Rifampicin and Tacrolimus: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Rifampicin and Tacrolimus unless specifically directed by your doctor.
How Rifampicin interacts with Tacrolimus
Rifampicin is a potent inducer of CYP3A4 and P-glycoprotein, dramatically reducing tacrolimus exposure and risking acute graft rejection in transplant recipients.
What you should do
Avoid combination if possible; if rifampicin is essential, increase tacrolimus dose substantially (often 3-5 fold) with daily trough monitoring.
Key facts
Severity
Major — avoid combination
Mechanism
Rifampicin is a potent inducer of CYP3A4 and P-glycoprotein, dramatically reducing tacrolimus exposure and risking acute...
Action
Avoid combination if possible; if rifampicin is essential, increase tacrolimus dose substantially (often 3-5 fold) with ...
Frequently asked questions
Can I take Rifampicin and Tacrolimus together?
No — this combination should generally be avoided. Avoid combination if possible; if rifampicin is essential, increase tacrolimus dose substantially (often 3-5 fold) with daily trough monitoring.
What is the severity of this interaction?
The interaction between Rifampicin and Tacrolimus is classified as Major — avoid combination. Rifampicin is a potent inducer of CYP3A4 and P-glycoprotein, dramatically reducing tacrolimus exposure and risking acute graft rejection in transplant recipients.
What should I do if I'm prescribed both?
Avoid combination if possible; if rifampicin is essential, increase tacrolimus dose substantially (often 3-5 fold) with daily trough monitoring. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.