Palbociclib and Rifabutin interaction

Palbociclib 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.

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 Palbociclib (Ibrance) label · effective 2026-07-02

Major

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers.

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Major

Avoid concomitant use of strong CYP3A inducers (e.g., phenytoin, rifampin, carbamazepine, enzalutamide, and St John's Wort) [see Clinical Pharmacology (12.3) ] .

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Moderate

Agents That May Decrease Palbociclib Plasma Concentrations Effect of CYP3A Inducers Coadministration of a strong CYP3A inducer (rifampin) decreased the plasma exposure of palbociclib in healthy subjects by 85%.

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From the Rifabutin label · effective 2026-09-01

Moderate

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

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Moderate

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

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Moderate

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

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Minor

Antiretroviral and Anti-HCV Drug Interactions Protease inhibitors act as substrates or inhibitors of CYP3A4 mediated metabolism.

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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.