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Rifampin + istradefylline refers to the coadministration of two distinct pharmaceutical agents. Rifampin is a broad-spectrum antibiotic primarily used in the treatment of tuberculosis and as prophylaxis for *Neisseria meningitidis* carriers. It acts by inhibiting bacterial DNA-dependent RNA polymerase, thereby suppressing RNA synthesis and subsequent protein production[1]. Istradefylline, developed by Kyowa Hakko Kirin, is a selective adenosine A2A receptor antagonist indicated as adjunctive therapy to levodopa/carbidopa for Parkinson's disease. It works by antagonizing adenosine A2A receptor in the basal ganglia, modulating neurotransmission involved in motor control[5][6]. When administered together, rifampin—a potent CYP3A4 inducer—significantly reduces plasma exposure to istradefylline due to increased metabolism[2].
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