Drug interactions
Eplerenone + Rifabutin
Severity: Moderate
Eplerenone 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 inducer of CYP3A4, the main enzyme that clears eplerenone. Co-administration can lower eplerenone exposure and weaken its antihypertensive or heart failure benefit. Rifabutin is a weaker inducer than rifampicin, so the effect is usually smaller.
What this interaction means in plain words
Eplerenone 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.
Eplerenone belongs to Cardiovascular; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces hepatic and intestinal CYP3A4, increasing the metabolism of eplerenone.
What to do
Monitor blood pressure and clinical response, and check potassium. Increase the eplerenone dose if the response is inadequate.
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 Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone 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 Eplerenone with Rifabutin?
MediHelp rates the interaction as moderate. Eplerenone 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 inducer of CYP3A4, the main enzyme that clears eplerenone. Co-administration can lower eplerenone exposure and weaken its antihypertensive or heart failure benefit. Rifabutin is a weaker inducer than rifampicin, so the effect is usually smaller.
How serious is the interaction between Eplerenone 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 blood pressure and clinical response, and check potassium. Increase the eplerenone dose if the response is inadequate.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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