Drug interactions
Oxycodone + Rifampin
Severity: Major
Oxycodone and Rifampin: major 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 oxycodone exposure, which can lead to loss of analgesia and possibly withdrawal in opioid-dependent patients. Stopping rifampin later can cause oxycodone levels to rise, risking overdose and respiratory depression.
What this interaction means in plain words
Oxycodone 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 P-glycoprotein, increasing oxycodone clearance.
What to do
Monitor pain control and withdrawal signs and titrate oxycodone upward if needed, or choose a non-CYP3A4 opioid. Reduce the dose and watch for respiratory depression when rifampin is discontinued.
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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Other interactions of Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Oxycodone with Rifampin?
MediHelp rates the interaction as major. Oxycodone 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 markedly lowers oxycodone exposure, which can lead to loss of analgesia and possibly withdrawal in opioid-dependent patients. Stopping rifampin later can cause oxycodone levels to rise, risking overdose and respiratory depression.
How serious is the interaction between Oxycodone 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 pain control and withdrawal signs and titrate oxycodone upward if needed, or choose a non-CYP3A4 opioid. Reduce the dose and watch for respiratory depression when rifampin is discontinued.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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