Drug interactions
Rifampin + Theophylline
Severity: Major
Rifampin and Theophylline: major interaction.
Last updated Sources: US FDA label
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
Rifampin induces enzymes involved in theophylline metabolism and can substantially lower its serum concentrations. This may cause loss of bronchodilator effect and worsening of airway disease.
What this interaction means in plain words
Rifampin and Theophylline 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
Rifampin induces hepatic CYP enzymes, including CYP1A2 and CYP3A4, increasing theophylline clearance.
What to do
Monitor theophylline serum levels and increase the dose as needed during rifampin therapy; reassess and reduce the dose after rifampin is stopped to avoid toxicity.
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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References
- Theophylline (Anhydrous) - FDA drug label (DailyMed) — openFDA / DailyMed
Other interactions of Theophylline
- Riociguat + Theophylline Contraindicated
- Adenosine + Theophylline Major
- Apalutamide + Theophylline Major
- Bupropion + Theophylline Major
- Carvedilol + Theophylline Major
- Cimetidine + Theophylline Major
Frequently asked questions
Can I take Rifampin with Theophylline?
MediHelp rates the interaction as major. Rifampin and Theophylline 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. Rifampin induces enzymes involved in theophylline metabolism and can substantially lower its serum concentrations. This may cause loss of bronchodilator effect and worsening of airway disease.
How serious is the interaction between Rifampin and Theophylline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor theophylline serum levels and increase the dose as needed during rifampin therapy; reassess and reduce the dose after rifampin is stopped to avoid toxicity.
What other medicines interact with Theophylline?
MediHelp also lists interactions of Theophylline with, for example, Riociguat, Adenosine, Apalutamide. The full list is on the Theophylline page.
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