Drug interactions
Letermovir + Rifabutin
Severity: Major
Letermovir and Rifabutin: 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
Rifabutin is expected to lower letermovir concentrations and may reduce its efficacy in preventing CMV disease. Labeling does not recommend using them together.
What this interaction means in plain words
Letermovir and Rifabutin 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.
Letermovir belongs to Anti Virals; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces drug-metabolizing enzymes, increasing letermovir clearance.
What to do
Avoid the combination; consider alternative therapy for the indication of rifabutin. If used, monitor for CMV breakthrough.
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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
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 Letermovir with Rifabutin?
MediHelp rates the interaction as major. Letermovir and Rifabutin 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. Rifabutin is expected to lower letermovir concentrations and may reduce its efficacy in preventing CMV disease. Labeling does not recommend using them together.
How serious is the interaction between Letermovir and Rifabutin?
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 the combination; consider alternative therapy for the indication of rifabutin. If used, monitor for CMV breakthrough.
What other medicines interact with Letermovir?
MediHelp also lists interactions of Letermovir with, for example, Ergotamine, Pimozide, Apalutamide. The full list is on the Letermovir page.
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