Drug interactions
Quinine + Rifampin
Severity: Major
Quinine and Rifampin: major 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
Rifampin is a potent CYP3A4 inducer and substantially lowers quinine exposure. This may cause antimalarial treatment failure.
What this interaction means in plain words
Quinine 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 P-gp), increasing quinine clearance.
What to do
Avoid the combination when quinine is used for malaria and choose an alternative antimalarial. If unavoidable, monitor parasitological response closely.
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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Other interactions of Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Frequently asked questions
Can I take Quinine with Rifampin?
MediHelp rates the interaction as major. Quinine 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 is a potent CYP3A4 inducer and substantially lowers quinine exposure. This may cause antimalarial treatment failure.
How serious is the interaction between Quinine 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: Avoid the combination when quinine is used for malaria and choose an alternative antimalarial. If unavoidable, monitor parasitological response closely.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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