Drug interactions
Rifabutin + Verapamil
Severity: Moderate
Rifabutin and Verapamil: 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 may substantially lower verapamil concentrations, causing loss of blood pressure or rate control. Rifabutin is a weaker inducer than rifampin, but the effect can still matter.
What this interaction means in plain words
Rifabutin and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Induction of CYP3A4 (and possibly P-gp) increases verapamil clearance and reduces bioavailability.
What to do
Monitor heart rate, blood pressure and arrhythmia control, and increase the verapamil dose if needed. Consider an alternative agent if control cannot be maintained.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil 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 Verapamil?
MediHelp rates the interaction as moderate. Rifabutin and Verapamil 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 may substantially lower verapamil concentrations, causing loss of blood pressure or rate control. Rifabutin is a weaker inducer than rifampin, but the effect can still matter.
How serious is the interaction between Rifabutin and Verapamil?
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 heart rate, blood pressure and arrhythmia control, and increase the verapamil dose if needed. Consider an alternative agent if control cannot be maintained.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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