Drug interactions
Paliperidone + Rifampin
Severity: Moderate
Paliperidone and Rifampin: 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
Rifampin induces P-glycoprotein and CYP3A4 and can substantially lower paliperidone concentrations. This may lead to loss of antipsychotic efficacy and relapse.
What this interaction means in plain words
Paliperidone and Rifampin 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.
Why it happens
Induction of P-glycoprotein (and CYP3A4) increasing paliperidone efflux and clearance.
What to do
Monitor for loss of symptom control and consider increasing the paliperidone dose during rifampin therapy. Reduce the dose again after rifampin 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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Paliperidone with Rifampin?
MediHelp rates the interaction as moderate. Paliperidone and Rifampin 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. Rifampin induces P-glycoprotein and CYP3A4 and can substantially lower paliperidone concentrations. This may lead to loss of antipsychotic efficacy and relapse.
How serious is the interaction between Paliperidone and Rifampin?
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 for loss of symptom control and consider increasing the paliperidone dose during rifampin therapy. Reduce the dose again after rifampin is stopped.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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