Drug interactions
Progesterone + Rifampin
Severity: Major
Progesterone 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 hepatic and intestinal drug metabolism and lowers progesterone exposure. This can lead to loss of progestogenic effect, such as endometrial protection failure, breakthrough bleeding or contraceptive failure.
What this interaction means in plain words
Progesterone 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 other enzymes), increasing the metabolic clearance of progesterone.
What to do
Avoid the combination where possible; if rifampin is needed, use a non-hormonal or non-induction-sensitive contraceptive method such as a copper IUD. For endometrial protection in HRT, consider an alternative regimen and monitor for bleeding.
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 Progesterone
Frequently asked questions
Can I take Progesterone with Rifampin?
MediHelp rates the interaction as major. Progesterone 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 hepatic and intestinal drug metabolism and lowers progesterone exposure. This can lead to loss of progestogenic effect, such as endometrial protection failure, breakthrough bleeding or contraceptive failure.
How serious is the interaction between Progesterone 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: Avoid the combination where possible; if rifampin is needed, use a non-hormonal or non-induction-sensitive contraceptive method such as a copper IUD. For endometrial protection in HRT, consider an alternative regimen and monitor for bleeding.
What other medicines interact with Progesterone?
MediHelp also lists interactions of Progesterone with, for example, Apalutamide, Carbamazepine, Enzalutamide. The full list is on the Progesterone page.
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