Drug interactions
Pimavanserin + Rifabutin
Severity: Moderate
Pimavanserin 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 is a CYP3A4 inducer, which can lower pimavanserin concentrations and weaken its antipsychotic effect. Pimavanserin labeling advises dose increase with strong CYP3A4 inducers; rifabutin is a moderate-to-strong inducer.
What this interaction means in plain words
Pimavanserin 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.
Pimavanserin belongs to Central Nervous System; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 by rifabutin increases the metabolism of pimavanserin.
What to do
Monitor for loss of psychosis control and consider increasing the pimavanserin dose; reduce the dose again if 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Pimavanserin and Rifabutin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin 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 Pimavanserin with Rifabutin?
MediHelp rates the interaction as moderate. Pimavanserin 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 is a CYP3A4 inducer, which can lower pimavanserin concentrations and weaken its antipsychotic effect. Pimavanserin labeling advises dose increase with strong CYP3A4 inducers; rifabutin is a moderate-to-strong inducer.
How serious is the interaction between Pimavanserin 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 for loss of psychosis control and consider increasing the pimavanserin dose; reduce the dose again if rifabutin is stopped.
What other medicines interact with Pimavanserin?
MediHelp also lists interactions of Pimavanserin with, for example, Lefamulin, Pimozide, Vandetanib. The full list is on the Pimavanserin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
