Darunavir and Rifampin interaction

Darunavir and Rifampin: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Darunavir (PREZISTA) label · effective 2025-08-29

Major

Alpha 1-adrenoreceptor antagonist: alfuzosin Anti-gout: colchicine, in patients with renal and/or hepatic impairment Antimycobacterial: rifampin Antipsychotics: lurasidone, pimozide Cardiac Disorders: dronedarone, ivabradine, ranolazine Ergot derivatives, e.g. dihydroergotamine, ergotamine, methylergonovine Herbal product: St.

Contraindicationsnames RifampinView label on DailyMed
Major

Antimycobacterials : rifampin ↓ darunavir Co-administration is contraindicated due to potential for loss of therapeutic effect and development of resistance. rifabutin (The reference regimen for rifabutin was 300 mg once daily.) ↑ darunavir ↑ rifabutin ↑ 25- O -desacetylrifabutin Dose reduction of rifabutin by at least 75% of the usual dose (300 mg once daily)…

Drug interactionsnames RifampinView label on DailyMed
Moderate

Initiation of medications that inhibit or induce CYP3A may increase or decrease concentrations of PREZISTA/ritonavir, respectively.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Drugs that induce CYP3A activity would be expected to increase the clearance of darunavir and ritonavir, resulting in lowered plasma concentrations of darunavir and ritonavir.

Drug interactionsby drug classView label on DailyMed
Moderate

Corticosteroids: dexamethasone (systemic) ↓ darunavir Co-administration of PREZISTA/ritonavir with systemic dexamethasone or other systemic corticosteroids that induce CYP3A may result in loss of therapeutic effect and development of resistance to darunavir.

Drug interactionsby drug classView label on DailyMed

From the Rifampin label · effective 2026-05-05

Major

(See PRECAUTIONS, Drug Interactions .) Rifampin is contraindicated in patients who are also receiving atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir, cabotegravir, fostemsavir and lenacapavir (see prescribing information for SUNLENCA ® ) due to the potential of rifampin to substantially decrease plasma concentrations of these antiviral drugs, which…

Contraindicationsnames DarunavirView label on DailyMed
Major

…Concentrations Administered with rifampin 600 mg daily, unless otherwise specified 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 Rifampin dosage used concomitantly with…

Drug interactionsby drug classView label on DailyMed
Major

Cabotegravir Decrease AUC by 59% Fostemsavir Decrease AUC by 82% Lenacapavir (SUNLENCA) Indicated for the treatment of human immunodeficiency virus-1 (HIV-1) infection Decrease AUC by 84% Antiretrovirals Prevention or Management: Avoid concomitant use Zidovudine Decrease AUC by 47% Indinavir Decrease AUC by 92% Efavirenz Decrease AUC by 26% Antiretrovirals Prevention…

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.