Drug interactions
Rifampin + Roflumilast
Severity: Major
Rifampin and Roflumilast: major 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
Rifampicin markedly lowers roflumilast and active metabolite exposure, and the label advises against use with strong inducers. Loss of therapeutic effect is likely.
What this interaction means in plain words
Rifampin and Roflumilast can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Rifampicin strongly induces CYP3A4 and CYP1A2, increasing roflumilast clearance.
What to do
Avoid concurrent use; if rifampicin is required, use an alternative COPD therapy for the duration. Induction persists for some weeks after stopping.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Roflumilast
Frequently asked questions
Can I take Rifampin with Roflumilast?
MediHelp rates the interaction as major. Rifampin and Roflumilast can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifampicin markedly lowers roflumilast and active metabolite exposure, and the label advises against use with strong inducers. Loss of therapeutic effect is likely.
How serious is the interaction between Rifampin and Roflumilast?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use; if rifampicin is required, use an alternative COPD therapy for the duration. Induction persists for some weeks after stopping.
What other medicines interact with Roflumilast?
MediHelp also lists interactions of Roflumilast with, for example, Apalutamide, Carbamazepine, Efavirenz. The full list is on the Roflumilast page.
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