Rifampin

Combined P-gp and strong CYP3A4 inducer that decreases apixaban exposure and increases risk of stroke and thromboembolic events. Avoid concomitant use.

Strong CYP3A4 inducer causing significant decreases in artemether (89%), DHA (85%), and lumefantrine (68%) exposure, resulting in loss of antimalarial efficacy.

Table 1: Drug Interactions with Rifampin that Affect Concomitant Drug Concentrations Administered with rifampin 600 mg daily, unless otherwise specified Drug or Drug Class and Prevention or Management Clinical Effect AUC = area under the time-concentration curve Antiretrovirals Prevention or Management: Concomitant use is contraindicated (see CONTRAINDICATIONS ) Atazanavir Decrease AUC by 72% Darunavir Rifampin dosage used concomitantly with the drug(s) is not specified in the proposed package insert.

Concomitant administration reduces atovaquone concentrations. Concomitant use with atovaquone oral suspension is not recommended.

Rifampin reduces atovaquone concentrations; concomitant use is not recommended.

Concomitant administration reduces atovaquone concentrations. Concomitant use with atovaquone oral suspension is not recommended.

Strong CYP3A4 inducer that decreases clozapine plasma concentration. Concomitant use is not recommended due to decreased clozapine effectiveness.

Table 1: Drug Interactions with Rifampin that Affect Concomitant Drug Concentrations Administered with rifampin 600 mg daily, unless otherwise specified Drug or Drug Class and Prevention or Management Clinical Effect AUC = area under the time-concentration curve Antiretrovirals Prevention or Management: Concomitant use is contraindicated (see CONTRAINDICATIONS ) Atazanavir Decrease AUC by 72% Darunavir Rifampin dosage used concomitantly with the drug(s) is not specified in the proposed package insert.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Co-administration decreases doravirine plasma concentrations. At least a 4-week cessation period is recommended prior to initiation of PIFELTRO.

Co-administration decreases doravirine plasma concentrations and is contraindicated. At least a 4-week cessation period is recommended prior to initiation of DELSTRIGO.

Avoid concomitant use due to decreased edoxaban blood levels via P-glycoprotein induction.

Strong CYP3A inducer that significantly decreases ivacaftor AUC by 89%, reducing TRIKAFTA efficacy. Concomitant use not recommended.

Strong CYP3A4 inducer causing 83% decrease in dienogest AUC and 44% decrease in estradiol AUC. Should not use Estradiol Valerate/Dienogest while taking or for 28 days after discontinuation.

Strong CYP3A4 inducer. Concurrent treatment is not recommended as it may decrease everolimus concentrations.

Strong CYP3A4 inducer; co-administration with everolimus is not recommended.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Concomitant use is contraindicated. Rifampin decreases fosamprenavir AUC by 82%.

Strong CYP3A4 inducer that significantly decreases temsavir plasma concentrations, contraindicated due to loss of virologic response.

Lack of efficacy of hydroxychloroquine reported with concurrent use; concomitant use should be avoided.

Strong CYP3A4 inducer substantially reduces exposure to irinotecan and SN-38. Do not administer unless no therapeutic alternatives exist.

97% decrease in isavuconazole exposure. Contraindicated coadministration of all potent CYP3A4 inducers.

Strong CYP3A4 inducer decreases istradefylline Cmax by 45% and AUC by 81%. Avoid concomitant use.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Strong CYP3A inducer. Avoid concomitant use with NINLARO (ixazomib).

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Strong CYP3A inducer that decreases lemborexant exposure, which may reduce DAYVIGO efficacy. Concomitant use should be avoided.

Severe hepatotoxicity occurred in healthy subjects receiving lorlatinib with rifampin (a strong CYP3A inducer). Grade 3-4 ALT/AST increases occurred in 83% of subjects.

Strong CYP3A4 inducer that decreases lurasidone exposure; concomitant use is contraindicated.

Strong CYP3A4 inducer significantly reduces macitentan exposure. Avoid co-administration.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin. ‡ Administered with rifampin 300 mg daily § Administered with rifampin 450 mg daily ¶ Administered with rifampin 1200 mg daily # Rifampin 1200 mg administered as a single oral dose 8 hours before administering a single oral dose of nifedipine 10 mg Þ Numerous cases in the literature describe a decrease in glucocorticoid effect when used concomitantly with rifampin.

Rifampin decreases systemic exposure of ospemifene by 58%, potentially decreasing clinical effect. Do not use concomitantly.

Strong CYP 3A inducer that decreases praziquantel AUC and Cmax, reducing efficacy of Biltricide.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

CYP3A4 inducer causing decreased quinine plasma levels. Concomitant administration should be avoided.

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Strong CYP3A4/P-gp inducer that decreases sirolimus concentrations. Avoid concomitant use; consider alternative agents.

Coadministration is contraindicated due to decreased rilpivirine plasma concentrations and loss of virologic response.

Coadministration is contraindicated. Induces CYP3A, resulting in decreased rilpivirine plasma concentrations and loss of virologic response.

As component of ritonavir-boosted saquinavir, concomitant use contraindicated due to severe hepatocellular toxicity.

Saquinavir/ritonavir combination with rifampin is not recommended.

Combined P-gp and strong CYP3A inducer that decreases rivaroxaban exposure and may increase thromboembolic risk. Avoid concomitant use.

Concomitant use with ritonavir-boosted saquinavir developed severe hepatocellular toxicity in healthy subjects. Contraindicated.

j Concomitant use with rifampin in 2 children k Administered with rifampin (10 mg/kg daily) l Administered with an antibiotic regimen including rifampin (450 mg/day), isoniazid (300 mg/day), and streptomycin (0.5 g/day) IM AUC = area under the time-concentration curve Drug or Drug Class and Prevention or Management Clinical Effect Antiretrovirals Prevention or Management: Concomitant use is contraindicated (See CONTRAINDICATIONS ) Atazanavir Decrease AUC by 72% Darunavir b Substantial decrease in exposure, which may result in loss of therapeutic effect and development of resistance.

Potent CYP3A inducer; avoid use of tadalafil in patients chronically taking rifampin.

Strong CYP3A4 inducers should not be used with tamoxifen. Rifampin reduces tamoxifen AUC and Cmax.

Telaprevir Decrease AUC by 92% Systemic Hormonal Contraceptives Prevention or Management Advise patients to change to non-hormonal methods of birth control during rifampin therapy Estrogens Decrease exposure Progestins Anticonvulsants Phenytoin § Decrease exposure § Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50% to 67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations of toremifene in serum Antithrombotic Agents Clopidogrel Prevention or Management Concomitant use of clopidogrel and rifampin should be discouraged Increase active metabolite exposure and risk of bleeding Ticagrelor Prevention or Management Avoid use Decrease exposure Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRADICTIONS ) Decrease exposure Oral Anticoagulants Prevention or Management Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease exposure Antifungals Fluconazole Decrease AUC by 23% Itraconazole Prevention or Management Not recommended 2 weeks before and during itraconazole treatment Decrease exposure Ketoconazole Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam *,¶ Decrease exposure Benzodiazepine-Related Drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers ¶ Diltiazem Decrease exposure Nifedipine # Decrease exposure Verapamil Decrease exposure Corticosteroids Þ Prednisolone Decrease exposure Cardiac Glycosides Digoxin Prevention or Management Measure serum digoxin concentrations before initiating rifampin.

Strong CYP3A inducer that substantially reduces ticagrelor exposure and decreases efficacy.

Concomitant use is contraindicated. Rifampin decreases tipranavir exposure significantly.

Strong CYP3A4 inducer that decreases upadacitinib exposure and may lead to reduced therapeutic effect. Coadministration is not recommended.

CYP450 inducer significantly reduces voriconazole plasma exposure.

Strong CYP3A4 inducer decreased abiraterone exposure by 55%. Avoid concomitant use; if necessary, increase abiraterone dosing frequency.

Strong CYP3A4 inducer decreased abiraterone exposure by 55%. Avoid concomitant use or increase abiraterone dosing frequency if co-administration necessary.

Strong CYP3A inducer decreases acalabrutinib plasma concentrations, reducing CALQUENCE activity. Avoid co-administration or increase acalabrutinib dose to 200 mg every 12 hours if unavoidable.

Decreases tenofovir alafenamide concentrations. Coadministration is not recommended.

Co-administration with rifampin (strong CYP450 inducer) decreases apremilast exposure and may result in loss of efficacy.

Strong CYP3A4 inducer substantially decreases aprepitant exposure, which may decrease efficacy. Avoid concomitant use.

Strong CYP3A4 inducer decreases aripiprazole exposure. Consider increasing aripiprazole dosage.

Strong CYP3A4 inducer that decreases aripiprazole exposure. Avoid concomitant use because dosage cannot be modified.

Strong CYP3A4 enzyme inducer decreases avacopan exposure. Avoid coadministration.

Strong CYP3A4/5 inducer reduces axitinib plasma exposure. Co-administration should be avoided.

CYP3A4 inducer decreases hydrocodone plasma concentration, resulting in decreased efficacy and risk of withdrawal syndrome. Stopping inducer may cause serious respiratory depression.

CYP3A4 inducer decreases buprenorphine plasma concentration, potentially resulting in decreased efficacy or withdrawal syndrome. Upon discontinuation, buprenorphine levels increase with risk of serious respiratory depression.

CYP3A4 inducer decreases codeine levels and morphine formation, reducing efficacy or causing withdrawal. Discontinuation may increase morphine levels and cause respiratory depression.

CYP3A4 inducer decreases codeine levels and morphine formation, resulting in decreased efficacy or withdrawal syndrome. Upon discontinuation, may cause serious respiratory depression.

UGT1A1 inducer that decreases cabotegravir plasma concentrations significantly. Coadministration expected to reduce cabotegravir efficacy.

Potent CYP3A4 inducer reduces plasma concentrations of caspofungin acetate. Dose increase to 70 mg daily (adults) or 70 mg/m² daily (pediatrics) required.

Strong CYP3A4/P-gp inducer decreased systemic exposure of ceritinib, which may decrease efficacy of ZYKADIA. Avoid concurrent use.

Decrease AUC by 56% Narcotic Analgesics Oxycodone Decrease AUC by 86% Morphine Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline i Decrease exposure Other Drugs Enalapril Decrease active metabolite exposure Chloramphenicol j Decrease exposure Clarithromycin Decrease exposure Dapsone Decrease exposure Doxycycline k Decrease exposure Irinotecan l Prevention or Management: Avoid the use of rifampin, strong CYP3A4 inducer, if possible.

Strong CYP2C19 inducer increases clopidogrel active metabolite levels and platelet inhibition, potentiating risk of bleeding. Avoid concomitant use.

Strong CYP2C19 inducer that increases clopidogrel active metabolite levels and platelet inhibition, potentiating risk of bleeding. Avoid concomitant use.

Strong CYP3A inducer may decrease cobimetinib exposure by >80% and reduce efficacy. Avoid concurrent use.

CYP3A4 inducer can result in lower codeine and morphine levels, decreasing efficacy or causing withdrawal syndrome. Avoid concomitant use.

CYP3A4 inducer that decreases codeine and morphine levels, resulting in reduced efficacy or withdrawal syndrome in dependent patients.

P-gp inducer that reduces exposure to dabigatran and should generally be avoided.

P-gp inducer that reduces exposure to dabigatran and should generally be avoided.

Antiretrovirals Prevention or Management: Avoid concomitant use Zidovudine Decrease AUC by 47% Indinavir Decrease AUC by 92% Efavirenz Decrease AUC by 26% Cortisol Receptor Blocker Mifepristone Prevention or Management: Avoid concomitant use Decrease exposure Hepatitis C Antiviral Prevention or Management: Avoid concomitant use Daclatasvir Decrease AUC by 79% Simeprevir Decrease AUC by 48% Sofosbuvir Decrease AUC by 72% Coadministration of sofosbuvir with rifampin may decrease sofosbuvir plasma concentrations, leading to reduced therapeutic effect of sofosbuvir.

Strong CYP3A4 inducer significantly decreases exposure of deflazacort's active metabolite 21-desDFZ. Avoid concomitant use.

Reduced efficacy and increased incidence of breakthrough bleeding and menstrual irregularities associated with concomitant use.

CYP3A4 inducer can lower plasma levels of diltiazem. Avoid concomitant use when possible and consider alternative therapy.

Enzyme-inducing drug that increases valproate clearance. Increased monitoring of valproate concentrations and dosage adjustment indicated.

Doxycycline Administered with rifampin (10 mg/kg daily) Decrease exposure Irinotecan Administered with an antibiotic regimen including rifampin (450 mg/day), isoniazid (300 mg/day), and streptomycin (0.5 g/day) IM Prevention or Management: Avoid the use of rifampin, a strong CYP3A4 inducer, if possible.

Concomitant use should be avoided. Rifampin decreases efavirenz AUC by 26%.

Strong CYP3A inducer. Concomitant use with elagolix 200 mg twice daily is not recommended; limit with 150 mg once daily to 6 months.

Strong P-gp or CYP3A4 inducer decreases linagliptin exposure and may reduce efficacy. Alternative treatments strongly recommended.

Decreases TAF concentration. Coadministration with DESCOVY is not recommended.

Decrease AUC by 56% Narcotic Analgesics Oxycodone Decrease AUC by 86% Morphine Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline i Decrease exposure Other Drugs Enalapril Decrease active metabolite exposure Chloramphenicol j Decrease exposure Clarithromycin Decrease exposure Dapsone Decrease exposure Doxycycline k Decrease exposure Irinotecan l Prevention or Management: Avoid the use of rifampin, strong CYP3A4 inducer, if possible.

CYP3A4 inducer and moderate CYP1A2 inducer decreases erlotinib exposure. Increase erlotinib dosage if co-administration is unavoidable.

CYP3A4 and moderate CYP1A2 inducer decreases erlotinib exposure. Increase erlotinib dosage if co-administration is unavoidable.

Potent CYP3A4 inducer decreases eszopiclone exposure by approximately 80% and reduces effects. Combination use may decrease therapeutic efficacy.

Reduced efficacy and increased incidence of breakthrough bleeding and menstrual irregularities with concomitant use.

Strong CYP 3A4 inducer that significantly decreases exemestane exposure. Dose increase to 50 mg recommended.

CYP3A4 inducer that decreases fentanyl plasma concentration, resulting in decreased efficacy and withdrawal syndrome. Discontinuation may cause serious respiratory depression.

CYP3A4 inducer that decreases fentanyl plasma concentration, resulting in decreased efficacy, withdrawal syndrome, and upon discontinuation, potential serious respiratory depression.

CYP3A4 inducer; concomitant use can decrease plasma concentration of fentanyl, resulting in decreased efficacy or withdrawal syndrome. Stopping inducer may increase fentanyl levels causing serious respiratory depression.

CYP3A4 inducer that decreases amprenavir concentrations, potentially reducing therapeutic effect of fosamprenavir.

Strong CYP3A4 inducer that decreases sorafenib AUC, which may decrease antitumor activity. Avoid concomitant use when possible.

CYP3A4 inducer that significantly decreases guanfacine plasma concentrations and exposure. Guanfacine dose increase up to double the target dosage may be needed.

Concomitant use increases potential for hepatotoxicity. Concomitant use should be avoided.

CYP3A4 inducer that decreases hydrocodone plasma concentration, resulting in decreased efficacy or withdrawal syndrome. Discontinuation may cause serious respiratory depression.

CYP3A4 inducer that decreases hydrocodone plasma concentration, resulting in decreased efficacy and potential withdrawal syndrome. Upon discontinuation, may cause serious respiratory depression.

CYP3A4 inducer that can decrease hydrocodone plasma concentration, resulting in decreased efficacy or withdrawal syndrome.

CYP3A4 inducer that decreases hydrocodone plasma concentration, resulting in decreased opioid efficacy or withdrawal syndrome. Discontinuation may cause serious respiratory depression.

CYP3A4 inducer that can decrease plasma concentration of hydrocodone, resulting in decreased efficacy or withdrawal syndrome.

Lack of efficacy of hydroxychloroquine reported; concomitant use should be avoided.

Strong CYP3A4 inducer that significantly decreases imatinib Cmax and AUC by 3.8-fold, reducing therapeutic exposure.

Antiretrovirals Prevention or Management: Avoid concomitant use Zidovudine Decrease AUC by 47% Indinavir Decrease AUC by 92% Efavirenz Decrease AUC by 26% Cortisol Receptor Blocker Mifepristone Prevention or Management: Avoid concomitant use Decrease exposure Hepatitis C Antiviral Prevention or Management: Avoid concomitant use Daclatasvir Decrease AUC by 79% Simeprevir Decrease AUC by 48% Sofosbuvir Decrease AUC by 72% Coadministration of sofosbuvir with rifampin may decrease sofosbuvir plasma concentrations, leading to reduced therapeutic effect of sofosbuvir.

Concomitant use increases potential for hepatotoxicity. Patients should be monitored closely.

Rifampicin reduces isradipine levels to below detectable limits, markedly reducing or abolishing therapeutic effects through increased metabolism and clearance.

CYP3A4 inducer that decreases ivabradine plasma concentrations; avoid concomitant use.

Strong CYP3A inducer significantly decreased ivacaftor exposure approximately 9-fold. Co-administration not recommended.

Rifampin decreases lamotrigine AUC by approximately 40%, requiring dose adjustment.

P-gp inducer that may decrease ledipasvir and sofosbuvir plasma concentrations, leading to reduced therapeutic effect. Use is not recommended.

Reduced efficacy and increased incidence of breakthrough bleeding and menstrual irregularities associated with concomitant use.

Stimulates hepatic microsomal enzyme activity causing increased hepatic degradation of levothyroxine, resulting in increased levothyroxine requirements.

Rifampin decreases linagliptin exposure and may reduce efficacy of TRADJENTA. Alternative treatments strongly recommended.

Strong P-gp or CYP3A4 inducer that decreases linagliptin exposure and may reduce linagliptin efficacy. Alternative treatments are strongly recommended.

Stimulates hepatic microsomal drug-metabolizing enzyme activity, causing increased hepatic degradation of thyroid hormones and increased liothyronine sodium requirements.

Strong CYP3A inducer decreases ivacaftor exposure by 57%, reducing ORKAMBI effectiveness. Co-administration not recommended.

Strong CYP3A4 inducer may reduce plasma macimorelin concentrations and lead to false positive test results. Discontinue prior to use.

Strong CYP3A4 inducer that significantly reduces macitentan exposure. Concomitant use should be avoided.

Strong CYP3A inducer may decrease medroxyprogesterone acetate concentrations and reduce contraceptive efficacy. Avoid concomitant use or use backup contraception.

CYP3A4 inducer that decreases methadone plasma concentration, resulting in decreased efficacy or withdrawal symptoms.

CYP3A4 inducer that decreases methadone plasma concentration, reducing efficacy and causing withdrawal symptoms, with risk of serious respiratory depression and death upon discontinuation.

Strong CYP 3A4 inducer; likely to decrease the pharmacological action of methylergonovine maleate.

Avoid concomitant use. Rifampin decreases mifepristone exposure.

May decrease mycophenolic acid concentrations; concomitant use is not recommended unless benefit outweighs risk.

Strong CYP3A inducer causing significant decrease in plasma naldemedine concentrations, which may reduce efficacy.

Strong CYP3A4 inducer that significantly decreases plasma naloxegol concentrations and may decrease efficacy; concomitant use is not recommended.

Coadministration may decrease nelfinavir plasma concentrations and reduce its therapeutic effect.

CYP3A4 inducer decreases plasma concentrations of netupitant; avoid concomitant use.

May reduce contraceptive effectiveness and result in unintended pregnancy or breakthrough bleeding by increasing metabolism of contraceptive steroids.

Rifampin increases metabolism of norethindrone and ethinyl estradiol, reducing contraceptive effectiveness and increasing breakthrough bleeding and menstrual irregularities.

Rifampin increases metabolism of norethindrone and ethinyl estradiol, reducing contraceptive effectiveness and increasing breakthrough bleeding and menstrual irregularities.

Reduced efficacy of oral contraceptive with increased breakthrough bleeding and menstrual irregularities.

May decrease plasma concentrations of COCs and potentially diminish effectiveness or increase breakthrough bleeding.

Strong CYP2C19/CYP3A4 inducer causing decreased exposure of omeprazole. Concomitant use should be avoided.

Strong CYP3A4/CYP2B6 inducer may decrease osilodrostat concentration and reduce efficacy. Dose increase may be needed; monitor cortisol.

Decrease AUC by 56% Narcotic Analgesics Oxycodone Decrease AUC by 86% Morphine Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline i Decrease exposure Other Drugs Enalapril Decrease active metabolite exposure Chloramphenicol j Decrease exposure Clarithromycin Decrease exposure Dapsone Decrease exposure Doxycycline k Decrease exposure Irinotecan l Prevention or Management: Avoid the use of rifampin, strong CYP3A4 inducer, if possible.

CYP3A4 inducer that decreases plasma concentration of oxycodone, resulting in decreased efficacy or withdrawal syndrome; discontinuation may cause increased respiratory depression.

CYP450 inducer decreases oxycodone AUC by 86% and Cmax by 63%, potentially causing lack of efficacy or abstinence syndrome.

CYP3A4 inducer that decreases oxycodone plasma concentration, resulting in decreased efficacy or withdrawal syndrome. Upon discontinuation, oxycodone levels increase risking serious respiratory depression.

CYP3A4 inducer that decreases oxycodone plasma concentration, resulting in decreased efficacy and withdrawal syndrome risk. Stopping rifampin increases oxycodone levels and serious respiratory depression risk.

CYP3A4 inducer that decreases oxycodone plasma concentration, resulting in decreased efficacy or withdrawal syndrome. Upon discontinuation, increased oxycodone levels may cause serious respiratory depression.

Strong CYP3A inducer decreases palbociclib plasma exposure by 85%. Avoid concomitant use.

Strong CYP3A4/P-gp inducer that may decrease paliperidone exposure. Avoid during 3-month dosing interval if possible; consider paliperidone extended-release tablets if necessary.

Rifampin significantly increases peak pitavastatin exposure and increases the risk of myopathy and rhabdomyolysis. Do not exceed pitavastatin 2 mg once daily.

Rifampin significantly increases peak pitavastatin exposure and increases the risk of myopathy and rhabdomyolysis. Dose limitation to 2 mg once daily is recommended.

Rifampin significantly increases peak pitavastatin exposure and increases the risk of myopathy and rhabdomyolysis. Dosage should not exceed 2 mg once daily.

Strong CYP3A4 and UGT1A1 inducer; coadministration with PONVORY is not recommended.

CYP 3A4 inducer enhances metabolism of prednisolone, requiring increased dosage of corticosteroid.

Strong CYP3A4 inducer that decreases pretomanid plasma concentrations. Co-administration should be avoided.

CYP3A4 inducer reduces codeine levels and morphine formation, decreasing efficacy or causing withdrawal syndrome. Avoid use; if necessary, monitor for reduced efficacy.

CYP3A4 inducer can result in lower codeine and morphine levels, causing decreased efficacy or withdrawal syndrome.

CYP3A4 inducer that decreases propafenone plasma concentrations by 50-84%, reducing efficacy.

Potent CYP3A4 inducer increases quetiapine clearance; increase quetiapine dose up to 5-fold during chronic use and reduce by 5-fold within 7-14 days of discontinuation.

Strong CYP3A4 inducer that decreases quetiapine exposure; quetiapine dose may need to be increased up to 5 fold.

CYP3A4 inducer that decreases quinine plasma levels. Concomitant administration should be avoided.

Strong inducer of UGT1A1 that reduces plasma concentrations of raltegravir. Dose adjustment to 800 mg twice daily recommended for ISENTRESS; coadministration not recommended for ISENTRESS HD.

Strong CYP enzyme inducer causing approximately 80% decrease in ramelteon exposure and metabolite M-II. Efficacy may be reduced.

Strong CYP3A4 inducer that decreases regorafenib plasma concentrations and may lead to decreased efficacy.

OATP1B1 and OATP1B3 inhibitor that may increase systemic exposure of revefenacin's active metabolite. Coadministration not recommended.

Strong CYP3A inducer may significantly reduce riociguat exposure. Data are not available to guide dosing.

Strong CYP450 enzyme inducer that decreases roflumilast systemic exposure and may reduce therapeutic effectiveness. Use not recommended.

Potent CYP3A4 inducer that increases romidepsin concentrations. Avoid co-administration with romidepsin.

Strong CYP3A4 inducer that decreases midostaurin concentrations and may reduce efficacy. Avoid coadministration.

Antiretrovirals Prevention or Management: Avoid concomitant use Zidovudine Decrease AUC by 47% Indinavir Decrease AUC by 92% Efavirenz Decrease AUC by 26% Cortisol Receptor Blocker Mifepristone Prevention or Management: Avoid concomitant use Decrease exposure Hepatitis C Antiviral Prevention or Management: Avoid concomitant use Daclatasvir Decrease AUC by 79% Simeprevir Decrease AUC by 48% Sofosbuvir Decrease AUC by 72% Coadministration of sofosbuvir with rifampin may decrease sofosbuvir plasma concentrations, leading to reduced therapeutic effect of sofosbuvir.

Decrease AUC by 56% Narcotic Analgesics Oxycodone Decrease AUC by 86% Morphine Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline i Decrease exposure Other Drugs Enalapril Decrease active metabolite exposure Chloramphenicol j Decrease exposure Clarithromycin Decrease exposure Dapsone Decrease exposure Doxycycline k Decrease exposure Irinotecan l Prevention or Management: Avoid the use of rifampin, strong CYP3A4 inducer, if possible.

Antiretrovirals Prevention or Management: Avoid concomitant use Zidovudine Decrease AUC by 47% Indinavir Decrease AUC by 92% Efavirenz Decrease AUC by 26% Cortisol Receptor Blocker Mifepristone Prevention or Management: Avoid concomitant use Decrease exposure Hepatitis C Antiviral Prevention or Management: Avoid concomitant use Daclatasvir Decrease AUC by 79% Simeprevir Decrease AUC by 48% Sofosbuvir Decrease AUC by 72% Coadministration of sofosbuvir with rifampin may decrease sofosbuvir plasma concentrations, leading to reduced therapeutic effect of sofosbuvir.

CYP3A4 inducer that decreases sufentanil plasma concentration, resulting in decreased efficacy or withdrawal syndrome. Upon discontinuation, can cause increased sufentanil levels and serious respiratory depression.

CYP3A4 inducer that decreases sufentanil plasma concentration, resulting in decreased efficacy or withdrawal syndrome. Discontinuation may cause increased sufentanil levels and serious respiratory depression.

Strong CYP3A inducer; substantially decreases suvorexant exposure and may reduce efficacy.

May decrease tacrolimus whole blood trough concentrations and increase risk of rejection. Increase tacrolimus dose and monitor concentrations.

Strong CYP3A inducer may decrease tacrolimus concentrations and increase risk of rejection. Increase tacrolimus dose and monitor concentrations.

Strong CYP3A4 inducer that decreases tasimelteon exposure, potentially causing a large decrease in drug levels with reduced efficacy.

Quinine Prevention or Management: Avoid concomitant use Decrease AUC by 75%–85% Telithromycin Decrease AUC by 86% Theophylline Decrease exposure by 20% to 40% Effect of Other Drugs on Rifampin Concomitant antacid administration may reduce the absorption of rifampin.

Strong CYP3A inducer. Significantly decreased ivacaftor exposure by 89%; co-administration not recommended due to reduced SYMDEKO efficacy.

Strong CYP3A4 inducer; avoid co-administration due to potential effects on efficacy and toxicity of thiotepa.

Strong CYP3A4 inducer decreases exposure to tofacitinib and may result in loss of or reduced clinical response. Concomitant use not recommended.

Strong CYP3A4 inducer that decreases toremifene steady-state concentration and should be avoided.

Strong CYP3A inducer decreased trabectedin systemic exposure by 31%. Avoid concomitant use with trabectedin.

Hepatic enzyme inducer that increases corticosteroid clearance, reducing their effect.

Strong CYP3A4 inducer resulting in significant reduction in ubrogepant exposure and loss of efficacy. Concomitant use should be avoided.

Strong CYP3A4 inducer that decreases vandetanib plasma concentrations. Avoid concomitant use during CAPRELSA therapy.

P-gp and moderate to strong CYP inducer that may decrease concentrations of sofosbuvir and/or velpatasvir, leading to reduced therapeutic effect. Use not recommended.

Strong CYP3A4 inducer that decreases vemurafenib plasma concentrations and may result in decreased efficacy. Avoid coadministration; replace with alternative drugs when possible.

Rifampin therapy may markedly reduce oral verapamil bioavailability.

CYP2C9 inducer that decreases warfarin exposure and INR; requires close INR monitoring.

CYP2C9 inducer that decreases warfarin effect and INR; requires closer INR monitoring.

Concomitant use should be avoided. Rifampin decreases zidovudine AUC by 47%.

Significantly reduces exposure and pharmacodynamic effects of zolpidem. Use in combination is not recommended.

P-glycoprotein inducer that decreases afatinib exposure. Increase GILOTRIF dose by 10 mg per day as tolerated.

CYP2C8 inducer may significantly decrease pioglitazone exposure. Changes in diabetes treatment may be needed based on clinical response.

Rifampin enhances theophylline clearance, resulting in decreased serum theophylline concentrations requiring dose increase.

May reduce atorvastatin plasma concentrations. Administer simultaneously with atorvastatin.

CYP3A4 inducer may decrease amlodipine exposure. Blood pressure should be monitored when co-administered.

CYP3A inducer that may reduce amlodipine effectiveness. Blood pressure should be closely monitored when coadministered.

Strong CYP3A4 inducer that decreases aripiprazole exposure. Consider increasing aripiprazole dosage when used concomitantly.

Strong CYP3A4 inducer and OATP1B1/OATP1B3 inhibitor resulting in significant decrease in atogepant exposure; dosage adjustment and monitoring for reduced efficacy recommended.

May reduce atorvastatin plasma concentrations. Administer simultaneously with ATORVALIQ.

May reduce atorvastatin plasma concentrations. Administer simultaneously with atorvastatin.

Hepatic enzyme induction may enhance corticosteroid metabolism, requiring increased corticosteroid dosage.

Increases metabolic clearance of bisoprolol fumarate, resulting in shortened elimination half-life; initial dose modification generally not necessary.

OATP1B1/1B3 inhibitor (single dose) increases brincidofovir AUC and Cmax, may increase adverse reactions. Monitor for elevations in transaminases, bilirubin, diarrhea, or GI events.

Co-administration decreases brivaracetam plasma concentrations via CYP2C19 induction. Brivaracetam dosage increase up to 100% is recommended.

Rifampin decreases brivaracetam plasma concentrations through CYP2C19 induction, requiring up to 100% dosage increase of brivaracetam.

Strong CYP3A4 inducer that decreased cabozantinib exposure by 77%. Avoid chronic co-administration or increase COMETRIQ dosage if unavoidable.

UGT enzyme inducer decreases canagliflozin exposure which may reduce effectiveness of INVOKANA. Dosage adjustment may be required.

UGT enzyme inducer that decreases canagliflozin exposure and may reduce effectiveness. May require canagliflozin dose increase.

Strong CYP3A4 and CYP2C19 inducer decreases cannabidiol and 7-OH-CBD plasma concentrations by approximately 32% and 63%, potentially reducing EPIDIOLEX efficacy.

CYP3A4 inducer that decreases carbamazepine plasma levels. Carbamazepine levels and/or dosage adjustment may be necessary.

CYP2C19 inducer that could result in decreased carisoprodol exposure and increased meprobamate exposure; full pharmacological impact unknown.

May decrease carvedilol levels, potentially reducing therapeutic efficacy.

May decrease carvedilol levels.

Strong CYP3A4 inducer may reduce plasma concentrations of clindamycin; monitor for loss of effectiveness.

Strong CYP3A4 inducer may reduce plasma concentrations of clindamycin; monitor for loss of effectiveness.

Strong CYP3A4 inducer may reduce plasma concentrations of clindamycin and decrease effectiveness; monitor for loss of effectiveness.

As a strong CYP3A4 inducer, rifampicin may reduce plasma concentrations of clindamycin, potentially decreasing effectiveness. Monitor for loss of effectiveness.

CYP3A4 inducer may reduce plasma concentrations of estrogens, possibly decreasing therapeutic effects and/or altering uterine bleeding profile.

CYP3A4 and UGT inducer may reduce estrogen and bazedoxifene concentrations, decreasing therapeutic effects and increasing endometrial hyperplasia risk.

Decreases cyclosporine concentrations; appropriate dosage adjustment required.

CYP2C8 inducer may decrease daprodustat exposure and result in loss of efficacy. Monitor hemoglobin and adjust dose accordingly.

May increase formation of dapsone hydroxylamine, a metabolite associated with hemolysis. Monitor for hemolytic reactions.

May increase formation of dapsone hydroxylamine, a metabolite associated with hemolysis.

Rifampin induces CYP3A4 enzyme activity, enhancing corticosteroid metabolism and requiring dose increases.

CYP 3A4 inducers may enhance metabolism of dexamethasone, requiring dosage increase.

Rifampin induces CYP 3A4 enzyme activity, enhancing dexamethasone metabolism and requiring dosage increase.

Rifampin induces CYP 3A4 and enhances dexamethasone metabolism, requiring dosage increase.

CYP2C9 inducer may compromise diclofenac efficacy. Dosage adjustment may be warranted.

Decreases digoxin concentrations. Requires monitoring and dose adjustment.

Rifampin shortens the half-life of doxycycline, thereby lowering doxycycline concentration in the body.

May decrease systemic concentrations of hormonal contraceptives and diminish effectiveness or increase breakthrough bleeding.

Induces CYP3A4 enzyme, may decrease effectiveness of COCs or increase breakthrough bleeding.

May decrease the effectiveness of hormonal contraceptives or increase breakthrough bleeding through CYP3A4 enzyme induction.

Enzyme inducer that may decrease effectiveness of COCs or increase breakthrough bleeding. Use back-up contraception.

Induces CYP3A activity, increasing efavirenz clearance and lowering plasma concentrations.

Induction of CYP3A activity by rifampin may increase clearance of efavirenz resulting in lowered plasma concentrations.

Rifampin induces metabolizing enzymes, reducing systemic exposure of elafibranor and its active metabolite, potentially resulting in delayed or suboptimal biochemical response.

Rifampin is not recommended with ORIAHNN as concomitant use may decrease elagolix, estradiol, and norethindrone plasma concentrations and reduce therapeutic effects.

OATP1B1 substrate; eltrombopag may increase exposure. Monitor closely and consider dose reduction if appropriate.

OATP1B1 substrate; monitor for excessive exposure and consider dose reduction if appropriate.

OATP1B1 inhibitor that may increase eluxadoline exposure. Requires monitoring for adverse reactions.

Rifampicin may interfere with biliary excretion, glucuronidation, and intestinal beta-glucuronidase of entacapone; caution should be exercised.

Strong CYP3A4 inducer that decreases plasma concentrations of enzalutamide and N-desmethyl enzalutamide, may decrease efficacy. Avoid coadministration; if unavoidable, increase XTANDI dosage.

Potent CYP3A inducer; expected to decrease estazolam concentrations and reduce efficacy.

CYP3A4 inducer that may reduce plasma concentrations of estradiol, possibly decreasing therapeutic effects and altering uterine bleeding profile.

CYP3A4 inducer may decrease estradiol acetate plasma concentration, resulting in decreased therapeutic effects and/or changes in uterine bleeding profile.

CYP3A4 inducer that may reduce plasma concentrations of estrogens, possibly decreasing therapeutic effects and/or altering uterine bleeding profile.

CYP3A4 inducer that may reduce plasma concentrations of estrogens, possibly decreasing therapeutic effects and/or altering uterine bleeding profile.

CYP3A4 inducer may reduce plasma concentrations of estrogens and progestins, possibly decreasing therapeutic effects and altering uterine bleeding profile.

CYP3A4 inducer that may reduce estradiol plasma concentrations, possibly decreasing therapeutic effects and altering uterine bleeding profile.

CYP3A4 inducer that may reduce estradiol plasma concentrations, possibly decreasing therapeutic effects and/or altering uterine bleeding profile.

CYP3A4 inducer that may reduce plasma concentrations of estradiol valerate, possibly decreasing therapeutic effects and altering uterine bleeding profile.

CYP3A4 inducer that may reduce plasma concentrations of estrogens, possibly decreasing therapeutic effects and altering uterine bleeding profile.

Rifampin decreases estrogen exposure. Advise patients to change to non-hormonal birth control methods during rifampin therapy.

CYP3A4 inducer may reduce plasma concentrations of estrogens, possibly decreasing therapeutic effects and altering uterine bleeding profile.

May decrease plasma concentrations of etonogestrel and diminish contraceptive effectiveness or increase breakthrough bleeding.

CYP3A4 enzyme inducer that may decrease plasma concentrations of etonogestrel and ethinyl estradiol, potentially diminishing contraceptive effectiveness or increasing breakthrough bleeding.

Induces CYP3A4, may decrease plasma concentrations of CHCs and potentially diminish effectiveness or increase breakthrough bleeding.

CYP3A4 inducer causing approximately 70% decrease in active metabolite Cmax and 75% decrease in AUC. No dosing adjustments recommended.

CYP3A4 inducer; concomitant use may decrease flibanserin exposure and therapeutic effect.

Increased metabolic clearance of fludrocortisone acetate due to hepatic enzyme induction. May require increased steroid dosage.

May decrease phenytoin serum levels; dose adjustment may be required.

Strong CYP3A4 inducer increases gefitinib metabolism and decreases plasma concentrations. Increase gefitinib to 500 mg daily during concomitant use.

OATP1B1 substrate; gemfibrozil inhibition may increase rifampin exposure, requiring dosing reduction.

May worsen glucose control of glyburide by significantly inducing metabolic isozymes.

May reduce glucose-lowering effect of glimepiride, leading to worsening glycemic control.

Strong CYP3A4 inducer that significantly decreases guanfacine plasma concentrations. Consider dose increase.

CYP3A4 inducer that can decrease hydrocodone plasma concentration, resulting in decreased efficacy or withdrawal syndrome.

Induces hepatic enzymes and increases clearance of corticosteroids, may require increased corticosteroid dose to achieve desired response.

Rifampin induces hepatic enzyme activity, enhancing corticosteroid metabolism and may require dosage increase.

Rifampin induces cytochrome P450 3A4 enzyme activity, enhancing corticosteroid metabolism and requiring increased corticosteroid dosage.

CYP3A4 inducer may increase metabolism of ifosfamide to active metabolites and increase formation of neurotoxic/nephrotoxic chloroacetaldehyde. Monitor for toxicities and consider dose adjustment.

CYP2C8 inducer may decrease iptacopan exposure, resulting in loss of or reduced efficacy. Monitor clinical response.

Hepatic enzyme inducer may increase corticosteroid metabolism and reduce efficacy.

Decreased lamotrigine AUC approximately 40%.

Decreases lamotrigine AUC approximately 40%.

Rifampin increases plasma concentration of teriflunomide (leflunomide's active metabolite) by 40%. Caution recommended due to potential for continued concentration increases with multiple dosing.

Rifampin, a potent CYP inducer, increased plasma concentration of teriflunomide (leflunomide's active metabolite) by 40%. Caution should be used with concomitant administration.

Rifampicin induces CYP3A4 and may decrease plasma concentrations of COCs, potentially diminishing contraceptive effectiveness or increasing breakthrough bleeding.

Rifampin induces CYP3A4 enzymes, potentially decreasing contraceptive effectiveness and increasing breakthrough bleeding.

Co-administration of rifampin with linezolid resulted in 21% decrease in linezolid Cmax and 32% decrease in linezolid AUC. Clinical significance is unknown.

Approximately 40% reduction in AUC of active metabolite and 30% reduction in AUC of losartan.

Rifampin decreased losartan AUC by approximately 30% and active metabolite AUC by approximately 40%. Inducer of drug metabolism may reduce efficacy.

Hepatic enzyme inducer may increase corticosteroid clearance.

Rifampin induces CYP3A4, potentially increasing the rate of elimination of donepezil.

Strong CYP 3A4 inducer; likely to decrease the pharmacological action of methylergonovine.

May increase the clearance of methylprednisolone and require increases in methylprednisolone dose to achieve the desired response.

Rifampin induces cytochrome P450 3A4 and may enhance corticosteroid metabolism, requiring dosage increase.

Rifampin induces CYP3A4 enzyme activity, enhancing corticosteroid metabolism and may require dosage increase.

Hepatic enzyme inducer that enhances corticosteroid metabolism and may require increased corticosteroid dosage.

Hepatic enzyme inducer that lowers mexiletine plasma levels; monitoring recommended to avoid ineffective therapy.

CYP3A4 inducer that markedly decreases midazolam C max and AUC, reducing its efficacy.

Drug interaction study conducted; no dose adjustment recommended when coadministered with mirabegron.

Strong CYP3A inducer decreases mirtazapine plasma concentration. May require dose increase.

Interferes with enterohepatic recirculation, decreasing mycophenolate mofetil systemic exposure. Monitor for alterations in efficacy.

Interferes with enterohepatic recirculation and induces glucuronidation, decreasing mycophenolic acid systemic exposure and potentially reducing Mycophenolate Mofetil efficacy.

CYP inducer that may reduce blood-glucose-lowering effect and increase susceptibility to hyperglycemia. Dose increases and increased glucose monitoring may be required.

P-gp and CYP3A4 inducer that decreased nintedanib exposure by 50%. May reduce nintedanib efficacy.

Enzyme inducer that may decrease plasma concentrations of CHCs and potentially diminish effectiveness or increase breakthrough bleeding.

May decrease plasma concentrations and efficacy of contraceptive; may increase breakthrough bleeding.

Rifampin increases metabolism of nortriptyline, requiring higher than expected doses; discontinuation causes nortriptyline levels to rise.

May cause an increase in olanzapine clearance.

Rifampin may increase olanzapine clearance.

Potent CYP3A4 inducer significantly increases ondansetron clearance and decreases blood concentrations. Monitor for reduced ondansetron efficacy.

Potent CYP3A4 inducer significantly increases ondansetron clearance and decreases blood concentrations. Monitor for reduced ondansetron efficacy.

Potent CYP3A4 inducer significantly increases ondansetron clearance and decreases blood concentrations. Monitor for potential decreased ondansetron efficacy.

Rifampin decreases plasma levels of MHD (active metabolite) by 25-49%. Monitoring of MHD levels and oxcarbazepine dose adjustment may be necessary.

CYP3A4 and CYP2C8 inducer; caution should be exercised when administering paclitaxel concomitantly.

May decrease phenytoin serum levels; monitoring of phenytoin levels recommended.

May decrease phenytoin serum levels; monitoring of phenytoin levels recommended.

CYP2C8 inducer may significantly decrease pioglitazone exposure, requiring diabetes treatment adjustment based on clinical response.

CYP2C8 inducer may significantly decrease pioglitazone exposure. Diabetes treatment changes may be needed based on clinical response.

CYP2C8 inducer may significantly decrease pioglitazone exposure. Diabetes treatment changes may be needed based on clinical response.

CYP2C8 inducer that may significantly decrease pioglitazone exposure. Changes in diabetes treatment may be needed based on clinical response.

CYP 3A4 enzyme inducer enhances metabolism of corticosteroids, requiring increased prednisone dosage.

Probenecid increases plasma elimination half-life and concentrations of rifampin; lower dosage may be required.

Probenecid increases mean plasma elimination half-life and plasma concentrations of rifampin; use lower dosages cautiously.

May increase elimination of progesterone through induction of hepatic cytochrome P450-3A4 system.

Decreases propafenone plasma concentrations by 50-67% with corresponding decreases in metabolite levels.

Hepatic enzyme inducer that decreases blood levels of propranolol by increasing hepatic metabolism.

Rifampin induces cytochrome P450 IIIA4 and accelerates hepatic elimination of quinidine.

Induces cytochrome P450 IIIA4, accelerating hepatic elimination and decreasing quinidine levels.

CYP3A4 and CYP2C8 inducer. Repaglinide dose increases and increased glucose monitoring may be required.

Strong CYP3A inducer may decrease AUC and Cmax of ritlecitinib, resulting in loss of or reduced clinical response. Coadministration is not recommended.

Metabolic enzyme inducer that may decrease systemic concentrations of estrogen and/or progestin, potentially diminishing contraceptive effectiveness.

Rifampin decreases seladelpar exposure and may result in delayed or suboptimal biochemical response. Monitor biochemical markers (ALP, bilirubin) when initiating rifampin.

CYP2C8 inducer that halved active metabolite exposure. Increase selexipag dose up to twice when co-administered; reduce when rifampin is stopped.

Rifampin induces UGT1A9, decreasing sotagliflozin exposure and potentially reducing efficacy. Consider monitoring of clinical status.

Rifampin is a strong inducer of CYP1A2, CYP3A4, and CYP2C19 and may decrease DIACOMIT concentrations. Concomitant use should be avoided or dosage adjustment made.

Probenecid inhibits OAT1/3, increasing rifampin plasma concentrations. Monitor more frequently for adverse reactions.

Potent CYP3A4/5 inducer decreases sirolimus (primary metabolite) Cmax by 65% and AUC by 56%. Dose adjustment of temsirolimus recommended if alternative cannot be used.

Potent CYP3A4/5 inducer decreased sirolimus (primary metabolite) Cmax by 65% and AUC by 56%. Dose adjustment of temsirolimus recommended if alternative cannot be used.

Rifampin increases terbinafine clearance by 100%. Coadministration may require terbinafine dose adjustment.

Rifampin increases terbinafine clearance by 100%, substantially reducing terbinafine exposure. Dose adjustment may be necessary.

Rifampin increases terbinafine clearance by 100%, substantially reducing terbinafine exposure.

Teriflunomide may increase exposure of rifampin. Consider reducing dose and monitor patients closely.

Enhances theophylline clearance, resulting in decreased serum theophylline concentrations. Requires higher theophylline doses to achieve therapeutic levels.

Rifampin enhances theophylline clearance, resulting in decreased serum theophylline concentrations. Larger theophylline doses required when initiating therapy.

CYP2C9 inducer that increases torsemide clearance and decreases plasma concentrations; monitor diuretic effect and adjust dose if necessary.

CYP3A4 inducer that may alter tramadol metabolism and exposure.

CYP3A4 inducer causing lowering of verapamil plasma levels. Patients should be monitored for drug interactions.

Strong CYP3A4 inducer decreases trazodone exposure. Monitor closely and consider increased trazodone dose.

CYP2C8 inducer decreases treprostinil exposure. Monitor for reduced treprostinil efficacy.

CYP 3A4 inducer enhances metabolism of corticosteroids and may require dosage increase.

CYP3A4 inducer decreases plasma concentrations of ulipristal acetate and may decrease its effectiveness as emergency contraception.

OAT1 inhibitor may increase vadadustat AUC, increasing risk of adverse reactions. Monitor for rapid hemoglobin increase and adverse effects.

Rifampin is an enzyme-inducing drug that can increase valproate clearance. Monitoring of valproate and rifampin concentrations and dosage adjustment are indicated.

Enzyme-inducing drug that can increase valproate clearance. Increased monitoring of valproate and concomitant drug concentrations and dosage adjustment indicated.

Rifampin is an inhibitor of hepatic uptake transporter OATP1B1, which may increase systemic exposure to valsartan.

Co-administration of rifampin (uptake transporter inhibitor) may increase systemic exposure to valsartan.

Strong CYP3A4 inducer that decreases vilazodone exposure; consider increasing dose by 2-fold up to 80 mg daily.

Strong CYP inducer decreases plasma concentrations of vortioxetine. Consider increasing TRINTELLIX dose; maximum dose not to exceed 3 times original dose.

Multiple-dose rifampin reduced zaleplon Cmax and AUC by approximately 80%, potentially leading to zaleplon ineffectiveness. Alternative non-CYP3A4 substrate hypnotic may be considered.

CYP3A4 inducer that significantly reduces exposure to and pharmacodynamic effects of zolpidem, potentially decreasing efficacy.

Co-administration resulted in no significant alteration in steady state pharmacokinetics of anidulafungin. No dosage adjustment needed.

No clinically meaningful differences in eribulin mesylate exposure observed when administered with rifampin, a CYP3A4 inducer.

Co-administration with micafungin did not alter micafungin pharmacokinetics.

Potent CYP3A/2B6 inducer did not significantly change pharmacokinetics of prasugrel's active metabolite or platelet aggregation inhibition.

Concomitant use with probenecid and cotrimoxazole increases the concentration of rifampin which may increase the risk of RIFADIN toxicities.

Substitute non-enzyme inducing therapies at least 2 weeks prior to initiation of irinotecan therapy Decrease irinotecan and active metabolite exposure Levothyroxine Decrease exposure Losartan Parent Decrease AUC by 30% Active metabolite (E3174) Decrease AUC by 40% Methadone In patients well-stabilized on methadone, concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms.

Decrease exposure Digitoxin Decrease exposure Fluoroquinolones Pefloxacin Administered with rifampin 900 mg daily Decrease exposure Moxifloxacin , Decrease exposure Oral Hypoglycemic Agents (e.g., sulfonylureas) Glyburide Decrease exposure Rifampin may worsen glucose control of glyburide.

Decrease exposure Digitoxin Decrease exposure Fluoroquinolones Pefloxacin Administered with rifampin 900 mg daily Decrease exposure Moxifloxacin , Decrease exposure Oral Hypoglycemic Agents (e.g., sulfonylureas) Glyburide Decrease exposure Rifampin may worsen glucose control of glyburide.

Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25 mg) was associated with higher than expected doses of nortriptyline were required to obtain a therapeutic drug level.