Rifapentine and Everolimus: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rifapentine
Everolimus
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.
What happens
Reduced everolimus exposure and reduced efficacy of everolimus
Interaction Deep Dive
Coadministration of everolimus with a strong CYP3A4 inducer is not recommended due to the potential for reduced everolimus exposure. If concurrent therapy is necessary, closely monitor everolimus whole blood trough levels3. Increase the dosage for everolimus with a strong CYP3A inducer as recommended. For breast cancer, neuroendocrine tumors of pancreatic origin (NET), renal cell carcinoma (RCC), and tuberous sclerosis complex (TSC)-associated renal angiomyolipoma, avoid coadministration where alternatives exist. If coadministration cannot be avoided, double the daily dose using increments of 5 mg or less. Multiple increments may be required. Resume the dosage administered prior to inducer initiation, once an inducer is discontinued for 5 days. For TSC-associated subependymal giant cell astrocytoma and TSC-associated partial-onset seizures, double the daily dose using increments of 5 mg or less. Multiple increments may be required. Addition of another strong CYP3A4 inducer in a patient already receiving treatment with a strong CYP3A4 inducer may not require additional dosage modification. Assess trough concentrations when initiating and discontinuing the inducer. Resume the dosage administered before starting any inducer, once all inducers are discontinued for 5 days 21.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of everolimus
Literature reports
1 report — tap to read
a) Coadministration of single 4 mg dose of everolimus (a CYP3A4 substrate) with multiple-dose of rifAMPin 600 mg once daily for 8 days (a strong CYP3A4 and P-gp inducer) increased everolimus clearance nearly 3-fold, decreased Cmax by 58%, and decreased AUC by 63% in healthy volunteers 3.
Common questions
Can I take Rifapentine and Everolimus together?
Reduced everolimus exposure and reduced efficacy of everolimus Always confirm with your pharmacist or prescriber before making any change.
How serious is the Rifapentine and Everolimus 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 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 Rifapentine or Everolimus 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 (3)
- Product Information: AFINITOR DISPERZ® tablets for oral suspension, everolimus tablets for oral suspension. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 2026. DailyMed
- Product Information: AFINITOR® oral tablets, everolimus oral tablets. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 2026. DailyMed
- Product Information: ZORTRESS(R) oral tablets, everolimus oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
Keep reading about Rifapentine
Keep reading about Everolimus
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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