Drug interactions
Rifabutin + Simvastatin
Severity: Moderate
Rifabutin and Simvastatin: 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, though less than rifampicin, and may reduce simvastatin exposure. The result can be reduced cholesterol lowering.
What this interaction means in plain words
Rifabutin and Simvastatin 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; Simvastatin belongs to Cardiovascular.
Why it happens
Rifabutin induces CYP3A4, increasing simvastatin metabolism.
What to do
Monitor LDL cholesterol and raise the simvastatin dose if needed, or use a statin not reliant on CYP3A4 such as pravastatin or rosuvastatin.
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 Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin 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 Rifabutin with Simvastatin?
MediHelp rates the interaction as moderate. Rifabutin and Simvastatin 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, though less than rifampicin, and may reduce simvastatin exposure. The result can be reduced cholesterol lowering.
How serious is the interaction between Rifabutin and Simvastatin?
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 LDL cholesterol and raise the simvastatin dose if needed, or use a statin not reliant on CYP3A4 such as pravastatin or rosuvastatin.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Simvastatin page.
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