Drug interactions
Donepezil + Rifabutin
Severity: Moderate
Donepezil 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 drug-metabolizing enzymes and may lower donepezil concentrations. This could reduce the clinical effect of donepezil on cognition.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and possibly CYP2D6-related clearance) by rifabutin increases donepezil metabolism.
What to do
Monitor cognitive response and consider a donepezil dose increase within the labeled range if benefit is lost. 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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
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 Donepezil with Rifabutin?
MediHelp rates the interaction as moderate. Donepezil 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 drug-metabolizing enzymes and may lower donepezil concentrations. This could reduce the clinical effect of donepezil on cognition.
How serious is the interaction between Donepezil 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 cognitive response and consider a donepezil dose increase within the labeled range if benefit is lost. Reassess the dose when rifabutin is stopped.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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