Drug interactions
Buprenorphine + Rifabutin
Severity: Moderate
Buprenorphine 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 CYP3A4, although less strongly than rifampicin, and can reduce buprenorphine concentrations. This may lead to opioid withdrawal symptoms or reduced analgesia.
What this interaction means in plain words
Buprenorphine 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.
Buprenorphine belongs to Musculoskeletal; Rifabutin belongs to Anti Bacterial.
Why it happens
CYP3A4 induction by rifabutin increases buprenorphine metabolism.
What to do
Monitor for withdrawal symptoms and inadequate pain control, and increase the buprenorphine dose according to response. 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 Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + 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 Buprenorphine with Rifabutin?
MediHelp rates the interaction as moderate. Buprenorphine 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 CYP3A4, although less strongly than rifampicin, and can reduce buprenorphine concentrations. This may lead to opioid withdrawal symptoms or reduced analgesia.
How serious is the interaction between Buprenorphine 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 withdrawal symptoms and inadequate pain control, and increase the buprenorphine dose according to response. Reassess the dose when rifabutin is stopped.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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