Drug interactions
Mefloquine + Rifabutin
Severity: Moderate
Mefloquine 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 induces CYP3A4 and can lower mefloquine concentrations, which may reduce its antimalarial effectiveness. Rifampicin has a well-documented effect of this kind and rifabutin is a weaker inducer.
What this interaction means in plain words
Mefloquine 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.
Mefloquine belongs to Anti Parasitic; Rifabutin belongs to Anti Bacterial.
Why it happens
CYP3A4 induction by rifabutin increases mefloquine metabolism.
What to do
Consider an alternative antimalarial for prophylaxis or treatment. If mefloquine is used, monitor for breakthrough infection.
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 Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide 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 Mefloquine with Rifabutin?
MediHelp rates the interaction as moderate. Mefloquine 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 induces CYP3A4 and can lower mefloquine concentrations, which may reduce its antimalarial effectiveness. Rifampicin has a well-documented effect of this kind and rifabutin is a weaker inducer.
How serious is the interaction between Mefloquine 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: Consider an alternative antimalarial for prophylaxis or treatment. If mefloquine is used, monitor for breakthrough infection.
What other medicines interact with Mefloquine?
MediHelp also lists interactions of Mefloquine with, for example, Arsenic trioxide, Dronedarone, Ibutilide. The full list is on the Mefloquine page.
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