Drug interactions
Metoprolol + Rifabutin
Severity: Moderate
Metoprolol 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 hepatic enzymes and may lower metoprolol concentrations, potentially reducing control of blood pressure, heart rate or angina. The induction effect develops over days to weeks and persists after stopping rifabutin. Rifabutin is a weaker inducer than rifampicin.
What this interaction means in plain words
Metoprolol 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.
Metoprolol belongs to Cardiovascular; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of hepatic metabolism, including CYP enzymes, increasing metoprolol clearance.
What to do
Monitor heart rate and blood pressure, and increase the metoprolol dose if response is lost. Reassess the dose after rifabutin is stopped.
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 Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol 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 Metoprolol with Rifabutin?
MediHelp rates the interaction as moderate. Metoprolol 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 hepatic enzymes and may lower metoprolol concentrations, potentially reducing control of blood pressure, heart rate or angina. The induction effect develops over days to weeks and persists after stopping rifabutin. Rifabutin is a weaker inducer than rifampicin.
How serious is the interaction between Metoprolol 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: Monitor heart rate and blood pressure, and increase the metoprolol dose if response is lost. Reassess the dose after rifabutin is stopped.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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