Drug interactions
Rifabutin + Voriconazole
Severity: Contraindicated
Rifabutin and Voriconazole: contraindicated 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 voriconazole metabolism and can lower antifungal levels enough to cause treatment failure. Voriconazole also increases rifabutin exposure, raising the risk of uveitis and neutropenia.
What this interaction means in plain words
Rifabutin and Voriconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Rifabutin belongs to Anti Bacterial; Voriconazole belongs to Anti Fungals.
Why it happens
Rifabutin induces CYP450 enzymes lowering voriconazole, while voriconazole inhibits CYP3A4 raising rifabutin.
What to do
Avoid the combination under labeling. If essential, use specialist guidance with voriconazole dose adjustment, therapeutic drug monitoring and monitoring for rifabutin toxicity.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
- Clarithromycin + Rifabutin Major
Frequently asked questions
Can I take Rifabutin with Voriconazole?
MediHelp rates the interaction as contraindicated. Rifabutin and Voriconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Rifabutin induces voriconazole metabolism and can lower antifungal levels enough to cause treatment failure. Voriconazole also increases rifabutin exposure, raising the risk of uveitis and neutropenia.
How serious is the interaction between Rifabutin and Voriconazole?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination under labeling. If essential, use specialist guidance with voriconazole dose adjustment, therapeutic drug monitoring and monitoring for rifabutin toxicity.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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