Drug interactions
Prednisolone + Rifampin
Severity: Major
Prednisolone and Rifampin: major interaction.
Last updated Sources: US FDA label
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 strongly induces hepatic and intestinal drug-metabolising enzymes and lowers systemic prednisolone exposure. This can cause loss of anti-inflammatory or immunosuppressive control, including relapse of asthma, autoimmune disease or transplant rejection. The effect begins within days and persists for a time after rifampin is stopped.
What this interaction means in plain words
Prednisolone and Rifampin 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.
Why it happens
Rifampin induces CYP3A4 and other enzymes, increasing the clearance of prednisolone.
What to do
Monitor clinical response and increase the prednisolone dose as needed, often by about double in practice. Reduce the dose again after rifampin is stopped to avoid steroid excess.
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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References
Other interactions of Prednisolone
- Bcg vaccine live + Prednisolone Contraindicated
- Measles mumps and rubella vaccine live + Prednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Prednisolone Contraindicated
- Measles vaccine + Prednisolone Contraindicated
- Mifepristone + Prednisolone Contraindicated
- Prednisolone + Radium-223 dichloride Contraindicated
Frequently asked questions
Can I take Prednisolone with Rifampin?
MediHelp rates the interaction as major. Prednisolone and Rifampin 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. Rifampin strongly induces hepatic and intestinal drug-metabolising enzymes and lowers systemic prednisolone exposure. This can cause loss of anti-inflammatory or immunosuppressive control, including relapse of asthma, autoimmune disease or transplant rejection. The effect begins within days and persists for a time after rifampin is stopped.
How serious is the interaction between Prednisolone and Rifampin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and increase the prednisolone dose as needed, often by about double in practice. Reduce the dose again after rifampin is stopped to avoid steroid excess.
What other medicines interact with Prednisolone?
MediHelp also lists interactions of Prednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Prednisolone page.
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