Does Rifabutin Interact with Ketoconazole?
Rifabutin and Ketoconazole have a major drug interaction according to U.S. FDA drug labeling data. Potent CYP3A4 enzyme inducer that may decrease ketoconazole bioavailability and reduce antifungal efficacy. Coadministration not recommended. The mechanism involves cyp3a4 induction decreases ketoconazole bioavailability. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Major
- Rifabutin Class
- Rifamycin Antimycobacterial
- Ketoconazole Class
- Azole Antifungal
- Management
- Close medical supervision required
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Rifabutin and Ketoconazole occurs because cyp3a4 induction decreases ketoconazole bioavailability. Clinically, this means potent cyp3a4 enzyme inducer that may decrease ketoconazole bioavailability and reduce antifungal efficacy. coadministration not recommended. This is classified as a major interaction, meaning it could cause serious harm if not properly managed. Your healthcare provider may need to adjust dosages, substitute one medication, or increase monitoring frequency.
What To Tell Your Doctor or Pharmacist
If you are taking Rifabutin and your doctor is considering prescribing Ketoconazole (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask how frequently you should be monitored while these are co-prescribed
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider