Drug interactions
Lefamulin + Rifampicin
Severity: Major
Lefamulin and Rifampicin: major 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
Rifampicin lowers lefamulin exposure, particularly oral, and may cause treatment failure of community-acquired pneumonia.
What this interaction means in plain words
Lefamulin and Rifampicin 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.
Lefamulin belongs to Anti Bacterial; Rifampicin belongs to Anti Bacterial.
Why it happens
Rifampicin induces CYP3A4 and P-gp, increasing lefamulin clearance.
What to do
Avoid coadministration and choose an alternative antibiotic for pneumonia. Do not use lefamulin during rifampicin therapy.
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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Other interactions of Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
Other interactions of Rifampicin
- Cabotegravir + Rifampicin Contraindicated
- Delamanid + Rifampicin Contraindicated
- Doravirine + Rifampicin Contraindicated
- Ensitrelvir + Rifampicin Contraindicated
- Fostemsavir + Rifampicin Contraindicated
- Isavuconazole + Rifampicin Contraindicated
Frequently asked questions
Can I take Lefamulin with Rifampicin?
MediHelp rates the interaction as major. Lefamulin and Rifampicin 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. Rifampicin lowers lefamulin exposure, particularly oral, and may cause treatment failure of community-acquired pneumonia.
How serious is the interaction between Lefamulin and Rifampicin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid coadministration and choose an alternative antibiotic for pneumonia. Do not use lefamulin during rifampicin therapy.
What other medicines interact with Lefamulin?
MediHelp also lists interactions of Lefamulin with, for example, Methadone, Pimavanserin, Pimozide. The full list is on the Lefamulin page.
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