Does Rifampin Interact with Cannabidiol?
Rifampin and Cannabidiol have a moderate drug interaction according to U.S. FDA drug labeling data. Strong CYP3A4 and CYP2C19 inducer decreases cannabidiol and 7-OH-CBD plasma concentrations by approximately 32% and 63%, potentially reducing EPIDIOLEX efficacy. The mechanism involves cyp3a4 and cyp2c19 induction. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Moderate
- Rifampin Class
- Rifamycin Antibacterial
- Cannabidiol Class
- Cytochrome P450 2C8 Inhibitors
- Management
- Monitor for effects
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Rifampin and Cannabidiol occurs because cyp3a4 and cyp2c19 induction. Clinically, this means strong cyp3a4 and cyp2c19 inducer decreases cannabidiol and 7-oh-cbd plasma concentrations by approximately 32% and 63%, potentially reducing epidiolex efficacy. This is classified as a moderate interaction. While it may not require stopping either medication, your healthcare provider should be aware you are taking both so they can monitor for potential effects and adjust treatment if necessary.
What To Tell Your Doctor or Pharmacist
If you are taking Rifampin and your doctor is considering prescribing Cannabidiol (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider