Drug interactions
Mefloquine + Rifampin
Severity: Major
Mefloquine and Rifampin: 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
Rifampin markedly induces mefloquine metabolism and has been shown to lower mefloquine concentrations. This may lead to loss of prophylactic or therapeutic efficacy against malaria.
What this interaction means in plain words
Mefloquine and Rifampin 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.
Why it happens
Induction of CYP3A4 and efflux transporters by rifampin increases mefloquine clearance.
What to do
Avoid the combination where possible and choose an antimalarial not dependent on CYP3A4. If it must be used, monitor closely for malaria 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 Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide Contraindicated
Frequently asked questions
Can I take Mefloquine with Rifampin?
MediHelp rates the interaction as major. Mefloquine and Rifampin 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. Rifampin markedly induces mefloquine metabolism and has been shown to lower mefloquine concentrations. This may lead to loss of prophylactic or therapeutic efficacy against malaria.
How serious is the interaction between Mefloquine and Rifampin?
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 where possible and choose an antimalarial not dependent on CYP3A4. If it must be used, monitor closely for malaria breakthrough.
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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