Drug interactions
Fentanyl + Rifabutin
Severity: Moderate
Fentanyl 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 and can lower fentanyl concentrations, leading to reduced analgesia or opioid withdrawal in dependent patients. When rifabutin is stopped, fentanyl levels may rise again and increase or prolong sedation and respiratory depression.
What this interaction means in plain words
Fentanyl 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.
Fentanyl belongs to Musculoskeletal; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces hepatic and intestinal CYP3A4, increasing the metabolism of fentanyl.
What to do
Monitor pain control and withdrawal signs when starting rifabutin, and titrate the fentanyl dose as needed. When rifabutin is discontinued, reduce the fentanyl dose and monitor for respiratory depression and sedation.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl 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 Fentanyl with Rifabutin?
MediHelp rates the interaction as moderate. Fentanyl 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 and can lower fentanyl concentrations, leading to reduced analgesia or opioid withdrawal in dependent patients. When rifabutin is stopped, fentanyl levels may rise again and increase or prolong sedation and respiratory depression.
How serious is the interaction between Fentanyl 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 pain control and withdrawal signs when starting rifabutin, and titrate the fentanyl dose as needed. When rifabutin is discontinued, reduce the fentanyl dose and monitor for respiratory depression and sedation.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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