Scared to start rifampin-interactions

My llmd changed my abx up to be on rifampin and zithro (was mepron, mino, zithro). I am nervous because the rifampin interacts with so much- we discussed this and she said there is biaxin but that rifampin works better- we said I would try it and see and if not, then use biaxin. Now that I am looking at it, I am nervous. I take wellbutrin, buspar, birth control- all of these would be made less effective/not effective. Should I just ask for biaxin??

Thanks,

It looks like rifampin is a good abx to try.. it just makes me nervous since it would effect my birth control, depression, and anxiety meds.

No. When I asked my llmd about it, she said she wasn't educated enough about it. What do you mean as an inhibitor?

It was babs but not aiming for bart.

Cindy - I put Busprion, Wellbutrin and rifampin in the drug interaction checker that I use.

It showed Rifampin may reduce the blood levels and effects of buproprion. (Wellbutrin) (Rated as Moderate)

It showed Rifampin may decrease the effects of buspar - (Rated as Moderate)


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Are you being prescribed the Rifampin once daily or twice daily? I have taken it both ways - 300 twice daily and 600 once daily. If you do decide to take it with those two medications - I suggest you take the Rifampin once daily dosing. Can you take your Buspar and Wellbutrin opposite times than the Rifampin? It will help with the interactions.

Wellbutrin half life is 12-30 hours
Buspar half life is 2-3 hours

Rifampin half life is 3-4 hours.


So - here's my thoughts. What if you were to do the once daily Rifampin dosing. So, at 8:00 a.m. you take the Rifampin.

By 4:00 p.m. it has gone through more than 2 half-lifes so is greatly reduced - then you take your Buspar and Wellbutrin.
The Buspar (short half-life) will be mostly eliminated by the 8:00 the next morning (when you take the Rifampin)

The Wellbutrin will be reduced...maybe by half or less...it's not ideal...but better than taking them all at the same time. You may have to increase the Wellbutrin dosage?


Biaxin really isn't as good against bart as the Rifampin.

Re: birth control. I didn't check that one out - but you may have to add some 'thing' - another birth control method while you're on the Rifampin.

cindy22706 said...
Girlie,

Thank you- your answers are always awesome. I just started buspar because my anxiety has been thru the roof- I was told I need to take it twice a day because it doesn't last in the system. I also was told to take wellbutrin in the morning since it causes energy/sleeplessness (not sure about energy, but don't know if I would have sleeplessness if I took it at night).

At the current moment, she has me taking 150mg twice a day of rifampin (when I start at the end of the week). I am thinking she is just starting slow because I have an appt. with her in 2 weeks from starting- so I think she will increase it then.

I also saw no grapefruit products with rifampin- does that mean no grapefruit seed extract? Not sure why she told me to keep taking it, guess she forgot. there are so many interactions to look at.

Oh and also, is it true absolutely no alcohol on rifampin? thanks

No, you shouldn't drink alcohol when on Rifampin. You need to protect your liver.
I believe the grapefruit products are because of the Cytochrome P450 interactions. I don't know if it applies to the Grapefruit seeds. You'll have to ask her.

I would discuss taking the Rifampin once daily with your Dr. Many LLMD's do this. You could do it in the evening
It isn't ideal with your other meds...but I think it's better for the timing. It would be at least 12 hours away from the Wellbutrin. ...and you could space it a few hours away from the Buspar.

I think it's workable - you just may need to adjust the Buspar and Wellbutrin dosages...

ok thank you. Ill ask.