam.

Losartan

RifAMPin may decrease the serum concentration of Losartan.

Lumacaftor

May decrease the serum concentration of P-glycoprotein/ABCB1 Substrates. Lumacaftor may increase the serum concentration of P-glycoprotein/ABCB1 Substrates.

Mirabegron

RifAMPin may decrease the serum concentration of Mirabegron.

Morphine (Systemic)

RifAMPin may decrease the serum concentration of Morphine (Systemic).

Nalmefene

RifAMPin may decrease the serum concentration of Nalmefene.

OLANZapine

RifAMPin may decrease the serum concentration of OLANZapine.

Oxcarbazepine

RifAMPin may decrease serum concentrations of the active metabolite(s) of OXcarbazepine. Specifically, concentrations of the major active 10-monohydroxy metabolite may be reduced.

OxyCODONE

RifAMPin may decrease the serum concentration of OxyCODONE.

P-glycoprotein/ABCB1 Inducers

May decrease the serum concentration of Pglycoprotein/ABCB1 Substrates. P-glycoprotein inducers may also further limit the distribution of p-glycoprotein substrates to specific cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.).

P-glycoprotein/ABCB1 Inhibitors

May increase the serum concentration of Pglycoprotein/ABCB1 Substrates. P-glycoprotein inhibitors may also enhance the distribution of pglycoprotein substrates to specific cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.).

P-glycoprotein/ABCB1 Substrates

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of P-glycoprotein/ABCB1 Substrates. P-glycoprotein inducers may also further limit the distribution of p-glycoprotein substrates to specific cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.). Exceptions: Betrixaban; Edoxaban.

Polatuzumab Vedotin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Polatuzumab Vedotin. Exposure to unconjugated MMAE, the cytotoxic small molecule component of polatuzumab vedotin, may be decreased.

Prasugrel

RifAMPin may diminish the antiplatelet effect of Prasugrel.

Pravastatin

RifAMPin may decrease the serum concentration of Pravastatin.

PrednisoLONE (Systemic)

CYP3A4 Inducers (Strong) may decrease the serum concentration of PrednisoLONE (Systemic).

PredniSONE

CYP3A4 Inducers (Strong) may decrease the serum concentration of PredniSONE.

Propacetamol

Isoniazid may enhance the hepatotoxic effect of Propacetamol.

Propacetamol

RifAMPin may increase the metabolism of Propacetamol. . This may 1) diminish the desired effects of propacetamol; and 2) increase the risk of liver damage.

Propafenone

CYP3A4 Inducers (Strong) may decrease the serum concentration of Propafenone.

Ramelteon

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ramelteon.

Reboxetine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Reboxetine.

Rifamycin Derivatives

May enhance the hepatotoxic effect of Isoniazid. Even so, this is a frequently employed combination regimen.

Rosuvastatin

RifAMPin may decrease the serum concentration of Rosuvastatin.

Ruxolitinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ruxolitinib.

Safinamide

May enhance the adverse/toxic effect of Isoniazid. Specifically, there is an increased risk for hypertension.

SAXagliptin

CYP3A4 Inducers (Strong) may decrease the serum concentration of SAXagliptin.

Sertraline

CYP3A4 Inducers (Strong) may decrease the serum concentration of Sertraline.

SUFentanil

CYP3A4 Inducers (Strong) may decrease the serum concentration of SUFentanil.

Sulfamethoxazole

RifAMPin may decrease the serum concentration of Sulfamethoxazole.

Terbinafine (Systemic)

RifAMPin may decrease the serum concentration of Terbinafine (Systemic).

Teriflunomide

May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates.

Tetrahydrocannabinol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tetrahydrocannabinol.

Tetrahydrocannabinol and Cannabidiol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tetrahydrocannabinol and Cannabidiol.

Theophylline Derivatives

Isoniazid may increase the serum concentration of Theophylline Derivatives. Exceptions: Dyphylline.

Thyroid Products

RifAMPin may decrease the serum concentration of Thyroid Products.

TraMADol

CYP3A4 Inducers (Strong) may decrease the serum concentration of TraMADol.

Treprostinil

RifAMPin may decrease the serum concentration of Treprostinil.

Trimethoprim

RifAMPin may decrease the serum concentration of Trimethoprim.

Tropisetron

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tropisetron.

Udenafil

CYP3A4 Inducers (Strong) may decrease the serum concentration of Udenafil.

Vitamin K Antagonists (eg, warfarin)

Rifamycin Derivatives may increase the metabolism of Vitamin K Antagonists.

Zidovudine

Rifamycin Derivatives may decrease the serum concentration of Zidovudine.

Zuclopenthixol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Zuclopenthixol.

Risk Factor D (Consider therapy modification)

Abiraterone Acetate

CYP3A4 Inducers (Strong) may decrease the serum concentration of Abiraterone Acetate. Management: Avoid whenever possible. If such a combination cannot be avoided, increase abiraterone acetate dosing frequency from once daily to twice daily during concomitant use.

Acalabrutinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Acalabrutinib. Management: Avoid co-administration of strong CYP3A inducers in patients taking acalabrutinib. If strong CYP3A inducers cannot be avoided, increase the dose of acalabrutinib to 200 mg twice daily.

Afatinib

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Afatinib. Management: Per US labeling: if requiring chronic use of P-gp inducers, increase afatinib dose by 10mg as tolerated; reduce to original afatinib dose 2-3 days after stopping P-gp inducers. Per Canadian labeling: avoid combination if possible.

Alfentanil

Rifamycin Derivatives may decrease the serum concentration of Alfentanil. Management: Monitor closely for decreased alfentanil effectiveness. Increased alfentanil doses will likely be needed. Alternatively, changing from alfentanil to a different opioid anesthetic (e.g., sufentanil) may also be considered.

Amiodarone

RifAMPin may decrease serum concentrations of the active metabolite(s) of Amiodarone. Specifically, desethylamiodarone concentrations may decrease. RifAMPin may decrease the serum concentration of Amiodarone. Management: Seek alternatives. When used together, monitor closely for decreased amiodarone concentrations/effects. Dose adjustment may be needed.

Antifungal Agents (Azole Derivatives, Systemic)

May increase the serum concentration of Rifamycin Derivatives. Only rifabutin appears to be affected. Rifamycin Derivatives may decrease the serum concentration of Antifungal Agents (Azole Derivatives, Systemic). Management: Avoid these combinations when possible. Voriconazole and isavuconazonium are considered contraindicated.

ARIPiprazole

CYP3A4 Inducers (Strong) may decrease the serum concentration of ARIPiprazole. Management: Double the oral aripiprazole dose and closely monitor. Reduce oral aripiprazole dose to 10-15 mg/day (for adults) if the inducer is discontinued. Avoid use of strong CYP3A4 inducers for more than 14 days with extended-release injectable aripiprazole.

ARIPiprazole Lauroxil

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of ARIPiprazole Lauroxil. Management: Patients taking the 441 mg dose of aripiprazole lauroxil increase their dose to 662 mg if used with a strong CYP3A4 inducer for more than 14 days. No dose adjustment is necessary for patients using the higher doses of aripiprazole lauroxil.

Avatrombopag

RifAMPin may decrease the serum concentration of Avatrombopag. Management: Management of this interaction varies based on avatrombopag indication. Dose adjustments are required for patients using avatrombopag for chronic immune thrombocytopenia. See monograph for details.

Brexpiprazole

CYP3A4 Inducers (Strong) may decrease the serum concentration of Brexpiprazole. Management: If brexpiprazole is used together with a strong CYP3A4 inducer, the brexpiprazole dose should gradually be doubled over the course of 1 to 2 weeks.

Brivaracetam

RifAMPin may decrease the serum concentration of Brivaracetam. Management: Increase the brivaracetam dose by up to 100% (ie, double the dose) if used together with rifampin.

BusPIRone

CYP3A4 Inducers (Strong) may decrease the serum concentration of BusPIRone. Management: Consider alternatives to this combination. If coadministration of these agents is deemed necessary, monitor patients for reduced buspirone effects and increase buspirone doses as needed.

Cabozantinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Cabozantinib. Management: Avoid use of strong CYP3A4 inducers with cabozantinib if possible. If combined, cabozantinib dose adjustments are recommended and vary based on the cabozantinib product used and the indication for use. See monograph for details.

Calcium Channel Blockers

Rifamycin Derivatives may decrease the serum concentration of Calcium Channel Blockers. This primarily affects oral forms of calcium channel blockers. Management: The labeling for some US and Canadian calcium channel blockers contraindicate use with rifampin, however recommendations vary. Consult appropriate labeling. Exceptions: Clevidipine.

Canagliflozin

RifAMPin may decrease the serum concentration of Canagliflozin. Management: Consider increasing canagliflozin dose to 300 mg/day in patients with estimated GFR >60 mL/min/1.73 m2 who tolerate canagliflozin 100 mg/day and require greater glycemic control. Consider alternatives in patients with estimated GFR 45-60 mL/min/1.73 m2.

Caspofungin

RifAMPin may decrease the serum concentration of Caspofungin. Management: Caspofungin prescribing information recommends using a dose of 70 mg daily in adults (or 70 mg/m , up to a maximum of 70 mg, daily in pediatric patients) who are also receiving rifampin.

CeFAZolin

May enhance the adverse/toxic effect of RifAMPin. Specifically, the risk for bleeding may be increased. Management: Avoid concomitant use of rifampin with cefazolin when possible. If combined, closely monitor prothrombin time or other coagulation tests and administer vitamin K as needed.

Cephalosporins (N-methylthiotetrazole [NMTT] Side Chain Containing)

May enhance the adverse/toxic effect of RifAMPin. Specifically, the risk for bleeding may be increased. Management: Avoid concomitant use of rifampin with cephalosporins that contain an Nmethylthiotetrazole (NMTT) side chain when possible. If combined, closely monitor prothrombin time or other coagulation tests and administer vitamin K as needed.

Chloramphenicol (Systemic)

RifAMPin may increase the metabolism of Chloramphenicol (Systemic).

Clarithromycin

CYP3A4 Inducers (Strong) may increase serum concentrations of the active metabolite(s) of Clarithromycin. Clarithromycin may increase the serum concentration of CYP3A4 Inducers (Strong). CYP3A4 Inducers (Strong) may decrease the serum concentration of Clarithromycin. Management: Consider alternative antimicrobial therapy for patients receiving a CYP3A inducer. Drugs that enhance the metabolism of clarithromycin into 14hydroxyclarithromycin may alter the clinical activity of clarithromycin and may impair clarithromycin efficacy.

CycloSPORINE (Systemic)

Rifamycin Derivatives may increase the metabolism of CycloSPORINE (Systemic).

CYP2C19 Substrates (High risk with Inducers)

CYP2C19 Inducers (Strong) may increase the metabolism of CYP2C19 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling.

CYP3A4 Substrates (High risk with Inducers)

CYP3A4 Inducers (Strong) may increase the metabolism of CYP3A4 Substrates (High risk with Inducers). Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Exceptions: Benzhydrocodone; Buprenorphine; CarBAMazepine; Etizolam; HYDROcodone; TraMADol; Zolpidem.

Dasatinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dasatinib. Management: Avoid when possible. If such a combination cannot be avoided, consider increasing dasatinib dose and monitor clinical response and toxicity closely.

Deferasirox

RifAMPin may decrease the serum concentration of Deferasirox. Management: Avoid combination when possible; if the combination must be used, consider a 50% increase in initial deferasirox dose, with monitoring of serum ferritin concentrations and clinical responses to guide further dosing.

Dexamethasone (Systemic)

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dexamethasone (Systemic). Management: Consider dexamethasone dose increases in patients receiving strong CYP3A4 inducers and monitor closely for reduced steroid efficacy.

Dolutegravir

RifAMPin may decrease the serum concentration of Dolutegravir. Management: Increase dolutegravir dose to 50 mg twice daily in adults or children. Consider alternatives to rifampin for INSTI experienced patients with clinically suspected INSTI resistance or certain INSTI associated resistance substitutions.

DOXOrubicin (Conventional)

CYP3A4 Inducers (Strong) may decrease the serum concentration of DOXOrubicin (Conventional). Management: Seek alternatives to strong CYP3A4 inducers in patients treated with doxorubicin. One U.S. manufacturer (Pfizer Inc.) recommends that these combinations be avoided.

DOXOrubicin (Conventional)

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of DOXOrubicin (Conventional). Management: Seek alternatives to P-glycoprotein inducers in patients treated with doxorubicin whenever possible. One U.S. manufacturer (Pfizer Inc.) recommends that these combinations be avoided.

Elagolix

RifAMPin may increase the serum concentration of Elagolix. Management: Use of the elagolix 200 mg twice daily dose with rifampin is not recommended. Limit combined use of the elagolix 150 mg once daily dose with rifampin to a maximum of 6 months.

Eluxadoline

RifAMPin may increase the serum concentration of Eluxadoline. Management: Decrease the eluxadoline dose to 75 mg twice daily if combined with rifampin and monitor patients for increased eluxadoline effects/toxicities.

Enzalutamide

CYP3A4 Inducers (Strong) may decrease the serum concentration of Enzalutamide. Management: Consider using an alternative agent that has no or minimal CYP3A4 induction potential when possible. If this combination cannot be avoided, increase the dose of enzalutamide from 160 mg daily to 240 mg daily.

Eravacycline

CYP3A4 Inducers (Strong) may decrease the serum concentration of Eravacycline. Management: Increase the eravacycline dose to 1.5 mg/kg every 12 hours when combined with strong CYP3A4 inducers.

Erlotinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Erlotinib. Management: Avoid combination if possible. If combination must be used, increase erlotinib dose by 50 mg increments every 2 weeks as tolerated, to a maximum of 450 mg/day.

Estrogen Derivatives (Contraceptive)

Rifamycin Derivatives may decrease the serum concentration of Estrogen Derivatives (Contraceptive). Contraceptive failure is possible. Management: Use of an alternative, nonhormonal contraceptive is recommended.

Etoposide

CYP3A4 Inducers (Strong) may decrease the serum concentration of Etoposide. Management: When possible, seek alternatives to strong CYP3A4-inducing medications in patients receiving etoposide. If combined, monitor patients closely for diminished etoposide response and need for etoposide dose increases.

Etoposide Phosphate

CYP3A4 Inducers (Strong) may decrease the serum concentration of Etoposide Phosphate. Management: When possible, seek alternatives to strong CYP3A4inducing medications in patients receiving etoposide phosphate. If these combinations cannot be avoided, monitor patients closely for diminished etoposide phosphate response.

Everolimus

CYP3A4 Inducers (Strong) may decrease the serum concentration of Everolimus. Management: Avoid concurrent use of strong CYP3A4 inducers if possible. If coadministration cannot be avoided, double the daily dose of everolimus using increments of 5 mg or less. Monitor everolimus serum concentrations closely when indicated.

Exemestane

CYP3A4 Inducers (Strong) may decrease the serum concentration of Exemestane. Management: Exemestane U.S. product labeling recommends using an increased dose (50 mg/day) in patients receiving concurrent strong CYP3A4 inducers. The Canadian product labeling does not recommend a dose adjustment with concurrent use of strong CYP3A4 inducers.

Fosphenytoin

Isoniazid may increase the serum concentration of Fosphenytoin. Management: Consider alternatives. If concomitant therapy cannot be avoided, monitor for increased phenytoin concentrations/effects with isoniazid initiation/dose increase, or decreased concentrations/effects with isoniazid discontinuation/dose decrease.

Fosphenytoin

RifAMPin may decrease the serum concentration of Fosphenytoin. Management: Seek alternatives when possible. If used together, monitor closely for decreased serum phenytoin concentrations following rifampin initiation/dose increase, or increased concentrations and toxic effects following rifampin discontinuation/dose decrease.

Gefitinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Gefitinib. Management: In the absence of severe adverse reactions, increase gefitinib dose to 500 mg daily in patients receiving strong CYP3A4 inducers; resume 250 mg dose 7 days after discontinuation of the strong inducer. Carefully monitor clinical response.

GuanFACINE

CYP3A4 Inducers (Strong) may decrease the serum concentration of GuanFACINE. Management: Increase the guanfacine dose by up to double when initiating guanfacine in a patient taking a strong CYP3A4 inducer. Increase guanfacine dose gradually over 1 to 2 weeks if initiating strong CYP3A4 inducer therapy in a patient already taking guanfacine.

HMG-CoA Reductase Inhibitors (Statins)

Rifamycin Derivatives may decrease the serum concentration of HMG-CoA Reductase Inhibitors (Statins). Management: Consider use of noninteracting antilipemic agents (note: pitavastatin concentrations may increase with rifamycin treatment). Monitor for altered HMG-CoA reductase inhibitor effects. Rifabutin and fluvastatin, or possibly pravastatin, may pose lower risk. Exceptions: Pitavastatin; Rosuvastatin.

Imatinib

Rifamycin Derivatives may decrease the serum concentration of Imatinib. Management: Avoid concurrent use of imatinib with the rifamycin derivatives when possible. If such a combination must be used, increase imatinib dose by at least 50% and monitor the patient's clinical response closely.

Imatinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Imatinib. Management: Avoid concurrent use of imatinib with strong CYP3A4 inducers when possible. If such a combination must be used, increase imatinib dose by at least 50% and monitor the patient's clinical response closely.

Ixabepilone

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ixabepilone. Management: Avoid this combination whenever possible. If this combination must be used, a gradual increase in ixabepilone dose from 40 mg/m to 60 mg/m (given as a 4-hour infusion), as tolerated, should be considered.

Larotrectinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Larotrectinib. Management: Avoid use of strong CYP3A4 inducers with larotrectinib. If this combination cannot be avoided, double the larotrectinib dose. Reduced to previous dose after stopping the inducer after a period of 3 to 5 times the inducer half-life.

Lefamulin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Lefamulin. Management: Avoid concomitant use of lefamulin with strong CYP3A4 inducers unless the benefits outweigh the risks.

Lefamulin

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Lefamulin. Management: Avoid concomitant use of lefamulin with P-glycoprotein/ABCB1 inducers unless the benefits outweigh the risks.

Lefamulin (Intravenous)

CYP3A4 Inducers (Strong) may decrease the serum concentration of Lefamulin (Intravenous). Management: Avoid concomitant use of lefamulin intravenous infusion with strong CYP3A4 inducers unless the benefits outweigh the risks.

Lefamulin (Intravenous)

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Lefamulin (Intravenous). Management: Avoid concomitant use of lefamulin (intravenous) with P-glycoprotein/ABCB1 inducers unless the benefits outweigh the risks.

LinaGLIPtin

CYP3A4 Inducers (Strong) may decrease the serum concentration of LinaGLIPtin. Management: Strongly consider using an alternative to any strong CYP3A4 inducer in patients who are being treated with linagliptin. If this combination is used, monitor patients closely for evidence of reduced linagliptin effectiveness.

LinaGLIPtin

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of LinaGLIPtin. Management: Strongly consider using an alternative to any strong P-glycoprotein inducer in patients who are being treated with linagliptin. If this combination is used, monitor patients closely for evidence of reduced linagliptin effectiveness.

Lomitapide

CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Management: Patients on lomitapide 5 mg/day may continue that dose. Patients taking lomitapide 10 mg/day or more should decrease the lomitapide dose by half. The lomitapide dose may then be titrated up to a max adult dose of 30 mg/day.

Macrolide Antibiotics

May decrease the metabolism of Rifamycin Derivatives. Exceptions: Azithromycin (Systemic); Fidaxomicin; Roxithromycin; Spiramycin.

Manidipine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Manidipine. Management: Consider avoiding concomitant use of manidipine and strong CYP3A4 inducers. If combined, monitor closely for decreased manidipine effects and loss of efficacy. Increased manidipine doses may be required.

Maraviroc

CYP3A4 Inducers (Strong) may decrease the serum concentration of Maraviroc. Management: Increase maraviroc adult dose to 600 mg twice daily when used with strong CYP3A4 inducers. This does not apply to patients also receiving strong CYP3A4 inhibitors. Do not use maraviroc with strong CYP3A4 inducers in patients with CrCl less than 30 mL/min.

Meperidine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Meperidine. Management: Consider increasing meperidine dose if concomitant use with strong CYP3A4 inducers is required. Monitor for signs and symptoms of opioid withdrawal.

Methadone

Rifamycin Derivatives may decrease the serum concentration of Methadone. Management: Seek alternatives when possible. If used concomitantly, monitor closely for symptoms of methadone withdrawal upon rifamycin derivative initiation, and for excess sedation upon rifamycin derivative discontinuation.

MethylPREDNISolone

CYP3A4 Inducers (Strong) may decrease the serum concentration of MethylPREDNISolone. Management: Consider methylprednisolone dose increases in patients receiving strong CYP3A4 inducers and monitor closely for reduced steroid efficacy.

Mirodenafil

CYP3A4 Inducers (Strong) may decrease the serum concentration of Mirodenafil. Management: Consider avoiding the concomitant use of mirodenafil and strong CYP3A4 inducers. If combined, monitor for decreased mirodenafil effects. Mirodenafil dose increases may be required to achieve desired effects.

Nevirapine

RifAMPin may decrease the serum concentration of Nevirapine. Management: Avoid whenever possible. When this combination is necessary, use immediate-release nevirapine (avoid extended-release nevirapine) at a dose of 200 mg twice daily with no lead-in (per adult/adolescent HIV guidelines). Monitor nevirapine response closely.

Nitrazepam

RifAMPin may decrease the serum concentration of Nitrazepam. Management: Monitor closely for reduced effects of nitrazepam. When possible, consider alternatives to one of these drugs, or increases in initial nitrazepam doses.

Osimertinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Osimertinib.

Paliperidone

Inducers of CYP3A4 (Strong) and P-glycoprotein may decrease the serum concentration of Paliperidone. Management: Avoid using the 3-month extended-release injectable suspension (Invega Trinza) with inducers of both CYP3A4 and P-glycoprotein during the 3-month dosing interval if possible. If combination is necessary, consider using extendedrelease tablets.

Perampanel

CYP3A4 Inducers (Strong) may decrease the serum concentration of Perampanel. Management: Increase the perampanel starting dose to 4 mg/day when perampanel is used concurrently with moderate and strong CYP3A4 inducers.

Phenytoin

Isoniazid may increase the serum concentration of Phenytoin. Management: Consider alternatives. If concomitant therapy cannot be avoided, monitor for increased phenytoin concentrations/effects with isoniazid initiation/dose increase, or decreased concentrations/effects with isoniazid discontinuation/dose decrease.

Phenytoin

RifAMPin may decrease the serum concentration of Phenytoin. Management: Seek alternatives when possible. If used together, monitor closely for decreased serum phenytoin concentrations following rifampin initiation/dose increase, or increased concentrations and toxic effects following rifampin discontinuation/dose decrease.

Pitavastatin

Rifamycin Derivatives may increase the serum concentration of Pitavastatin. Management: Limit pitavastatin dose to a maximum of 2 mg/day with concurrent rifampin.

Pitolisant

CYP3A4 Inducers (Strong) may decrease the serum concentration of Pitolisant. Management: For patients who are stable on pitolisant doses of 8.9 mg or 17.8 mg/day and who are also taking a strong CYP3A4 inducer, increase the pitolisant dose over 7 days to double the original dose (ie, to either 17.8 mg/day or 35.6 mg/day, respectively).

Progestins (Contraceptive)

Rifamycin Derivatives may decrease the serum concentration of Progestins (Contraceptive). Contraceptive failure is possible. Management: Contraceptive failure is possible. Use of an alternative, nonhormonal contraceptive is recommended.

Propofol

RifAMPin may enhance the hypotensive effect of Propofol. Management: Note that use of propofol in a patient who has been taking rifampin may result in clinically significant hypotension. If possible, avoid use of this combination.

Prothionamide

RifAMPin may enhance the hepatotoxic effect of Prothionamide. Management: Avoid concomitant use of prothionamide and rifampin if possible. If combined use is considered necessary, monitor patients closely for signs and symptoms of hepatotoxicity (eg, jaundice, elevations in liver function tests).

Prothionamide

Isoniazid may increase the serum concentration of Prothionamide. Prothionamide may increase the serum concentration of Isoniazid. Management: Consider a prothionamide dose reduction and do not exceed 500 mg per day if combined with isoniazid. Additionally, monitor for increased isoniazid toxicities and ensure pyridoxine supplementation is provided if these drugs are combined.

Pyrazinamide

May enhance the hepatotoxic effect of RifAMPin. Severe (even fatal) liver injury has been reported in patients receiving these 2 drugs as a 2-month treatment regimen for latent TB infection.

QUEtiapine

CYP3A4 Inducers (Strong) may decrease the serum concentration of QUEtiapine. Management: An increase in quetiapine dose (as much as 5 times the regular dose) may be required to maintain therapeutic benefit. Reduce the quetiapine dose back to the previous/regular dose within 7-14 days of discontinuing the inducer.

QuiNIDine

Rifamycin Derivatives may decrease the serum concentration of QuiNIDine. Management: Consider alternatives to combination treatment with quinidine and rifampin due to large potential decreases in quinidine concentrations. Monitor for decreased quinidine concentrations/effects with initiation/dose increase of any rifamycin derivative.

Radotinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Radotinib. Management: Consider alternatives to this combination when possible as the risk of radotinib treatment failure may be increased.

Raltegravir

RifAMPin may decrease the serum concentration of Raltegravir. Management: Increase raltegravir dose to 800 mg twice daily (adult dose) when used concomitantly with rifampin. Concurrent use of rifampin with once-daily raltegravir (Isentress HD) is not recommended.

Repaglinide

RifAMPin may decrease the serum concentration of Repaglinide. Management: Consider alternatives to this combination. Dose timing may substantially affect this interaction; in clinical studies, the lowest magnitude of interaction was seen when repaglinide was given 1 h after rifampin (compared to 0, 12, or 24 h).

RisperiDONE

CYP3A4 Inducers (Strong) may decrease the serum concentration of RisperiDONE. Management: Consider increasing the dose of oral risperidone (to no more than double the original dose) if a strong CYP3A4 inducer is initiated. For patients on IM risperidone, consider an increased IM dose or supplemental doses of oral risperidone.

Rolapitant

CYP3A4 Inducers (Strong) may decrease the serum concentration of Rolapitant. Management: Avoid rolapitant use in patients requiring chronic administration of strong CYP3A4 inducers. Monitor for reduced rolapitant response and the need for alternative or additional antiemetic therapy even with shorter-term use of such inducers.

Selexipag

RifAMPin may decrease serum concentrations of the active metabolite(s) of Selexipag.

Sirolimus

CYP3A4 Inducers (Strong) may decrease the serum concentration of Sirolimus. Management: Avoid concomitant use of strong CYP3A4 inducers and sirolimus if possible. If combined, monitor for reduced serum sirolimus concentrations. Sirolimus dose increases will likely be necessary to prevent subtherapeutic sirolimus levels.

Sodium Picosulfate

Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic.

Sulfonylureas

RifAMPin may decrease the serum concentration of Sulfonylureas. Management: Seek alternatives to these combinations when possible. Monitor closely for diminished therapeutic effects of sulfonylureas if rifampin is initiated/dose increased, or enhanced effects if rifampin is discontinued/dose decreased.

SUNItinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of SUNItinib. Management: Avoid when possible. If such a combination cannot be avoided, sunitinib dose increases are recommended, and vary by indication. See full monograph for details.

Tacrolimus (Systemic)

Rifamycin Derivatives may decrease the serum concentration of Tacrolimus (Systemic). Management: Consider alternatives when possible. If these combination are used, monitor for reduced tacrolimus concentrations/effects following rifamycin initiation/dose increase, or increased concentrations/effects following rifamycin discontinuation/dose decrease.

Tadalafil

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tadalafil. Management: Erectile dysfunction: monitor for decreased effectiveness - no standard dose adjustments recommended. Avoid use of tadalafil for pulmonary arterial hypertension in patients receiving a strong CYP3A4 inducer.

Tamoxifen

Rifamycin Derivatives may increase the metabolism of Tamoxifen.

Tamoxifen

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Tamoxifen. CYP3A4 Inducers (Strong) may decrease the serum concentration of Tamoxifen. Management: Consider alternatives to concomitant use of strong CYP3A4 inducers and tamoxifen. If the combination cannot be avoided, monitor for reduced therapeutic effects of tamoxifen.

Temsirolimus

Rifamycin Derivatives may decrease the serum concentration of Temsirolimus. Rifamycins will likely cause an even greater decrease in the concentration of the active metabolite sirolimus. Management: Temsirolimus prescribing information recommends against coadministration with strong CYP3A4 inducers such as rifampin; however, if concurrent therapy is necessary, an increase in temsirolimus adult dose to 50 mg/week should be considered.

Temsirolimus

CYP3A4 Inducers (Strong) may decrease the serum concentration of Temsirolimus. Management: Consider increasing the dose of temsirolimus to 50 mg IV/week (from 25 mg IV/week) if a concomitant CYP3A4 strong inducer is necessary.

Thiazolidinediones

RifAMPin may increase the metabolism of Thiazolidinediones. Management: Consider alternatives to the concomitant use of rifampin with thiazolidinedione antidiabetic agents. Monitor patients receiving these combinations for decreased effects of the thiazolidinedione derivative.

Thiotepa

CYP3A4 Inducers (Strong) may increase serum concentrations of the active metabolite(s) of Thiotepa. CYP3A4 Inducers (Strong) may decrease the serum concentration of Thiotepa. Management: Thiotepa prescribing information recommends avoiding concomitant use of thiotepa and strong CYP3A4 inducers. If concomitant use is unavoidable, monitor for adverse effects.

TiaGABine

CYP3A4 Inducers (Strong) may decrease the serum concentration of TiaGABine. Management: Approximately 2-fold higher tiagabine doses and a more rapid dose titration will likely be required in patients concomitantly taking a strong CYP3A4 inducer.

Typhoid Vaccine

Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 3 days after cessation of antibacterial agents.

Valproate Products

RifAMPin may decrease the serum concentration of Valproate Products.

Vemurafenib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Vemurafenib. Management: Avoid concurrent use of vemurafenib with a strong CYP3A4 inducer and replace with another agent when possible. If a strong CYP3A4 inducer is indicated and unavoidable, the dose of vemurafenib may be increased by 240 mg (1 tablet) as tolerated.

Vilazodone

CYP3A4 Inducers (Strong) may decrease the serum concentration of Vilazodone. Management: Consider increasing vilazodone dose by as much as 2-fold (do not exceed 80 mg/day), based on response, in patients receiving strong CYP3A4 inducers for > 14 days. Reduce to the original vilazodone dose over 1-2 weeks after inducer discontinuation.

Vortioxetine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Vortioxetine. Management: Consider increasing the vortioxetine dose to no more than 3 times the original dose when used with a strong drug metabolism inducer for more than 14 days. The vortioxetine dose should be returned to normal within 14 days of stopping the strong inducer.

Zaleplon

CYP3A4 Inducers (Strong) may decrease the serum concentration of Zaleplon. Management: Consider the use of an alternative hypnotic that is not metabolized by CYP3A4 in patients receiving strong CYP3A4 inducers. If zalephon is combined with a strong CYP3A4 inducer, monitor for decreased effectiveness of zaleplon.

Risk Factor X (Avoid combination)

Abemaciclib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Abemaciclib.

Alpelisib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Alpelisib.

Antihepaciviral Combination Products

CYP3A4 Inducers (Strong) may decrease the serum concentration of Antihepaciviral Combination Products.

Apixaban

CYP3A4 Inducers (Strong) may decrease the serum concentration of Apixaban.

Apremilast

CYP3A4 Inducers (Strong) may decrease the serum concentration of Apremilast.

Aprepitant

CYP3A4 Inducers (Strong) may decrease the serum concentration of Aprepitant.

Artemether

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Artemether. Specifically, dihydroartemisinin concentrations may be reduced. CYP3A4 Inducers (Strong) may decrease the serum concentration of Artemether.

Asunaprevir

RifAMPin may decrease the serum concentration of Asunaprevir. This effect is most likely with longer-term coadministration; single-dose rifampin may increase asunaprevir concentrations. RifAMPin may increase the serum concentration of Asunaprevir. This effect is likely following only single-dose or short-term rifampin administration. Longer-term coadministration is likely to result in decreased asunaprevir concentrations.

Atazanavir

RifAMPin may decrease the serum concentration of Atazanavir.

Atovaquone

Rifamycin Derivatives may decrease the serum concentration of Atovaquone.

Axitinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Axitinib.

BCG (Intravesical)

Antibiotics may diminish the therapeutic effect of BCG (Intravesical).

Bedaquiline

CYP3A4 Inducers (Strong) may decrease the serum concentration of Bedaquiline.

Betrixaban

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Betrixaban.

Bictegravir

RifAMPin may decrease the serum concentration of Bictegravir.

Bortezomib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Bortezomib.

Bosutinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Bosutinib.

Brigatinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Brigatinib.

Cariprazine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Cariprazine.

Ceritinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ceritinib.

Cholera Vaccine

Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics.

CloZAPine

CYP3A4 Inducers (Strong) may decrease the serum concentration of CloZAPine.

Cobicistat

RifAMPin may decrease the serum concentration of Cobicistat.

Cobimetinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Cobimetinib.

Copanlisib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Copanlisib.

Crizotinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Crizotinib.

Dabigatran Etexilate

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Dabigatran Etexilate. Management: Avoid concurrent use of dabigatran with P-glycoprotein inducers whenever possible.

Daclatasvir

CYP3A4 Inducers (Strong) may decrease the serum concentration of Daclatasvir.

Darolutamide

Inducers of CYP3A4 (Strong) and P-glycoprotein may decrease the serum concentration of Darolutamide.

Darunavir

RifAMPin may decrease the serum concentration of Darunavir.

Dasabuvir

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dasabuvir.

Deflazacort

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Deflazacort.

Delamanid

CYP3A4 Inducers (Strong) may decrease the serum concentration of Delamanid.

Delavirdine

Rifamycin Derivatives may increase the metabolism of Delavirdine. Delavirdine may increase the serum concentration of Rifamycin Derivatives. Specifically, Rifabutin serum concentration may be increased.

Dienogest

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dienogest. Management: Avoid use of dienogest for contraception when using medications that induce CYP3A4 and for at least 28 days after discontinuation of a CYP3A4 inducer. An alternative form of contraception should be used during this time.

DilTIAZem

RifAMPin may decrease the serum concentration of DilTIAZem.

Doravirine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Doravirine.

Dronedarone

CYP3A4 Inducers (Strong) may decrease the serum concentration of Dronedarone.

Duvelisib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Duvelisib.

Edoxaban

RifAMPin may decrease the serum concentration of Edoxaban.

Elbasvir

CYP3A4 Inducers (Strong) may decrease the serum concentration of Elbasvir.

Eliglustat

CYP3A4 Inducers (Strong) may decrease the serum concentration of Eliglustat.

Elvitegravir

RifAMPin may decrease the serum concentration of Elvitegravir.

Encorafenib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Encorafenib.

Entrectinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Entrectinib.

Erdafitinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Erdafitinib.

Esomeprazole

RifAMPin may decrease the serum concentration of Esomeprazole.

Etravirine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Etravirine.

Fedratinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Fedratinib.

Fimasartan

RifAMPin may increase the serum concentration of Fimasartan.

Flibanserin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Flibanserin.

Fosamprenavir

RifAMPin may decrease the serum concentration of Fosamprenavir. Specifically, concentrations of amprenavir (active metabolite) may be decreased.

Fosaprepitant

CYP3A4 Inducers (Strong) may decrease the serum concentration of Fosaprepitant. Specifically, CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite aprepitant.

Fosnetupitant

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Fosnetupitant.

Fostamatinib

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Fostamatinib.

Gemigliptin

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Gemigliptin. CYP3A4 Inducers (Strong) may decrease the serum concentration of Gemigliptin.

Gilteritinib

Combined Inducers of CYP3A4 and P-glycoprotein may decrease the serum concentration of Gilteritinib.

Glasdegib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Glasdegib.

Glecaprevir and Pibrentasvir

RifAMPin may decrease the serum concentration of Glecaprevir and Pibrentasvir. RifAMPin may increase the serum concentration of Glecaprevir and Pibrentasvir. Specifically, a single dose of rifampin may increase glecaprevir/pibrentasvir concentrations, while chronic daily use of rifampin may decrease glecaprevir/pibrentasvir concentrations.

Grazoprevir

RifAMPin may decrease the serum concentration of Grazoprevir. Conversely, single doses of Rifampin may increase Grazoprevir concentrations.

Ibrutinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ibrutinib.

Idelalisib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Idelalisib.

Indinavir

RifAMPin may decrease the serum concentration of Indinavir.

Irinotecan Products

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Irinotecan Products. Specifically, serum concentrations of SN-38 may be reduced. CYP3A4 Inducers (Strong) may decrease the serum concentration of Irinotecan Products.

Isavuconazonium Sulfate

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Isavuconazonium Sulfate. Specifically, CYP3A4 Inducers (Strong) may decrease isavuconazole serum concentrations.

Itraconazole

CYP3A4 Inducers (Strong) may decrease the serum concentration of Itraconazole.

Ivabradine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ivabradine.

Ivacaftor

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ivacaftor.

Ivosidenib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ivosidenib.

Ixazomib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ixazomib.

Lapatinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Lapatinib. Management: If therapy overlap cannot be avoided, consider titrating lapatinib gradually from 1,250 mg/day up to 4,500 mg/day (HER2 positive metastatic breast cancer) or 1,500 mg/day up to 5,500 mg/day (hormone receptor/HER2 positive breast cancer) as tolerated.

Ledipasvir

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Ledipasvir.

Letermovir

RifAMPin may decrease the serum concentration of Letermovir.

Lopinavir

RifAMPin may enhance the adverse/toxic effect of Lopinavir. Specifically, the risk of hepatocellular toxicity may be increased. RifAMPin may decrease the serum concentration of Lopinavir.

Lorlatinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Lorlatinib.

Lumefantrine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Lumefantrine.

Lurasidone

CYP3A4 Inducers (Strong) may decrease the serum concentration of Lurasidone.

Macimorelin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Macimorelin.

Macitentan

CYP3A4 Inducers (Strong) may decrease the serum concentration of Macitentan.

Midostaurin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Midostaurin.

MiFEPRIStone

CYP3A4 Inducers (Strong) may decrease the serum concentration of MiFEPRIStone.

Mycophenolate

Rifamycin Derivatives may decrease the serum concentration of Mycophenolate. Specifically, rifamycin derivatives may decrease the concentration of the active metabolite mycophenolic acid.

Naldemedine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Naldemedine.

Naloxegol

CYP3A4 Inducers (Strong) may decrease the serum concentration of Naloxegol.

Nelfinavir

RifAMPin may decrease the serum concentration of Nelfinavir.

Neratinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Neratinib.

Netupitant

CYP3A4 Inducers (Strong) may decrease the serum concentration of Netupitant.

NIFEdipine

CYP3A4 Inducers (Strong) may decrease the serum concentration of NIFEdipine.

Nilotinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Nilotinib.

NiMODipine

CYP3A4 Inducers (Strong) may decrease the serum concentration of NiMODipine.

Nintedanib

Combined Inducers of CYP3A4 and P-glycoprotein may decrease the serum concentration of Nintedanib.

Nisoldipine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Nisoldipine.

Olaparib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Olaparib.

Omeprazole

RifAMPin may decrease the serum concentration of Omeprazole.

Palbociclib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Palbociclib.

Panobinostat

CYP3A4 Inducers (Strong) may decrease the serum concentration of Panobinostat.

PAZOPanib

CYP3A4 Inducers (Strong) may decrease the serum concentration of PAZOPanib.

Pexidartinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Pexidartinib.

Pimavanserin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Pimavanserin.

Pimozide

CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide.

Piperaquine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Piperaquine.

PONATinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of PONATinib.

Praziquantel

CYP3A4 Inducers (Strong) may decrease the serum concentration of Praziquantel. Management: Use of praziquantel with strong CYP3A4 inducers is contraindicated. Discontinue rifampin 4 weeks prior to initiation of praziquantel therapy. Rifampin may be resumed the day following praziquantel completion.

Pretomanid

CYP3A4 Inducers (Strong) may decrease the serum concentration of Pretomanid.

QuiNINE

RifAMPin may decrease the serum concentration of QuiNINE.

Ranolazine

RifAMPin may decrease the serum concentration of Ranolazine.

Regorafenib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Regorafenib.

Revefenacin

OATP1B1/1B3 (SLCO1B1/1B3) Inhibitors may increase serum concentrations of the active metabolite(s) of Revefenacin.

Ribociclib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ribociclib.

Rilpivirine

Rifamycin Derivatives may decrease the serum concentration of Rilpivirine.

Ritonavir

RifAMPin may decrease the serum concentration of Ritonavir.

Rivaroxaban

CYP3A4 Inducers (Strong) may decrease the serum concentration of Rivaroxaban.

Roflumilast

RifAMPin may decrease the serum concentration of Roflumilast. Management: Roflumilast U.S. prescribing information recommends against combining rifampin with roflumilast. The Canadian product monograph makes no such recommendation but notes that rifampin may reduce roflumilast therapeutic effects.

RomiDEPsin

RifAMPin may increase the serum concentration of RomiDEPsin.

Saquinavir

RifAMPin may enhance the adverse/toxic effect of Saquinavir. Specifically, the risk of hepatocellular toxicity may be increased. RifAMPin may decrease the serum concentration of Saquinavir.

Simeprevir

CYP3A4 Inducers (Strong) may decrease the serum concentration of Simeprevir.

Siponimod

RifAMPin may decrease the serum concentration of Siponimod. Management: Coadministration of siponimod with rifampin, a moderate inducer of CYP2C9 and a strong inducer of CYP3A4, is not recommended.

Sofosbuvir

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Sofosbuvir.

Sonidegib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Sonidegib.

SORAfenib

CYP3A4 Inducers (Strong) may decrease the serum concentration of SORAfenib.

Tasimelteon

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tasimelteon.

Tenofovir Alafenamide

RifAMPin may decrease the serum concentration of Tenofovir Alafenamide.

Ticagrelor

CYP3A4 Inducers (Strong) may decrease serum concentrations of the active metabolite(s) of Ticagrelor. CYP3A4 Inducers (Strong) may decrease the serum concentration of Ticagrelor.

Tipranavir

RifAMPin may decrease the serum concentration of Tipranavir.

Tofacitinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tofacitinib.

Tolvaptan

CYP3A4 Inducers (Strong) may decrease the serum concentration of Tolvaptan. Management: If concurrent use is necessary, increased doses of tolvaptan (with close monitoring for toxicity and clinical response) may be needed.

Toremifene

CYP3A4 Inducers (Strong) may decrease the serum concentration of Toremifene.

Trabectedin

CYP3A4 Inducers (Strong) may decrease the serum concentration of Trabectedin.

Ulipristal

CYP3A4 Inducers (Strong) may decrease the serum concentration of Ulipristal.

Upadacitinib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Upadacitinib.

Valbenazine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Valbenazine.

Vandetanib

CYP3A4 Inducers (Strong) may decrease the serum concentration of Vandetanib.

Velpatasvir

CYP2B6 Inducers (Moderate) may decrease the serum concentration of Velpatasvir.

Velpatasvir

CYP3A4 Inducers (Strong) may decrease the serum concentration of Velpatasvir.

Velpatasvir

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of Velpatasvir.

Venetoclax

CYP3A4 Inducers (Strong) may decrease the serum concentration of Venetoclax.

VinCRIStine (Liposomal)

CYP3A4 Inducers (Strong) may decrease the serum concentration of VinCRIStine (Liposomal).

VinCRIStine (Liposomal)

P-glycoprotein/ABCB1 Inducers may decrease the serum concentration of VinCRIStine (Liposomal).

Vinflunine

CYP3A4 Inducers (Strong) may decrease the serum concentration of Vinflunine.

Vorapaxar

CYP3A4 Inducers (Strong) may decrease the serum concentration of Vorapaxar.

Voriconazole

May increase the serum concentration of Rifamycin Derivatives. Rifamycin Derivatives may decrease the serum concentration of Voriconazole.

Voxilaprevir

RifAMPin may increase the serum concentration of Voxilaprevir. Specifically, a single dose of rifampin may increase voxilaprevir concentrations, while chronic daily use of rifampin may decrease voxilaprevir concentrations. RifAMPin may decrease the serum concentration of Voxilaprevir.

Zolpidem

RifAMPin may decrease the serum concentration of Zolpidem.