Drug interactions
Aprepitant + Rifampin
Severity: Major
Aprepitant and Rifampin: major interaction.
Last updated Sources: US FDA label
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
Rifampin markedly lowers aprepitant plasma concentrations, which may lead to loss of antiemetic efficacy. This is relevant in chemotherapy-induced nausea prophylaxis.
What this interaction means in plain words
Aprepitant and Rifampin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Rifampin strongly induces CYP3A4, accelerating aprepitant metabolism.
What to do
Avoid the combination; use an antiemetic regimen not dependent on aprepitant. If unavoidable, monitor for breakthrough nausea and vomiting.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Frequently asked questions
Can I take Aprepitant with Rifampin?
MediHelp rates the interaction as major. Aprepitant and Rifampin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifampin markedly lowers aprepitant plasma concentrations, which may lead to loss of antiemetic efficacy. This is relevant in chemotherapy-induced nausea prophylaxis.
How serious is the interaction between Aprepitant and Rifampin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; use an antiemetic regimen not dependent on aprepitant. If unavoidable, monitor for breakthrough nausea and vomiting.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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