Drug interactions
Leflunomide + Rifampin
Severity: Moderate
Leflunomide and Rifampin: 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
Rifampin is a strong enzyme inducer and may modestly increase formation or clearance of teriflunomide. Labeling for teriflunomide reports a small rise in exposure with repeated rifampin. The effect on efficacy or toxicity is not well defined, including hepatotoxicity risk that is additive for both drugs.
What this interaction means in plain words
Leflunomide and Rifampin 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.
Why it happens
Rifampin induces metabolic enzymes and transporters, altering teriflunomide disposition; both drugs are also hepatotoxic.
What to do
Monitor liver enzymes and clinical response to leflunomide when rifampin is started or stopped. Consider alternatives if liver tests rise.
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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Frequently asked questions
Can I take Leflunomide with Rifampin?
MediHelp rates the interaction as moderate. Leflunomide and Rifampin 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. Rifampin is a strong enzyme inducer and may modestly increase formation or clearance of teriflunomide. Labeling for teriflunomide reports a small rise in exposure with repeated rifampin. The effect on efficacy or toxicity is not well defined, including hepatotoxicity risk that is additive for both drugs.
How serious is the interaction between Leflunomide and Rifampin?
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 liver enzymes and clinical response to leflunomide when rifampin is started or stopped. Consider alternatives if liver tests rise.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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