Abrocitinib and Rifampin: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rifampin
Abrocitinib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Rifampin can make abrocitinib (Cibinqo) work less well. Abrocitinib is a pill that calms the immune system to help clear moderate to severe eczema. Rifampin, an antibiotic, speeds up the liver enzymes that break abrocitinib down. When that happens, your body clears the eczema medicine faster, so less of it stays in your blood to do its job.
In studies, this dropped the active drug level by about half. That could mean your eczema flares up again. Please don't stop either medicine on your own. Let your pharmacist or doctor know you take both, and they can sort out the safest plan for you.
Effect: Rifampin (strong CYP2C19/CYP2C9 inducer) increases metabolism of abrocitinib and its active metabolites, reducing exposure. Abrocitinib is an active drug (not a prodrug), so induction lowers efficacy.
- Magnitude: ~31% decrease in Cmax, ~56% decrease in AUC of abrocitinib and active metabolites.
- Mechanism: Induction of CYP2C19/CYP2C9-mediated metabolism.
- Onset: Unspecified; enzyme induction typically develops over days to weeks.
- Evidence: Theoretical per file, though supported by PK data.
Management: Avoid coadministration with strong CYP2C19/CYP2C9 inducers. If unavoidable, monitor closely for loss of dermatologic response and consider alternative therapy in consultation with the prescriber.
What happens
Decreased abrocitinib and active metabolite exposure
Interaction Deep Dive
Giving abrocitinib alongside potent CYP2C19 or CYP2C9 inducers can reduce the exposure of abrocitinib together with its active metabolites, potentially resulting in a diminished or absent clinical response. When rifampin, a strong CYP2C19 inducer, was administered concurrently with abrocitinib, the Cmax of abrocitinib and its active metabolites fell by 31% and the AUC dropped by 56%. Concurrent use of abrocitinib with strong CYP2C19 or CYP2C9 inducers should be avoided1.
Why it happens (mechanism)
Induction of CYP2C19 and CYP2C9-mediated abrocitinib metabolism
How to manage this interaction
The main strategy here is to avoid using these two together. Because rifampin can significantly lower the amount of active abrocitinib in your body, your eczema treatment may become less effective.
- Keep taking both exactly as prescribed for now; do not start, stop, or change anything on your own.
- Tell your pharmacist and dermatologist that you have been prescribed both so they can review your regimen.
- Your care team may choose a different antibiotic or a different eczema plan, and may watch your skin response more closely.
- Report any worsening or flare of your eczema.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) When rifampin 600 mg was given once daily for 8 days (a strong inducer of CYP2C19) together with abrocitinib 200 mg, the Cmax of abrocitinib and its active metabolites fell by 31% and the AUC(infinity) fell by 56% 1.
Common questions
Can I take Abrocitinib and Rifampin together?
Rifampin can cut abrocitinib levels roughly in half and may cause your eczema treatment to stop working, so this combination is usually avoided. Talk to your pharmacist or doctor before combining them. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abrocitinib and Rifampin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abrocitinib and Rifampin interaction managed?
The main strategy here is to avoid using these two together. Because rifampin can significantly lower the amount of active abrocitinib in your body, your eczema treatment may become less effective. Keep taking both exactly as prescribed for now; do not start, stop, or change anything on your own. Tell your pharmacist and dermatologist that you have been prescribed both so they can review your regi… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abrocitinib or Rifampin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: CIBINQO(TM) oral tablets, abrocitinib oral tablets. Pfizer Labs (per FDA), New York, NY, 2022. DailyMed
Keep reading about Rifampin
Keep reading about Abrocitinib
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