Drug interactions
Clomipramine + Rifabutin
Severity: Moderate
Clomipramine 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 is an enzyme inducer and may lower clomipramine plasma concentrations, with a possible loss of antidepressant or antiobsessional effect. The induction is weaker than that of rifampicin.
What this interaction means in plain words
Clomipramine 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.
Clomipramine belongs to Central Nervous System; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of hepatic CYP enzymes (including CYP3A4) by rifabutin increases clomipramine metabolism.
What to do
Monitor clinical response and consider measuring clomipramine and desmethylclomipramine levels. Increase the clomipramine dose if needed and reduce it again after 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 Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine 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 Clomipramine with Rifabutin?
MediHelp rates the interaction as moderate. Clomipramine 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 is an enzyme inducer and may lower clomipramine plasma concentrations, with a possible loss of antidepressant or antiobsessional effect. The induction is weaker than that of rifampicin.
How serious is the interaction between Clomipramine 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 clinical response and consider measuring clomipramine and desmethylclomipramine levels. Increase the clomipramine dose if needed and reduce it again after rifabutin is stopped.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
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