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Drug interactions

Diazepam + Rifampin

Severity: Moderate

Diazepam and Rifampin: moderate interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Rifampin markedly lowers diazepam concentrations by accelerating its metabolism. The anxiolytic, sedative or anticonvulsant effect of diazepam may be lost.

What this interaction means in plain words

Diazepam and Rifampin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Evidence level: High

Why it happens

Rifampin induces CYP3A4 and CYP2C19, increasing diazepam clearance.

What to do

Monitor clinical response and increase the diazepam dose if necessary. Expect the effect to persist for some days after rifampin is stopped, and watch for toxicity then.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Diazepam with Rifampin?

MediHelp rates the interaction as moderate. Diazepam and Rifampin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rifampin markedly lowers diazepam concentrations by accelerating its metabolism. The anxiolytic, sedative or anticonvulsant effect of diazepam may be lost.

How serious is the interaction between Diazepam and Rifampin?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and increase the diazepam dose if necessary. Expect the effect to persist for some days after rifampin is stopped, and watch for toxicity then.

What other medicines interact with Diazepam?

MediHelp also lists interactions of Diazepam with, for example, Calcium / magnesium / potassium / sodium oxybates, Alfentanil, Alprazolam. The full list is on the Diazepam page.

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