Drug interactions
Azithromycin + Rifabutin
Severity: Moderate
Azithromycin 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
Azithromycin and rifabutin are often co-prescribed for Mycobacterium avium complex, and rifabutin-related adverse effects such as uveitis and neutropenia may occur more often. Gastrointestinal intolerance and raised rifabutin levels have also been reported with macrolides.
What this interaction means in plain words
Azithromycin 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.
Azithromycin belongs to Anti Bacterial; Rifabutin belongs to Anti Bacterial.
Why it happens
Possible reduced rifabutin clearance; the mechanism is not firmly established because azithromycin is a weak CYP3A4 inhibitor.
What to do
Monitor for uveitis, visual symptoms, neutropenia and liver enzyme changes during combined therapy. Refer promptly for an eye assessment if visual symptoms appear.
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 Azithromycin
- Azithromycin + Cisapride Contraindicated
- Azithromycin + Domperidone Contraindicated
- Azithromycin + Dronedarone Contraindicated
- Azithromycin + Pimozide Contraindicated
- Azithromycin + Piperaquine Contraindicated
- Azithromycin + Thioridazine 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 Azithromycin with Rifabutin?
MediHelp rates the interaction as moderate. Azithromycin 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. Azithromycin and rifabutin are often co-prescribed for Mycobacterium avium complex, and rifabutin-related adverse effects such as uveitis and neutropenia may occur more often. Gastrointestinal intolerance and raised rifabutin levels have also been reported with macrolides.
How serious is the interaction between Azithromycin 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 for uveitis, visual symptoms, neutropenia and liver enzyme changes during combined therapy. Refer promptly for an eye assessment if visual symptoms appear.
What other medicines interact with Azithromycin?
MediHelp also lists interactions of Azithromycin with, for example, Cisapride, Domperidone, Dronedarone. The full list is on the Azithromycin page.
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