Drug interactions
Brexpiprazole + Rifapentine
Severity: Major
Brexpiprazole and Rifapentine: 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
Rifapentine induces CYP3A4 and can substantially lower brexpiprazole exposure. This may lead to loss of antipsychotic or antidepressant-augmentation efficacy and relapse of symptoms.
What this interaction means in plain words
Brexpiprazole and Rifapentine 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; Rifapentine belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 by rifapentine increases the metabolic clearance of brexpiprazole.
What to do
Brexpiprazole labeling advises roughly doubling the dose over 1 to 2 weeks with strong CYP3A4 inducers, with clinical response monitoring. Reduce the dose back to the usual level over 1 to 2 weeks once rifapentine 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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References
Other interactions of Brexpiprazole
Other interactions of Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Brexpiprazole with Rifapentine?
MediHelp rates the interaction as major. Brexpiprazole and Rifapentine 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. Rifapentine induces CYP3A4 and can substantially lower brexpiprazole exposure. This may lead to loss of antipsychotic or antidepressant-augmentation efficacy and relapse of symptoms.
How serious is the interaction between Brexpiprazole and Rifapentine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Brexpiprazole labeling advises roughly doubling the dose over 1 to 2 weeks with strong CYP3A4 inducers, with clinical response monitoring. Reduce the dose back to the usual level over 1 to 2 weeks once rifapentine 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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