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What the FDA labels say about taking them together

Osilodrostat and rifampin

Osilodrostat's FDA label of November 18, 2025 names rifampin in its drug interactions section; the rifampin label PlainMeds reads does not name osilodrostat. The osilodrostat label: “Concomitant use of ISTURISA with strong CYP3A4 and/or CYP2B6 inducers may cause a decrease in osilodrostat concentration and may reduce the efficacy of ISTURISA. …”

Check it at the source: the osilodrostat FDA label on DailyMed (effective November 18, 2025, Recordati Rare Diseases, Inc.); the rifampin FDA label on DailyMed (effective February 11, 2026, Lupin Pharmaceuticals, Inc.).

What does the osilodrostat label say about rifampin?

Osilodrostat label, drug interactions

CYP3A4 and CYP2B6 Inducers Clinical Impact: Concomitant use of ISTURISA with strong CYP3A4 and/or CYP2B6 inducers (…) may cause a decrease in osilodrostat concentration and may reduce the efficacy of ISTURISA. Discontinuation of strong CYP3A4 and/or CYP2B6 inducers while using ISTURISA may cause an increase in osilodrostat concentration and may increase the risk of … Intervention: During concomitant use of ISTURISA with strong CYP3A4 and CYP2B6 inducers, monitor cortisol concentration and patient's signs and symptoms. An increase in ISTURISA dosage may be needed. …

Source: FDA drug label (Isturisa), Recordati Rare Diseases, Inc., effective November 18, 2025 (SPL set f3a5ec24-63c3-4d83-b1c0-6c550fbe7ae2), via openFDA; the full label on DailyMed

What does the rifampin label say about osilodrostat?

Rifampin's label (effective February 11, 2026) does not name osilodrostat in these sections. A label lists what its studies and reports found; it is not a complete list.

Source: FDA drug label (rifampin), Lupin Pharmaceuticals, Inc., effective February 11, 2026 (SPL set b56004f0-f23d-47f6-80c7-39884fccbccc), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

0Osilodrostat generic labelers
13Rifampin generic labelers
OsilodrostatRifampin
Labeled forn/an/a
Boxed warningNoNo
Pharmacy cost (NADAC)n/a$0.679 per capsule 300 mg capsule
Shortage nowNo current entryIn shortage

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?