Drug interactions
Rifabutin + Tolbutamide
Severity: Moderate
Rifabutin and Tolbutamide: 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 hepatic enzymes including CYP2C9 and may reduce tolbutamide exposure, with loss of glycemic control. The induction is weaker than with rifampicin.
What this interaction means in plain words
Rifabutin and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
Rifabutin induction of CYP2C9 increases tolbutamide metabolism.
What to do
Monitor blood glucose after starting or stopping rifabutin and adjust the tolbutamide dose accordingly.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
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 Tolbutamide?
MediHelp rates the interaction as moderate. Rifabutin and Tolbutamide 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 hepatic enzymes including CYP2C9 and may reduce tolbutamide exposure, with loss of glycemic control. The induction is weaker than with rifampicin.
How serious is the interaction between Rifabutin and Tolbutamide?
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 blood glucose after starting or stopping rifabutin and adjust the tolbutamide dose accordingly.
What other medicines interact with Tolbutamide?
MediHelp also lists interactions of Tolbutamide with, for example, Glyburide-metformin, Insulin degludec-liraglutide, Aceclofenac. The full list is on the Tolbutamide page.
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