Drug interactions
Eplerenone + Rifampin
Severity: Moderate
Eplerenone and Rifampin: 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
Rifampin markedly lowers eplerenone exposure, which can lead to loss of its antihypertensive and heart failure benefit. The effect develops over days after rifampin is started and wanes after it is stopped.
What this interaction means in plain words
Eplerenone and Rifampin 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.
Why it happens
Rifampin induces CYP3A4 (and intestinal efflux transporters), increasing eplerenone metabolism.
What to do
Monitor blood pressure, clinical response and potassium, and titrate eplerenone upward if needed. Reassess the dose when rifampin 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 Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Eplerenone with Rifampin?
MediHelp rates the interaction as moderate. Eplerenone and Rifampin 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. Rifampin markedly lowers eplerenone exposure, which can lead to loss of its antihypertensive and heart failure benefit. The effect develops over days after rifampin is started and wanes after it is stopped.
How serious is the interaction between Eplerenone and Rifampin?
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, clinical response and potassium, and titrate eplerenone upward if needed. Reassess the dose when rifampin is stopped.
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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