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Drug Interactions between clindamycin and rifapentine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

clindamycin rifapentine

Applies to: clindamycin and rifapentine

MONITOR: Coadministration with strong CYP450 3A4 inducers may decrease plasma concentrations and antimicrobial effects of clindamycin, which is metabolized predominantly by the isoenzyme. In a pharmacokinetic analysis among patients (n=34) with staphylococcal osteoarticular infection receiving treatment with clindamycin (600 mg 3 times a day) and either rifampin (a strong CYP450 3A4 inducer; 600 mg twice a day) or levofloxacin (500 mg twice a day), clindamycin mean trough concentrations and Cmax values for patients treated with levofloxacin were 4.7 and 10.2 mcg/mL, respectively, compared to 0.79 and 3.48 mcg/mL, respectively, for patients treated with rifampin. However, while these findings confirm rifampin is an effective inducer of clindamycin, this combination has been used clinically with some success. The extent of the interaction or clinical use with other 3A4 inducers has not been established.

MANAGEMENT: Monitor closely for diminished therapeutic response to clindamycin during coadministration with strong CYP450 3A4 inducers. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever a strong CYP450 3A4 inducer is added to or withdrawn from therapy with clindamycin. An alternative agent with no or minimal CYP450 3A4-inducing activity may also be considered.

References

  1. (2002) "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn
  2. Bernard A, Kermarrec G, Parize P, et al. (2015) "Dramatic reduction of clindamycin serum concentration in staphylococcal osteoarticular infection patients treated with the oral clindamycin-rifampicin combination." J Infect, 71, p. 200-6

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Drug and food interactions

Moderate

rifapentine food

Applies to: rifapentine

ADJUST DOSING INTERVAL: Administration with food may increase the oral bioavailability of rifapentine and reduce the incidence of gastrointestinal adverse events. Administration with a high fat meal typically increases rifapentine's maximum concentration (Cmax) and systemic exposure (AUC) by approximately 40% to 50% over that observed when rifapentine is administered under fasting conditions. Rifapentine is often prescribed in combination with isoniazid. When single doses of rifapentine (900 mg) and isoniazid (900 mg) were administered with a low fat, high carbohydrate breakfast, the Cmax and AUC of rifapentine increased by 47% and 51%, respectively. On the other hand, isoniazid's Cmax and AUC decreased by 46% and 23%, respectively.

MANAGEMENT: Products containing oral rifapentine as the sole ingredient recommend administration with a meal to increase bioavailability and reduce the occurrence of gastrointestinal upset, nausea, and/or vomiting. Consultation of product labeling for combination products and/or relevant guidelines may be helpful if rifapentine is combined with a medication that is typically taken on an empty stomach.

References

  1. (2021) "Product Information. Isoniazid/Rifapentine 300 mg/300 mg (Macleods) (isoniazid-rifapentine)." Imported (India), 2
  2. (2021) "Product Information. Priftin (rifapentine)." sanofi-aventis

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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