Drug interactions
Rifapentine + Voriconazole
Severity: Major
Rifapentine and Voriconazole: 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
Rifapentine induces drug-metabolizing enzymes and can lower voriconazole concentrations substantially, risking loss of antifungal efficacy and treatment failure. Rifamycins are known to make voriconazole levels subtherapeutic.
What this interaction means in plain words
Rifapentine and Voriconazole 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.
Rifapentine belongs to Anti Bacterial; Voriconazole belongs to Anti Fungals.
Why it happens
Induction of CYP3A4, CYP2C19 and CYP2C9 by rifapentine increases voriconazole clearance.
What to do
Avoid the combination where possible and use an alternative antifungal or antimycobacterial regimen. If unavoidable, monitor voriconazole trough levels and adjust the dose.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Other interactions of Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Rifapentine with Voriconazole?
MediHelp rates the interaction as major. Rifapentine and Voriconazole 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. Rifapentine induces drug-metabolizing enzymes and can lower voriconazole concentrations substantially, risking loss of antifungal efficacy and treatment failure. Rifamycins are known to make voriconazole levels subtherapeutic.
How serious is the interaction between Rifapentine and Voriconazole?
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 and use an alternative antifungal or antimycobacterial regimen. If unavoidable, monitor voriconazole trough levels and adjust the dose.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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