Drug interactions
Rifabutin + Thalidomide
Severity: Major
Rifabutin and Thalidomide: 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 hepatic enzymes, less strongly than rifampicin, and may reduce hormonal contraceptive effectiveness. This is critical in patients on thalidomide because of its teratogenic potential.
What this interaction means in plain words
Rifabutin and Thalidomide 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; Thalidomide belongs to Miscellaneous.
Why it happens
Enzyme induction accelerates contraceptive steroid metabolism.
What to do
Use a non-hormonal highly effective method, with a barrier method added, during and after rifabutin treatment.
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 Thalidomide
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 Thalidomide?
MediHelp rates the interaction as major. Rifabutin and Thalidomide 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 hepatic enzymes, less strongly than rifampicin, and may reduce hormonal contraceptive effectiveness. This is critical in patients on thalidomide because of its teratogenic potential.
How serious is the interaction between Rifabutin and Thalidomide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-hormonal highly effective method, with a barrier method added, during and after rifabutin treatment.
What other medicines interact with Thalidomide?
MediHelp also lists interactions of Thalidomide with, for example, Bortezomib, Carbamazepine, Griseofulvin. The full list is on the Thalidomide page.
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