Drug interactions
Primaquine + Rifabutin
Severity: Moderate
Primaquine 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 and may lower primaquine exposure, which could reduce efficacy for radical cure or prophylaxis. The effect of rifabutin is weaker than that of rifampicin, and the clinical impact has not been well characterized. Primaquine's active metabolites are formed by several pathways, so the effect is uncertain.
What this interaction means in plain words
Primaquine 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.
Primaquine belongs to Anti Parasitic; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces hepatic CYP enzymes, including CYP3A4, which may increase primaquine clearance.
What to do
Monitor for treatment failure or relapse of malaria. Consider an alternative if efficacy is critical and relapse occurs.
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 Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine 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 Primaquine with Rifabutin?
MediHelp rates the interaction as moderate. Primaquine 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 and may lower primaquine exposure, which could reduce efficacy for radical cure or prophylaxis. The effect of rifabutin is weaker than that of rifampicin, and the clinical impact has not been well characterized. Primaquine's active metabolites are formed by several pathways, so the effect is uncertain.
How serious is the interaction between Primaquine 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 treatment failure or relapse of malaria. Consider an alternative if efficacy is critical and relapse occurs.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine page.
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