Drug interactions
Propafenone + Rifabutin
Severity: Moderate
Propafenone 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 hepatic and intestinal metabolic enzymes and may lower propafenone exposure, which could lead to loss of antiarrhythmic control. The effect is generally weaker than with rifampicin.
What this interaction means in plain words
Propafenone 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.
Propafenone belongs to Cardiovascular; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and possibly CYP1A2) metabolism of propafenone.
What to do
Monitor heart rhythm and clinical response to propafenone, and consider adjusting the dose or checking ECG when rifabutin is started or 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?
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Other interactions of Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
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 Propafenone with Rifabutin?
MediHelp rates the interaction as moderate. Propafenone 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 hepatic and intestinal metabolic enzymes and may lower propafenone exposure, which could lead to loss of antiarrhythmic control. The effect is generally weaker than with rifampicin.
How serious is the interaction between Propafenone 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 heart rhythm and clinical response to propafenone, and consider adjusting the dose or checking ECG when rifabutin is started or stopped.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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