Drug interactions
Rifabutin + Zonisamide
Severity: Moderate
Rifabutin and Zonisamide: 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 lower zonisamide concentrations, potentially reducing seizure control. The effect is weaker than with rifampicin.
What this interaction means in plain words
Rifabutin and Zonisamide 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; Zonisamide belongs to Central Nervous System.
Why it happens
CYP3A4 induction by rifabutin increases zonisamide metabolism.
What to do
Monitor seizure control and consider zonisamide level monitoring, with dose increases if needed. Readjust when rifabutin is stopped.
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 Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide 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 Zonisamide?
MediHelp rates the interaction as moderate. Rifabutin and Zonisamide 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 lower zonisamide concentrations, potentially reducing seizure control. The effect is weaker than with rifampicin.
How serious is the interaction between Rifabutin and Zonisamide?
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 seizure control and consider zonisamide level monitoring, with dose increases if needed. Readjust when rifabutin is stopped.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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