Nevirapine and Rifabutin interaction
Nevirapine and Rifabutin: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Rifabutin label · effective 2026-09-01
Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ).
The concomitant use of protease inhibitors may require at least a 50% reduction in rifabutin dose, and depending on the protease inhibitor, an adjustment of the antiretroviral drug dose.
Co-administration with antiretroviral drugs metabolized by CYP3A, including but not limited to products containing bictegravir, elvitegravir, oral rilpivirine, or doravirine and anti-HCV drugs including but not limited to sofosbuvir (alone or in combination) may decrease plasma concentrations of those drugs, which may lead to loss of virologic response and possible…
Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes.
Antiretroviral and Anti-HCV Drug Interactions Protease inhibitors act as substrates or inhibitors of CYP3A4 mediated metabolism.
From the Nevirapine label · effective 2026-07-15
Rifabutin ↑ Rifabutin Rifabutin and its metabolite concentrations were moderately increased.
Due to high intersubject variability, however, some patients may experience large increases in rifabutin exposure and may be at higher risk for rifabutin toxicity.
Physicians needing to treat patients co-infected with tuberculosis and using a nevirapine-containing regimen may use rifabutin instead.
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Open in the checkerNot 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.