Drug interactions
Nilotinib + Rifabutin
Severity: Major
Nilotinib 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 induces CYP3A4 and can lower nilotinib concentrations, risking treatment failure in leukemia. The inducing effect is weaker than that of rifampicin but still potentially relevant.
What this interaction means in plain words
Nilotinib 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.
Nilotinib belongs to Oncology; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 by rifabutin increases nilotinib metabolism and lowers its exposure.
What to do
Avoid the combination and consider an alternative antimycobacterial. If it is unavoidable, monitor response and consider nilotinib dose adjustment with ECG monitoring.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib 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 Nilotinib with Rifabutin?
MediHelp rates the interaction as major. Nilotinib 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 induces CYP3A4 and can lower nilotinib concentrations, risking treatment failure in leukemia. The inducing effect is weaker than that of rifampicin but still potentially relevant.
How serious is the interaction between Nilotinib 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 and consider an alternative antimycobacterial. If it is unavoidable, monitor response and consider nilotinib dose adjustment with ECG monitoring.
What other medicines interact with Nilotinib?
MediHelp also lists interactions of Nilotinib with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Nilotinib page.
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