Drug interactions
Ketamine + Rifampin
Severity: Moderate
Ketamine 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 is a potent inducer of CYP3A4 and CYP2B6, the main enzymes that metabolize ketamine. Concurrent use can lower ketamine concentrations and shorten or weaken its effect, particularly with oral dosing where first-pass metabolism is increased.
What this interaction means in plain words
Ketamine 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.
Why it happens
Rifampin induces hepatic and intestinal CYP2B6 and CYP3A4, increasing ketamine clearance.
What to do
Monitor analgesic or anesthetic response and titrate ketamine upward if effect is inadequate. Reassess dose when rifampin is stopped, as exposure will rise.
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?
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Other interactions of Ketamine
Frequently asked questions
Can I take Ketamine with Rifampin?
MediHelp rates the interaction as moderate. Ketamine 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 is a potent inducer of CYP3A4 and CYP2B6, the main enzymes that metabolize ketamine. Concurrent use can lower ketamine concentrations and shorten or weaken its effect, particularly with oral dosing where first-pass metabolism is increased.
How serious is the interaction between Ketamine 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 analgesic or anesthetic response and titrate ketamine upward if effect is inadequate. Reassess dose when rifampin is stopped, as exposure will rise.
What other medicines interact with Ketamine?
MediHelp also lists interactions of Ketamine with, for example, Benzhydrocodone / acetaminophen, Brexanolone, Buprenorphine buccal. The full list is on the Ketamine page.
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