Drug interactions
Pioglitazone + Rifabutin
Severity: Moderate
Pioglitazone 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 CYP enzymes, including CYP2C8 and CYP3A4, which metabolize pioglitazone. Pioglitazone exposure may fall, with reduced glycemic control. The effect is smaller than with rifampicin.
What this interaction means in plain words
Pioglitazone 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.
Pioglitazone belongs to Endocrine; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP2C8 and CYP3A4 by rifabutin increases pioglitazone clearance.
What to do
Monitor glucose and HbA1c when starting or stopping rifabutin. Increase the pioglitazone dose if needed, within the labeled maximum.
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 Pioglitazone
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 Pioglitazone with Rifabutin?
MediHelp rates the interaction as moderate. Pioglitazone 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 CYP enzymes, including CYP2C8 and CYP3A4, which metabolize pioglitazone. Pioglitazone exposure may fall, with reduced glycemic control. The effect is smaller than with rifampicin.
How serious is the interaction between Pioglitazone 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 glucose and HbA1c when starting or stopping rifabutin. Increase the pioglitazone dose if needed, within the labeled maximum.
What other medicines interact with Pioglitazone?
MediHelp also lists interactions of Pioglitazone with, for example, Insulin aspart-insulin aspart protamine, Insulin aspart, Insulin degludec-insulin aspart. The full list is on the Pioglitazone page.
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