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The following safety and warning information is crucial for anyone prescribed rifabutin (Mycobutin). It is important to discuss any concerns with your healthcare provider to ensure safe use of this medication.

• Not for Tuberculosis Treatment: Do not use rifabutin (Mycobutin) to prevent MAC if you have active tuberculosis, as this can lead to significant antibiotic resistance. A combination of different anti-TB antibiotics is required for TB infection. Your healthcare provider will confirm you do not have TB before starting rifabutin and will monitor you for TB infections while on this medication.

• Drug Interactions: Rifabutin (Mycobutin) can interact with numerous medications, including clarithromycin and HIV protease inhibitors. Ensure all your healthcare providers and pharmacists are aware of all medications you are taking to avoid interactions and to adjust dosages appropriately.

• Allergic Reactions and Skin Issues: There is a risk of severe allergic reactions, including anaphylaxis. Seek immediate medical attention if you experience symptoms such as dizziness, rash, facial swelling, or difficulty breathing.

• Eye Inflammation: Rare cases of uveitis, an inflammation of the eye, have been reported, particularly in those also taking medications like clarithromycin, azithromycin, or fluconazole. Report any eye redness, pain, or vision changes to your provider immediately.

• Infectious Diarrhea: Rifabutin (Mycobutin) can increase the risk of severe bacterial infections in the gut, causing diarrhea even after treatment ends. Contact your healthcare provider if severe diarrhea occurs.

• Low Blood Cell Counts: This medication may lead to decreased white blood cells and platelets. Regular blood tests will be conducted by your provider to monitor these levels.

• Contraindications: Do not use rifabutin (Mycobutin) if you are allergic to rifamycins. Discuss any allergies with your healthcare provider before taking this medication.

When taking this medication, you may experience some common side effects that are generally mild and manageable. These include changes in urine color, which is harmless and temporary, as well as nausea, diarrhea, stomach upset, changes in taste, and vomiting. Additionally, some people may notice low appetite, excessive gas, or a rash. It's important to inform your healthcare provider if these symptoms persist or become bothersome.

In some cases, this drug can lead to a low blood cell count, higher liver enzymes, or mild headaches. Although these are less common, monitoring your body's response is essential. If you experience easy bleeding or bruising, muscle weakness or pain, joint pain or swelling, or unusual tiredness, contact your healthcare provider promptly.

Rare but serious side effects require immediate medical attention. These include severe allergic reactions characterized by fever, persistent lymph node swelling, rash, severe dizziness, or trouble breathing. The medication may also cause a severe intestinal condition due to a bacteria called C. difficile, marked by persistent diarrhea, abdominal pain or cramping, and blood or mucus in the stool.

Be on the lookout for signs like dark urine or yellowing of the eyes or skin, as these can indicate liver issues. Remember, these serious side effects are rare, but it's crucial to seek medical help if they occur. Always discuss any unexpected symptoms with your healthcare provider to ensure your safety while using this medication.

Rifabutin, known by the brand name Mycobutin, can interact with a variety of medications and supplements. It's important to inform your doctor and pharmacist about all medications or supplements you are taking, whether they are prescribed, over-the-counter, vitamins, or herbal supplements. Below is a summary of potential interactions with Rifabutin:

1. Medications to Avoid: Rifabutin should not be used in combination with certain medications such as Artemether, Delamanid, Lumefantrine, Lurasidone, Ranolazine, and Voriconazole. These combinations are generally not recommended, and your doctor may choose to avoid prescribing Rifabutin if you are already taking these drugs.

2. Medications That May Require Special Consideration: There are several medications that might not be recommended to use alongside Rifabutin; however, in some cases, they may be necessary. If both are prescribed, your doctor might adjust the dosage or frequency. This includes drugs like Azole antifungals (e.g., fluconazole, itraconazole), Ciprofloxacin, Macrolide antibiotics (e.g., clarithromycin), and other medications like Apremilast, Atazanavir, and Clarithromycin.

3. Possible Increased Side Effects: Using Rifabutin with certain medications may increase the risk of side effects, but this combination might still be the best treatment option. In such cases, your doctor may adjust dosages. Medications in this category include Azithromycin, Dapsone, Didanosine, Nevirapine, Sirolimus, Sulfamethoxazole, Trimetrexate, and Warfarin.

4. Effect on Birth Control: Rifabutin can reduce the effectiveness of hormonal birth control methods such as pills, patches, or rings, increasing the risk of pregnancy. It’s advisable to discuss with your healthcare provider about using additional birth control methods and to notify them if you experience any new spotting or breakthrough bleeding.

Always consult with your healthcare provider before making any changes to your medication regimen to ensure safety and efficacy.