Drug interactions
Fluconazole + Rifabutin
Severity: Moderate
Fluconazole 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 modestly lower fluconazole levels. More importantly, fluconazole increases rifabutin exposure, raising the risk of uveitis, neutropenia and other toxicity.
What this interaction means in plain words
Fluconazole 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.
Fluconazole belongs to Anti Fungals; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces fluconazole clearance, while fluconazole inhibits CYP3A4 metabolism of rifabutin.
What to do
Monitor for uveitis, leukopenia and antifungal efficacy. Consider reducing the rifabutin dose or adjusting fluconazole based on response.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole 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 Fluconazole with Rifabutin?
MediHelp rates the interaction as moderate. Fluconazole 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 modestly lower fluconazole levels. More importantly, fluconazole increases rifabutin exposure, raising the risk of uveitis, neutropenia and other toxicity.
How serious is the interaction between Fluconazole 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 for uveitis, leukopenia and antifungal efficacy. Consider reducing the rifabutin dose or adjusting fluconazole based on response.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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