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Drug Interactions between iptacopan and rifampin

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

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Interactions between your drugs

Major

rifAMPin iptacopan

Applies to: rifampin and iptacopan

MONITOR CLOSELY: Coadministration with potent inducers of CYP450 2C8, uridine diphosphate glucuronosyltransferase (UGT) 1A1, P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), and/or organic anion transporting polypeptide (OATP) 1B1/3 (e.g., rifampin) may significantly decrease iptacopan plasma concentrations. Decreased plasma concentrations of iptacopan may result in a loss of its efficacy. The proposed mechanism is induction of CYP450 2C8-mediated metabolism of iptacopan, which is primarily metabolized by the isoenzyme, glucuronidation via UGT1A1, which is a minor elimination pathway, and the transporters P-gp, BCRP, and OATP1B1/3, for which iptacopan is a substrate. However, clinical data evaluating the interaction are not available.

MANAGEMENT: The potential for diminished pharmacologic effects of iptacopan should be considered during coadministration with potent inducers of CYP450 2C8, UGT1A1, P-gp, BCRP, and/or OATP1B1/3. The manufacturer recommends the close monitoring of clinical response to iptacopan therapy as well as for potential signs and symptoms of hemolysis. Treatment with the potent inducer should be discontinued if loss of therapeutic efficacy occurs.

References (3)
  1. (2024) "Product Information. Fabhalta (iptacopan)." Novartis Pharmaceuticals Australia Pty Ltd
  2. (2024) "Product Information. Fabhalta (iptacopan)." Novartis Pharmaceuticals, SUPPL-1
  3. Novartis Pharmaceuticals Canada Inc Product Monograph. Fabhalta (iptacopan) https://pdf.hres.ca/dpd_pm/00078186.PDF

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 (6)
  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.

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

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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

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

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