Does Rifampin Interact With Tacrolimus?
Glipizide Decrease exposure Immunosuppressive Agents Cyclosporine Decrease exposure Tacrolimus Prevention or Management: Monitoring of whole blood concentrations and appropriate dosage adjustments of tacrolimus are recommended when rifampin and tacrolimus are used concomitantly.
Severity: Moderate
Severity basis: drug interactions section (keywords: monitor, dosage adjustment). Combining Rifampin (Rifamycin antibiotic (strong CYP3A4 inducer)) and Tacrolimus (Calcineurin inhibitor immunosuppressant) is classified as a moderate interaction.
What to Do
Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.
How This Interaction Works
Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Rifampin is a rifamycin antibiotic (strong cyp3a4 inducer) and Tacrolimus is a calcineurin inhibitor immunosuppressant; together they are documented as a moderate interaction. How much this matters depends on your dose, your other medications, and your overall health.
If You Take Both Medications
If you have been prescribed both Rifampin and Tacrolimus, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
From the FDA Label
Glipizide Decrease exposure Immunosuppressive Agents Cyclosporine Decrease exposure Tacrolimus Prevention or Management: Monitoring of whole blood concentrations and appropriate dosage adjustments of tacrolimus are recommended when rifampin and tacrolimus are used concomitantly.
Source: FDA structured product labeling (set_id 036ab68e-5085-4edc-bd83-784b43d64eab).
Tacrolimus
Calcineurin inhibitor immunosuppressant
Brands: Prograf, Astagraf XL
View Tacrolimus safety profileCheck these against your full medication list in our free Interaction Checker
Frequently Asked Questions
Can you take Rifampin and Tacrolimus together?
Rifampin and Tacrolimus have a documented moderate interaction. Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.
How serious is the Rifampin and Tacrolimus interaction?
It is classified as a moderate interaction, based on the FDA label's drug interactions section (keywords: monitor, dosage adjustment). A moderate interaction can be clinically meaningful and usually calls for monitoring or a dose adjustment.
What should I do if I'm taking both Rifampin and Tacrolimus?
If you have been prescribed both Rifampin and Tacrolimus, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
This information is educational — not medical advice.
This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.
Other Rifampin Interactions
- Rifampin + Apixaban(major)
- Rifampin + Clopidogrel(major)
- Rifampin + Dabigatran(major)
- Rifampin + Doxycycline(major)
- Rifampin + Edoxaban(major)
- Rifampin + Fluconazole(major)
- Rifampin + Itraconazole(major)
- Rifampin + Ketoconazole(major)
- Rifampin + Lansoprazole(major)
- Rifampin + Phenytoin(major)
- Rifampin + Rivaroxaban(major)
- Rifampin + Ticagrelor(major)
- Rifampin + Warfarin(major)
- Rifampin + Atorvastatin(moderate)
- Rifampin + Carvedilol(moderate)
- Rifampin + Clarithromycin(moderate)
- Rifampin + Cyclosporine(moderate)
- Rifampin + Eszopiclone(moderate)
- Rifampin + Gemfibrozil(moderate)
- Rifampin + Glimepiride(moderate)
- Rifampin + Glipizide(moderate)
- Rifampin + Hydrocodone Acetaminophen(moderate)
- Rifampin + Methylprednisolone(moderate)
- Rifampin + Mirtazapine(moderate)
- Rifampin + Oxycodone(moderate)
- Rifampin + Pioglitazone(moderate)
- Rifampin + Tramadol(moderate)
- Rifampin + Zolpidem(moderate)
- Rifampin + Aripiprazole(minor)
- Rifampin + Buprenorphine Naloxone(minor)
- Rifampin + Canagliflozin(minor)
- Rifampin + Carbamazepine(minor)
- Rifampin + Carbidopa Levodopa(minor)
- Rifampin + Celecoxib(minor)
- Rifampin + Codeine(minor)
- Rifampin + Dapagliflozin(minor)
- Rifampin + Dexamethasone(minor)
- Rifampin + Diazepam(minor)
- Rifampin + Digoxin(minor)
- Rifampin + Diltiazem(minor)
- Rifampin + Enalapril(minor)
- Rifampin + Glyburide(minor)
- Rifampin + Hydroxychloroquine(minor)
- Rifampin + Lamotrigine(minor)
- Rifampin + Levothyroxine(minor)
- Rifampin + Liothyronine(minor)
- Rifampin + Losartan(minor)
- Rifampin + Metoprolol(minor)
- Rifampin + Morphine(minor)
- Rifampin + Nifedipine(minor)
- Rifampin + Nortriptyline(minor)
- Rifampin + Olanzapine(minor)
- Rifampin + Ondansetron(minor)
- Rifampin + Prednisolone(minor)
- Rifampin + Propranolol(minor)
- Rifampin + Quetiapine(minor)
- Rifampin + Simvastatin(minor)
- Rifampin + Tadalafil(minor)
- Rifampin + Trazodone(minor)
- Rifampin + Valproic Acid(minor)
- Rifampin + Verapamil(minor)
Other Tacrolimus Interactions
- Tacrolimus + Amiodarone(moderate)
- Tacrolimus + Amlodipine(moderate)
- Tacrolimus + Carbamazepine(moderate)
- Tacrolimus + Clarithromycin(moderate)
- Tacrolimus + Diltiazem(moderate)
- Tacrolimus + Estradiol(moderate)
- Tacrolimus + Fluconazole(moderate)
- Tacrolimus + Itraconazole(moderate)
- Tacrolimus + Ketoconazole(moderate)
- Tacrolimus + Lansoprazole(moderate)
- Tacrolimus + Methylprednisolone(moderate)
- Tacrolimus + Metoclopramide(moderate)
- Tacrolimus + Nifedipine(moderate)
- Tacrolimus + Omeprazole(moderate)
- Tacrolimus + Phenytoin(moderate)
- Tacrolimus + Prednisone(moderate)
- Tacrolimus + Verapamil(moderate)
- Tacrolimus + Cyclosporine(minor)
- Tacrolimus + Fenofibrate(minor)
- Tacrolimus + Fluoxetine(minor)