Drug interactions
Pretomanid + Rifampicin
Severity: Major
Pretomanid and Rifampicin: 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
Rifampicin lowers pretomanid exposure, which may reduce efficacy against drug-resistant tuberculosis. Subtherapeutic levels also risk resistance development.
What this interaction means in plain words
Pretomanid and Rifampicin 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.
Pretomanid belongs to Anti Bacterial; Rifampicin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 by rifampicin increases pretomanid metabolism.
What to do
Avoid coadministration; use regimens that do not combine pretomanid with rifamycins.
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 Pretomanid
Other interactions of Rifampicin
- Cabotegravir + Rifampicin Contraindicated
- Delamanid + Rifampicin Contraindicated
- Doravirine + Rifampicin Contraindicated
- Ensitrelvir + Rifampicin Contraindicated
- Fostemsavir + Rifampicin Contraindicated
- Isavuconazole + Rifampicin Contraindicated
Frequently asked questions
Can I take Pretomanid with Rifampicin?
MediHelp rates the interaction as major. Pretomanid and Rifampicin 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. Rifampicin lowers pretomanid exposure, which may reduce efficacy against drug-resistant tuberculosis. Subtherapeutic levels also risk resistance development.
How serious is the interaction between Pretomanid and Rifampicin?
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 coadministration; use regimens that do not combine pretomanid with rifamycins.
What other medicines interact with Pretomanid?
MediHelp also lists interactions of Pretomanid with, for example, Amiodarone, Amobarbital, Amoxicillin-clavulanic acid. The full list is on the Pretomanid page.
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