Drug interactions
Estradiol + Rifampin
Severity: Major
Estradiol and Rifampin: major interaction.
Last updated Sources: US FDA label
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 strongly induces CYP3A4 and other enzymes, lowering estradiol concentrations. This can cause loss of menopausal symptom control, breakthrough bleeding, or reduced contraceptive efficacy.
What this interaction means in plain words
Estradiol and Rifampin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Rifampin induces CYP3A4 and glucuronidation, increasing estradiol clearance.
What to do
Monitor for loss of estrogen effect and increase estradiol dose if needed, or use an alternative to rifampin. Use non-hormonal contraception during and after rifampin if contraception is required.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Estradiol
- Anastrozole + Estradiol Contraindicated
- Estradiol + Fezolinetant Contraindicated
- Estradiol + Ospemifene Contraindicated
- Antithrombin alfa + Estradiol Major
- Antithrombin iii + Estradiol Major
- Estradiol + Exemestane Major
Frequently asked questions
Can I take Estradiol with Rifampin?
MediHelp rates the interaction as major. Estradiol and Rifampin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifampin strongly induces CYP3A4 and other enzymes, lowering estradiol concentrations. This can cause loss of menopausal symptom control, breakthrough bleeding, or reduced contraceptive efficacy.
How serious is the interaction between Estradiol and Rifampin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of estrogen effect and increase estradiol dose if needed, or use an alternative to rifampin. Use non-hormonal contraception during and after rifampin if contraception is required.
What other medicines interact with Estradiol?
MediHelp also lists interactions of Estradiol with, for example, Anastrozole, Fezolinetant, Ospemifene. The full list is on the Estradiol page.
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