Drug interactions
Amitriptyline + Rifabutin
Severity: Moderate
Amitriptyline and Rifabutin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Rifabutin induces hepatic metabolism and may lower amitriptyline exposure, potentially reducing antidepressant efficacy. The effect is generally weaker than with rifampicin.
What this interaction means in plain words
Amitriptyline and Rifabutin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP enzymes (including CYP3A4) increasing amitriptyline clearance.
What to do
Monitor clinical response and consider amitriptyline plasma concentrations or a dose increase if efficacy falls. Reassess the dose when rifabutin is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Amitriptyline with Rifabutin?
MediHelp rates the interaction as moderate. Amitriptyline and Rifabutin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rifabutin induces hepatic metabolism and may lower amitriptyline exposure, potentially reducing antidepressant efficacy. The effect is generally weaker than with rifampicin.
How serious is the interaction between Amitriptyline and Rifabutin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and consider amitriptyline plasma concentrations or a dose increase if efficacy falls. Reassess the dose when rifabutin is stopped.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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