Drug interactions
Rifabutin + Ziprasidone
Severity: Moderate
Rifabutin and Ziprasidone: 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 since CYP3A4 contributes to ziprasidone metabolism this may lower ziprasidone exposure. The reduction is probably modest because aldehyde oxidase is the main clearance pathway, but efficacy could be reduced.
What this interaction means in plain words
Rifabutin and Ziprasidone 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; Ziprasidone belongs to Central Nervous System.
Why it happens
CYP3A4 induction by rifabutin increases ziprasidone clearance.
What to do
Monitor for loss of psychiatric symptom control and adjust ziprasidone dose based on response.
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 Ziprasidone
- Amiodarone + Ziprasidone Contraindicated
- Amitriptyline + Ziprasidone Contraindicated
- Arsenic trioxide + Ziprasidone Contraindicated
- Bedaquiline + Ziprasidone Contraindicated
- Chloroquine + Ziprasidone Contraindicated
- Citalopram + Ziprasidone Contraindicated
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 Ziprasidone?
MediHelp rates the interaction as moderate. Rifabutin and Ziprasidone 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 since CYP3A4 contributes to ziprasidone metabolism this may lower ziprasidone exposure. The reduction is probably modest because aldehyde oxidase is the main clearance pathway, but efficacy could be reduced.
How serious is the interaction between Rifabutin and Ziprasidone?
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 for loss of psychiatric symptom control and adjust ziprasidone dose based on response.
What other medicines interact with Ziprasidone?
MediHelp also lists interactions of Ziprasidone with, for example, Amiodarone, Amitriptyline, Arsenic trioxide. The full list is on the Ziprasidone page.
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