Drug interactions
Ranolazine + Rifabutin
Severity: Major
Ranolazine and Rifabutin: 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
Rifabutin induces CYP3A4 and can substantially lower ranolazine plasma concentrations. This may lead to loss of antianginal efficacy.
What this interaction means in plain words
Ranolazine and Rifabutin 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.
Ranolazine belongs to Cardiovascular; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces intestinal and hepatic CYP3A4, increasing ranolazine metabolism.
What to do
Avoid the combination; ranolazine labeling advises against use with CYP3A inducers. Choose an alternative antianginal or antimycobacterial agent where possible.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine with Rifabutin?
MediHelp rates the interaction as major. Ranolazine and Rifabutin 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. Rifabutin induces CYP3A4 and can substantially lower ranolazine plasma concentrations. This may lead to loss of antianginal efficacy.
How serious is the interaction between Ranolazine and Rifabutin?
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; ranolazine labeling advises against use with CYP3A inducers. Choose an alternative antianginal or antimycobacterial agent where possible.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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