Drug interactions
Ifosfamide + Rifabutin
Severity: Moderate
Ifosfamide 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 a CYP3A4 inducer and may speed up the conversion of ifosfamide into both its active alkylating metabolites and its toxic by-product chloroacetaldehyde. This can raise the risk of neurotoxicity, nephrotoxicity and myelosuppression while the efficacy impact is uncertain.
What this interaction means in plain words
Ifosfamide 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.
Ifosfamide belongs to Oncology; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and CYP2B6) by rifabutin increases ifosfamide bioactivation and N-dechloroethylation to neurotoxic and nephrotoxic metabolites.
What to do
Monitor for encephalopathy, renal function and blood counts during ifosfamide cycles, and consider an alternative antimycobacterial that is not an enzyme inducer if feasible.
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 Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live 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 Ifosfamide with Rifabutin?
MediHelp rates the interaction as moderate. Ifosfamide 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 a CYP3A4 inducer and may speed up the conversion of ifosfamide into both its active alkylating metabolites and its toxic by-product chloroacetaldehyde. This can raise the risk of neurotoxicity, nephrotoxicity and myelosuppression while the efficacy impact is uncertain.
How serious is the interaction between Ifosfamide 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 encephalopathy, renal function and blood counts during ifosfamide cycles, and consider an alternative antimycobacterial that is not an enzyme inducer if feasible.
What other medicines interact with Ifosfamide?
MediHelp also lists interactions of Ifosfamide with, for example, Adenovirus types 4 and 7 live, Measles mumps and rubella vaccine, Measles mumps and rubella vaccine live. The full list is on the Ifosfamide page.
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