Drug interactions
Rifabutin + Rivaroxaban
Severity: Moderate
Rifabutin and Rivaroxaban: 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 CYP3A4 and P-glycoprotein, though less potently than rifampicin, and may lower rivaroxaban levels. Reduced anticoagulant effect may increase the risk of thrombosis.
What this interaction means in plain words
Rifabutin and Rivaroxaban 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 belongs to Anti Bacterial; Rivaroxaban belongs to Cardiovascular.
Why it happens
Induction of CYP3A4 and P-glycoprotein increases rivaroxaban elimination.
What to do
Monitor for loss of efficacy and thromboembolic events. Consider an alternative anticoagulant if the treatment is prolonged.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban 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 Rifabutin with Rivaroxaban?
MediHelp rates the interaction as moderate. Rifabutin and Rivaroxaban 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 CYP3A4 and P-glycoprotein, though less potently than rifampicin, and may lower rivaroxaban levels. Reduced anticoagulant effect may increase the risk of thrombosis.
How serious is the interaction between Rifabutin and Rivaroxaban?
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 efficacy and thromboembolic events. Consider an alternative anticoagulant if the treatment is prolonged.
What other medicines interact with Rivaroxaban?
MediHelp also lists interactions of Rivaroxaban with, for example, Defibrotide, Ketoconazole, Ketorolac. The full list is on the Rivaroxaban page.
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