Drug interactions
Brexpiprazole + Rifabutin
Severity: Major
Brexpiprazole and Rifabutin: major 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 CYP3A4, though less potently than rifampicin, and may lower brexpiprazole concentrations. Reduced efficacy is possible.
What this interaction means in plain words
Brexpiprazole and Rifabutin 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.
Brexpiprazole belongs to Central Nervous System; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces CYP3A4, increasing brexpiprazole clearance.
What to do
Increase the brexpiprazole dose toward twice the usual dose over 1 to 2 weeks and monitor response. Reduce it again when rifabutin is stopped.
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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Other interactions of Brexpiprazole
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Clarithromycin + Rifabutin Major
Frequently asked questions
Can I take Brexpiprazole with Rifabutin?
MediHelp rates the interaction as major. Brexpiprazole and Rifabutin 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. Rifabutin induces CYP3A4, though less potently than rifampicin, and may lower brexpiprazole concentrations. Reduced efficacy is possible.
How serious is the interaction between Brexpiprazole and Rifabutin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Increase the brexpiprazole dose toward twice the usual dose over 1 to 2 weeks and monitor response. Reduce it again when rifabutin is stopped.
What other medicines interact with Brexpiprazole?
MediHelp also lists interactions of Brexpiprazole with, for example, Alfentanil, Amisulpride, Apalutamide. The full list is on the Brexpiprazole page.
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