Skip to main content

Drug Interactions between Daliresp and rifampin

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

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

rifAMPin roflumilast

Applies to: rifampin and Daliresp (roflumilast)

GENERALLY AVOID: Coadministration with potent CYP450 inducers may significantly reduce the systemic exposure to roflumilast and its pharmacologically active N-oxide metabolite, the former of which is metabolized by CYP450 1A2 and 3A4, and the latter of which is metabolized by CYP450 2C19 and 3A4. In 15 healthy volunteers, administration of a single 500 mcg oral dose of roflumilast in combination with the potent CYP450 3A4 inducer rifampin (600 mg once daily for 11 days) resulted in a 68% reduction of roflumilast peak plasma concentration (Cmax) and 80% reduction of systemic exposure (AUC) compared to administration of roflumilast alone. In addition, rifampin increased the Cmax of roflumilast N-oxide by 30% and decreased its AUC and half-life by 56% and 2.5-fold (from 24 to 9.9 hours), respectively. Total phosphodiesterase 4 inhibitory activity (i.e., combined effect of both roflumilast and roflumilast N-oxide) decreased by 58% in association with these changes.

MANAGEMENT: Due to the potential for reduced therapeutic effectiveness of roflumilast, concomitant use with potent CYP450 enzyme inducers such as carbamazepine, phenobarbital, phenytoin, rifampin, and St. John's wort is not recommended.

References

  1. Nassr N, Huennemeyer A, Herzog R, et al. (2009) "Effects of rifampicin on the pharmacokinetics of roflumilast and roflumilast N-oxide in healthy subjects." Br J Clin Pharmacol, 68, p. 580-7
  2. (2011) "Product Information. Daliresp (roflumilast)." Astra-Zeneca Pharmaceuticals

Switch to consumer interaction data

Drug and food interactions

Moderate

rifAMPin food

Applies to: rifampin

GENERALLY AVOID: Concurrent use of rifampin in patients who ingest alcohol daily may result in an increased incidence of hepatotoxicity. The increase in hepatotoxicity may be due to an additive risk as both alcohol and rifampin are individually associated with this adverse reaction. However, the exact mechanism has not been established.

ADJUST DOSING INTERVAL: Administration with food may reduce oral rifampin absorption, increasing the risk of therapeutic failure or resistance. In a randomized, four-period crossover phase I study of 14 healthy male and female volunteers, the pharmacokinetics of single dose rifampin 600 mg were evaluated under fasting conditions and with a high-fat meal. Researchers observed that administration of rifampin with a high-fat meal reduced rifampin peak plasma concentration (Cmax) by 36%, nearly doubled the time to reach peak plasma concentration (Tmax) but reduced overall exposure (AUC) by only 6%.

MANAGEMENT: The manufacturer of oral forms of rifampin recommends administration on an empty stomach, 30 minutes before or 2 hours after meals. Patients should be encouraged to avoid alcohol or strictly limit their intake. Patients who use alcohol and rifampin concurrently or have a history of alcohol use disorder may require additional monitoring of their liver function during treatment with rifampin.

References

  1. (2022) "Product Information. Rifampin (rifAMPin)." Akorn Inc
  2. (2022) "Product Information. Rifampicin (rifampicin)." Mylan Pharmaceuticals Inc
  3. (2023) "Product Information. Rifadin (rifampicin)." Sanofi
  4. (2024) "Product Information. Rifadin (rifaMPICin)." Sanofi-Aventis Australia Pty Ltd
  5. Peloquin CA, Namdar R, Singleton MD, Nix DE (2024) Pharmacokinetics of rifampin under fasting conditions, with food, and with antacids https://pubmed.ncbi.nlm.nih.gov/9925057/
  6. (2019) "Product Information. Rofact (rifampin)." Bausch Health, Canada Inc.
View all 6 references

Switch to consumer interaction data

Minor

roflumilast food

Applies to: Daliresp (roflumilast)

Food intake does not affect the total exposure to roflumilast and its pharmacologically active N-oxide metabolite, but delays the time to maximum concentration (Tmax) of roflumilast by one hour and reduces its peak plasma concentration (Cmax) by approximately 40%. The Tmax and Cmax of
roflumilast N-oxide are unaffected. Roflumilast may be taken with or without food.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2011) "Product Information. Daxas (roflumilast)." Nycomed Inc
  3. (2011) "Product Information. Daliresp (roflumilast)." Astra-Zeneca Pharmaceuticals

Switch to consumer interaction data

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.

See also

Report options

Loading...
QR code containing a link to this page

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer