Macitentan and Rifampicin: Drug Interaction Guide

Quick answer: This combination requires caution. Macitentan and Rifampicin can be used together with adjustments and monitoring.

How Macitentan interacts with Rifampicin

Rifampicin induces CYP3A4 and other drug-metabolizing pathways, reducing macitentan exposure. This may reduce pulmonary arterial hypertension treatment efficacy.

What you should do

Avoid if possible or monitor for loss of clinical response and consider alternative anti-infective therapy.

Key facts

Severity

Moderate — caution required

Mechanism

Rifampicin induces CYP3A4 and other drug-metabolizing pathways, reducing macitentan exposure. This may reduce pulmonary ...

Action

Avoid if possible or monitor for loss of clinical response and consider alternative anti-infective therapy.

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Macitentan and Rifampicin together?

With caution. Avoid if possible or monitor for loss of clinical response and consider alternative anti-infective therapy.

What is the severity of this interaction?

The interaction between Macitentan and Rifampicin is classified as Moderate — caution required. Rifampicin induces CYP3A4 and other drug-metabolizing pathways, reducing macitentan exposure. This may reduce pulmonary arterial hypertension treatment efficacy.

What should I do if I'm prescribed both?

Avoid if possible or monitor for loss of clinical response and consider alternative anti-infective therapy. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: May 28, 2026 by iMedic Medical Editorial Team. Our editorial process.