Drug interactions
Rifampin + Tofacitinib
Severity: Major
Rifampin and Tofacitinib: 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
Rifampin is a potent CYP3A4 inducer that markedly lowers tofacitinib exposure. This can lead to loss of therapeutic effect.
What this interaction means in plain words
Rifampin and Tofacitinib 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
Potent CYP3A4 induction increases tofacitinib metabolic clearance.
What to do
Avoid the combination where possible, as the labeling notes efficacy may be lost; if rifampin is essential, monitor response closely or choose another agent.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib Major
Frequently asked questions
Can I take Rifampin with Tofacitinib?
MediHelp rates the interaction as major. Rifampin and Tofacitinib 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 is a potent CYP3A4 inducer that markedly lowers tofacitinib exposure. This can lead to loss of therapeutic effect.
How serious is the interaction between Rifampin and Tofacitinib?
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 the combination where possible, as the labeling notes efficacy may be lost; if rifampin is essential, monitor response closely or choose another agent.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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