ArticleDrug and alcohol dependence2011
Rifampin, but not rifabutin, may produce opiate withdrawal in buprenorphine-maintained patients.
Article in Drug and alcohol dependence, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Clinical outcomes associated with drug-drug interactions involving buprenorphine: a systematic review.Addiction science & clinical practice · 2026Pooled it
- Clinically significant drug-drug interactions involving opioid analgesics used for pain treatment in patients with cancer: a systematic review.Drug design, development and therapy · 2015Pooled it
- Rifampicin markedly decreases the exposure to oral and intravenous tramadol.European journal of clinical pharmacology · 2013Trial
- Drug Interactions Are Crucial in the Care of Patients on Opioid Substitutional Therapy-A Case Report.Reports (MDPI) · 2026Article
- State-of-the-Art Review: The Intersection of Infectious Diseases and Carceral Medicine.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Review
- Mechanisms of altered hepatic drug disposition during pregnancy: small molecules.Expert opinion on drug metabolism & toxicology · 2025Review
- Common Bacterial Infections in Persons Who Inject Drugs.Medicines (Basel, Switzerland) · 2025Review
- Article
- The impact of alcohol and illicit substance use on the pharmacokinetics of first-line TB drugs.The Journal of antimicrobial chemotherapy · 2024Article
- Frame Shift: Focusing on Harm Reduction and Shared Decision Making for People Who Use Drugs Hospitalized With Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Association Between Buprenorphine Dose and the Urine "Norbuprenorphine" to "Creatinine" Ratio: Revised.Substance abuse : research and treatment · 2023Article
- Model-Based Comparative Analysis of Rifampicin and Rifabutin Drug-Drug Interaction Profile.Antimicrobial agents and chemotherapy · 2021Article
- Applying the Infectious Diseases Literature to People who Inject Drugs.Infectious disease clinics of North America · 2020Review
- Opioid analgesics-related pharmacokinetic drug interactions: from the perspectives of evidence based on randomized controlled trials and clinical risk management.Journal of pain research · 2017Review
- Rifampicin decreases exposure to sublingual buprenorphine in healthy subjects.Pharmacology research & perspectives · 2016Article
- [Interaction of opioid analgesics at the level of biotransformation].Schmerz (Berlin, Germany) · 2016Article
- New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone.Substance abuse and rehabilitation · 2015Review
- P-glycoprotein is a major determinant of norbuprenorphine brain exposure and antinociception.The Journal of pharmacology and experimental therapeutics · 2012Article
- Buprenorphine, Norbuprenorphine, and Naloxone Levels in Adulterated Urine Samples: Can They be Detected When Buprenorphine/Naloxone Film is Dipped into Urine or Water?Substance use : research and treatmentArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThis series of studies examines the pharmacokinetic/pharmacodynamic interactions between buprenorphine, an opioid partial agonist increasingly used in treatment of opioid dependence, and rifampin, a medication used as a first line treatment for tuberculosis; or rifabutin, an alternative antituberculosis medication.
methodsOpioid-dependent individuals on stable doses of buprenorphine/naloxone underwent two, 24-h blood sampling studies: (1) for buprenorphine pharmacokinetics and (2) following 15 days of rifampin 600 mg daily or rifabutin 300 mg daily for buprenorphine and rifampin or rifabutin pharmacokinetics.
resultsRifampin administration produced significant reduction in plasma buprenorphine concentrations (70% reduction in mean area under the curve (AUC); p=<0.001) and onset of opiate withdrawal symptoms in 50% of participants (p=0.02). While rifabutin administration to buprenorphine-maintained subjects resulted in a significant decrease in buprenorphine plasma concentrations (35% decrease in AUC; p<0.001) no opiate withdrawal was seen. Compared with historical control data, buprenorphine had no significant effect on rifampin pharmacokinetics, but was associated with 22% lower rifabutin mean AUC (p=0.009), although rifabutin and its active metabolite concentrations remained in the therapeutic range.
conclusionsRifampin is a more potent inducer of buprenorphine metabolism than rifabutin with pharmacokinetic and pharmacodynamic adverse consequences. Those patients requiring rifampin treatment for tuberculosis and receiving buprenorphine therapy are likely to require an increase in buprenorphine dose to prevent withdrawal symptoms. Rifabutin administration was associated with decreases in buprenorphine plasma concentrations, but no clinically significant adverse events were observed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.