Drug interactions
Hydrocortisone + Rifapentine
Severity: Major
Hydrocortisone and Rifapentine: major interaction.
Last updated Sources: US FDA label
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
Rifapentine induces CYP3A4 and speeds hydrocortisone clearance, which can lower corticosteroid effect. Adrenal crisis has been reported with rifamycins in patients on replacement therapy.
What this interaction means in plain words
Hydrocortisone and Rifapentine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Hydrocortisone belongs to Endocrine; Rifapentine belongs to Anti Bacterial.
Why it happens
Induction of hepatic and intestinal CYP3A4 by rifapentine increases hydrocortisone metabolism.
What to do
Monitor for under-replacement and increase the hydrocortisone dose as needed in patients with adrenal insufficiency. Review the dose when rifapentine is stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
Other interactions of Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Hydrocortisone with Rifapentine?
MediHelp rates the interaction as major. Hydrocortisone and Rifapentine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifapentine induces CYP3A4 and speeds hydrocortisone clearance, which can lower corticosteroid effect. Adrenal crisis has been reported with rifamycins in patients on replacement therapy.
How serious is the interaction between Hydrocortisone and Rifapentine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for under-replacement and increase the hydrocortisone dose as needed in patients with adrenal insufficiency. Review the dose when rifapentine is stopped.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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