Drug interactions
Itraconazole + Rifaximin
Severity: Moderate
Itraconazole and Rifaximin: 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
Itraconazole is a strong P-glycoprotein inhibitor and can raise systemic rifaximin exposure. The effect is generally modest but may be more relevant in severe liver disease.
What this interaction means in plain words
Itraconazole and Rifaximin 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.
Itraconazole belongs to Anti Fungals; Rifaximin belongs to Anti Bacterial.
Why it happens
P-glycoprotein inhibition by itraconazole reduces intestinal efflux of rifaximin.
What to do
Use usual rifaximin doses and monitor for adverse effects; be especially watchful in patients with Child-Pugh C disease.
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 Rifaximin
- Cholera vaccine + Rifaximin Major
- Microbiota + Rifaximin Major
- Amiodarone + Rifaximin Moderate
- Bcg intravesical live + Rifaximin Moderate
- Cyclosporine + Rifaximin Moderate
- Cyclosporin + Rifaximin Moderate
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Itraconazole with Rifaximin?
MediHelp rates the interaction as moderate. Itraconazole and Rifaximin 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. Itraconazole is a strong P-glycoprotein inhibitor and can raise systemic rifaximin exposure. The effect is generally modest but may be more relevant in severe liver disease.
How serious is the interaction between Itraconazole and Rifaximin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use usual rifaximin doses and monitor for adverse effects; be especially watchful in patients with Child-Pugh C disease.
What other medicines interact with Rifaximin?
MediHelp also lists interactions of Rifaximin with, for example, Cholera vaccine, Microbiota, Amiodarone. The full list is on the Rifaximin page.
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