Drug interactions
Rifabutin + Tofacitinib
Severity: Moderate
Rifabutin and Tofacitinib: 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 can reduce tofacitinib concentrations. Reduced exposure may cause loss of disease control. The induction by rifabutin is weaker than that of rifampicin.
What this interaction means in plain words
Rifabutin and Tofacitinib 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; Tofacitinib belongs to Musculoskeletal.
Why it happens
Rifabutin induces CYP3A4, increasing the metabolic clearance of tofacitinib.
What to do
Monitor disease activity and response to tofacitinib during and after rifabutin therapy. Consider an alternative antimycobacterial or immunomodulatory option if response declines.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib 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 Tofacitinib?
MediHelp rates the interaction as moderate. Rifabutin and Tofacitinib 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 can reduce tofacitinib concentrations. Reduced exposure may cause loss of disease control. The induction by rifabutin is weaker than that of rifampicin.
How serious is the interaction between Rifabutin and Tofacitinib?
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 disease activity and response to tofacitinib during and after rifabutin therapy. Consider an alternative antimycobacterial or immunomodulatory option if response declines.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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