MajorAntifungals, triazole derivatives×Antituberculous antibiotic
Updated · Methodology
Mechanism
Rifampicin strongly induces CYP3A4, which partly metabolises fluconazole. Fluconazole plasma levels fall by 25%; antifungal efficacy decreases.
Symptoms
Recurrence of mycosis symptoms: ongoing fever, skin or mucosal lesions; in immunocompromised patients, risk of systemic mycosis progression.
Management
When combined, increase fluconazole by 50–100% with efficacy monitoring. Alternative antifungal during anti-TB therapy: echinocandins (micafungin, caspofungin; no CYP3A4 dependence).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
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Sources
- FDA: Rifampin capsule (Ani Pharmaceuticals, Inc.) – Prescribing Information (2010)– ; DailyMed setid b389b1a3-672f-47e3-916c-4a9c044b211b
- AEMPS: Ficha técnica: Fluconazol (nº registro 67929), sección 4.5 (2026)– AEMPS, CIMA, nº registro 67929, revisión 10/2026, sección 4.5
- AEMPS: Ficha técnica: Rifampicina (nº registro 49034), sección 4.5 (2026)– AEMPS, CIMA, nº registro 49034, revisión 08/2026, sección 4.5