Drug interaction between maribavir and rifampin: a case report.
Minh P Lê, Thibaut D'Izarny-Gargas, Louise Chantelot et al.
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Case in brief
A 47-year-old renal transplant patient with ganciclovir-resistant cytomegalovirus (CMV) and concurrent tuberculosis was treated with maribavir and rifampin. Despite the known drug interaction that significantly reduced maribavir's plasma levels, dose escalation to 800 mg three times daily, guided by therapeutic drug monitoring, successfully controlled CMV viremia without adverse effects.
Diagnostic / clinical pearl
Clinicians should be aware that dose adjustments of maribavir, guided by therapeutic drug monitoring, can help manage significant drug-drug interactions with rifampin in patients requiring both medications.
Why it matters
This case highlights the importance of individualized dosing strategies in managing drug interactions, particularly in complex cases involving immunocompromised patients.