Fluconazole and Rifabutin interaction

Fluconazole and Rifabutin: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Fluconazole label · effective 2026-04-02

Moderate

(See CONTRAINDICATIONS . ) Rifabutin There have been reports that an interaction exists when fluconazole is administered concomitantly with rifabutin, leading to increased serum levels of rifabutin up to 80%.

Drug interactionsnames RifabutinView label on DailyMed
Moderate

Patients receiving rifabutin and fluconazole concomitantly should be carefully monitored.

Drug interactionsnames RifabutinView label on DailyMed
Minor

There have been reports of uveitis in patients to whom fluconazole and rifabutin were coadministered.

Drug interactionsnames RifabutinView label on DailyMed

From the Rifabutin label · effective 2026-09-01

Moderate

Uveitis Due to the possible occurrence of uveitis, patients should also be carefully monitored when rifabutin is given in combination with clarithromycin (or other macrolides) and/or fluconazole and related compounds (see PRECAUTIONS-Drug Interactions, Table 2 ).

Warningsnames FluconazoleView label on DailyMed
Moderate

ANTIFUNGALS Fluconazole 200 mg once a day for 2 weeks 300 mg once a day for 2 weeks HIV-infected patients (12) ↑ AUC by 82%, ↑ C max by 88% ↔ Monitor for rifabutin associated adverse events.

Drug interactionsnames FluconazoleView label on DailyMed
Moderate

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin.

Drug interactionsby drug classView label on DailyMed
Moderate

Therefore, carefully monitor for rifabutin associated adverse events in those patients also receiving CYP3A inhibitors, which include fluconazole and clarithromycin.

Drug interactionsby drug classView label on DailyMed
Moderate

In some cases, the dosage of rifabutin may need to be reduced when it is co-administered with CYP3A inhibitors.

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.