Drug interactions
Naldemedine + Rifampicin
Severity: Major
Naldemedine and Rifampicin: 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
Rifampicin substantially reduces naldemedine concentrations and may blunt its effect on opioid-induced constipation.
What this interaction means in plain words
Naldemedine and Rifampicin 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.
Naldemedine belongs to Gastrointestinal Tract; Rifampicin belongs to Anti Bacterial.
Why it happens
Strong CYP3A induction by rifampicin increases naldemedine clearance.
What to do
Avoid concomitant use and use an alternative laxative strategy during rifampicin therapy.
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 Naldemedine
- Bupropion-naltrexone + Naldemedine Major
- Naldemedine + Naltrexone Major
- Naldemedine + Phenytoin Major
- Amobarbital + Naldemedine Moderate
- Apalutamide + Naldemedine Moderate
- Aprepitant + Naldemedine Moderate
Other interactions of Rifampicin
- Cabotegravir + Rifampicin Contraindicated
- Delamanid + Rifampicin Contraindicated
- Doravirine + Rifampicin Contraindicated
- Ensitrelvir + Rifampicin Contraindicated
- Fostemsavir + Rifampicin Contraindicated
- Isavuconazole + Rifampicin Contraindicated
Frequently asked questions
Can I take Naldemedine with Rifampicin?
MediHelp rates the interaction as major. Naldemedine and Rifampicin 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. Rifampicin substantially reduces naldemedine concentrations and may blunt its effect on opioid-induced constipation.
How serious is the interaction between Naldemedine and Rifampicin?
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 concomitant use and use an alternative laxative strategy during rifampicin therapy.
What other medicines interact with Naldemedine?
MediHelp also lists interactions of Naldemedine with, for example, Bupropion-naltrexone, Naltrexone, Phenytoin. The full list is on the Naldemedine page.
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