Drug interactions
Ramelteon + Rifabutin
Severity: Moderate
Ramelteon 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 including CYP3A4, and may lower ramelteon concentrations. Reduced hypnotic efficacy may result. The induction is weaker than with rifampicin, which is known to cut ramelteon exposure substantially.
What this interaction means in plain words
Ramelteon 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.
Ramelteon belongs to Central Nervous System; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and possibly CYP1A2) by rifabutin, speeding ramelteon clearance.
What to do
Monitor for loss of sleep benefit and consider an alternative hypnotic if efficacy is inadequate.
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 Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
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 Ramelteon with Rifabutin?
MediHelp rates the interaction as moderate. Ramelteon 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 including CYP3A4, and may lower ramelteon concentrations. Reduced hypnotic efficacy may result. The induction is weaker than with rifampicin, which is known to cut ramelteon exposure substantially.
How serious is the interaction between Ramelteon 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 loss of sleep benefit and consider an alternative hypnotic if efficacy is inadequate.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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