Rifabutin

A rifamycin antibiotic, FDA-approved to prevent disseminated Mycobacterium avium complex (MAC) disease in advanced HIV; also part of an H. pylori combination capsule.

psilodex.org/m/rifabutin · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: ~45 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Rifabutin”, v2026.10.05. psilodex.org/m/rifabutin

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

Prevention of disseminated Mycobacterium avium complex (MAC) disease in advanced HIV infection

Sources [1]

Other safety

The label warns of uveitis (eye inflammation), especially when combined with clarithromycin or fluconazole, and of hypersensitivity and severe skin reactions.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Not studied with psilocybin; it speeds an enzyme with a minor role in clearing psilocybin, so slightly weaker effects are possible.

Detail Rifabutin induces (speeds up) CYP3A enzymes, though more weakly than rifampin. CYP3A4 metabolized psilocin (psilocybin's active form) in lab studies (Thomann 2024). So rifabutin may slightly lower psilocin levels. However, the body clears psilocin mainly by glucuronidation and conversion to 4-HIAA. No psilocybin data exist. Sources [1][2]

Human data with psilocybin: No psilocybin data; based on how it works
Half-life: ~45 h (range 16–69 h) (FDA label, checked 2026-10-04) Mean terminal half-life in healthy adults.

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

1 listed · counted on reports

Speeds up drug metabolism: Increases the liver enzymes that break down many medicines, lowering their levels. When it is stopped, levels of other medicines can rise over the following weeks. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

None linked

No condition named in state rules is linked to this medication.

05 Sources

Rifabutin capsules (Mylan) · FDA label (DailyMed) — revised 2026-07 | Speeds up drug metabolism: Warnings, Antiretroviral and Anti-HCV Drug Interactions "RIFABUTIN is a CYP3A inducer." | Precautions "Although a weaker enzyme inducer than rifampin, rifabutin may be expected to have some effect on those drugs as well." | Clinical Pharmacology "with a mean terminal half-life of 45 (±17) hours (range: 16 to 69 hours)."
Thomann J, Kolaczynska KE, Stoeckmann OV, et al. In vitro and in vivo metabolism of psilocybin’s active metabolite psilocin. Front Pharmacol 2024;15:1391689. — Abstract: "recombinant CYP2D6 and CYP3A4 enzymes metabolized nearly 100% and 40% of psilocin, respectively." "MAO-A transformed psilocin into minimal amounts of 4-HIAA and 4-HTP." "In conclusion, MAO-A, CYP2D6, and CYP3A4 are involved in psilocin's metabolism." Introduction: "Around 33% of a psilocybin dose is renally excreted as 4-HIAA."

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

Report an error in this record →