Finch Christopher K, Chrisman Cary R, Baciewicz Anne M, Self Timothy H
Department of Clinical Pharmacy, University of Tennessee, 26 S Dunlap, Suite 210, Memphis, TN 38163, USA.
Arch Intern Med. 2002 May 13;162(9):985-92. doi: 10.1001/archinte.162.9.985.
Rifampin is a potent inducer of cytochrome P-450 oxidative enzymes. A few examples of well-documented clinically significant interactions include interactions with warfarin, oral contraceptives, cyclosporine, glucocorticoids, ketoconazole or itraconazole, theophylline, quinidine sulfate, digitoxin or digoxin, verapamil hydrochloride, human immunodeficiency virus-related protease inhibitors, zidovudine, delavirdine mesylate, nifedipine, and midazolam. Recent reports have demonstrated clinically relevant interactions with numerous other drugs, such as buspirone hydrochloride, zolpidem tartrate, simvastatin, propafenone hydrochloride, tacrolimus, ondansetron hydrochloride, and opiates. Rifabutin reduces serum concentrations of antiretroviral agents, but less so than rifampin. To avoid a reduced therapeutic response, therapeutic failure, or toxic reactions when rifampin is added to or discontinued from medication regimens, clinicians need to be cognizant of these interactions. Enhanced knowledge of known interactions will continue to develop, including research on the induction of specific cytochrome P-450 isoenzymes and on the importance of the P-glycoprotein transport system. New rifampin and rifabutin interactions will be discovered with further investigations.
利福平是一种强效的细胞色素P - 450氧化酶诱导剂。一些有充分文献记载的具有临床意义的相互作用实例包括与华法林、口服避孕药、环孢素、糖皮质激素、酮康唑或伊曲康唑、茶碱、硫酸奎尼丁、洋地黄毒苷或地高辛、盐酸维拉帕米、人类免疫缺陷病毒相关蛋白酶抑制剂、齐多夫定、甲磺酸地拉韦啶、硝苯地平及咪达唑仑的相互作用。近期报告显示，利福平还与许多其他药物存在临床相关相互作用，如盐酸丁螺环酮、酒石酸唑吡坦、辛伐他汀、盐酸普罗帕酮、他克莫司、盐酸昂丹司琼及阿片类药物。利福布汀可降低抗逆转录病毒药物的血清浓度，但程度比利福平轻。为避免在药物治疗方案中添加或停用利福平时出现治疗反应降低、治疗失败或毒性反应，临床医生需要了解这些相互作用。对已知相互作用的深入了解将不断发展，包括对特定细胞色素P - 450同工酶诱导作用以及P - 糖蛋白转运系统重要性的研究。随着进一步研究，还会发现利福平和利福布汀的新相互作用。
