Drug interactions
Rifabutin + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Major
Rifabutin and Sofosbuvir-velpatasvir-voxilaprevir: 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 is an inducer of P-glycoprotein and CYP enzymes and can markedly lower concentrations of sofosbuvir, velpatasvir and voxilaprevir. This risks loss of antiviral efficacy and treatment failure.
What this interaction means in plain words
Rifabutin and Sofosbuvir-velpatasvir-voxilaprevir 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 belongs to Anti Bacterial; Sofosbuvir-velpatasvir-voxilaprevir belongs to Anti Virals.
Why it happens
Induction of intestinal P-glycoprotein and CYP3A4/CYP2B6/CYP2C8 increases clearance and reduces absorption of the combination components.
What to do
Do not coadminister; the labeling recommends avoiding rifamycins with this regimen. Consider an alternative antimycobacterial or defer HCV therapy.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Rifabutin and Sofosbuvir-velpatasvir-voxilaprevir, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Sofosbuvir-velpatasvir-voxilaprevir
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenobarbital + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifampin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir 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 Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates the interaction as major. Rifabutin and Sofosbuvir-velpatasvir-voxilaprevir 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 is an inducer of P-glycoprotein and CYP enzymes and can markedly lower concentrations of sofosbuvir, velpatasvir and voxilaprevir. This risks loss of antiviral efficacy and treatment failure.
How serious is the interaction between Rifabutin and Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; the labeling recommends avoiding rifamycins with this regimen. Consider an alternative antimycobacterial or defer HCV therapy.
What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
