rifabutin reducing malarone concentrations

I read that using rifabutin with malarone will decrease the madrone concentrations by 34%, will this cause the malarone not to work? Would it help if I had a 3 hour gap between taking them?

The 3 hour gap won't work.

The term that applies here is enzyme induction and enzyme deinductIon.

For example with Rifampin, or any drug, there would be 3 steps:

1) The Induction of the enzyme itself, which is the time for the enzyme to become induced, such as CYP3A4 for rifampin (although there are many for rifampin).

2) Then once it's induced there's also the half-life of the drug itself that applies (however this is now also affected by step 1 and 3).

3) Then once you stop the drug, there's the deinductIon of the liver enzyme, which is the time for the enzyme to go to normal levels again.

So in other words, the enzyme induction/deinduction isn't the same as the half-life.

And with Rifampin that process can in some cases take weeks. So the 3 hour gap won't make much difference.

(Sorry I just realized you were talking about Rifabutin but the same logic applies.)

bro123 said...
Should I ask my llmd to take a higher dose then?

I would discuss doing the Mepron for Babs first
And then after you have treated Babs - treat bart with the Rifabutin/Rifampin.

I wouldn’t try to treat them both at once.