Tramadol and Rifampin Interaction
Drug interaction information between Tramadol and Rifampin.
Tramadol and Rifampin have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Tramadol and Rifampin. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Rifampin speeds up the process of clearing the pain medicine from your body. This can lead to the pain medicine not working as well as it should.
What To Do
Your doctor may need to adjust your dose of tramadol. Tell your healthcare provider if your pain is not being controlled.
FDA Label Information
Examples: Rifampin, carbamazepine, phenytoin Benzodiazepines and Other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death [see Warnings and Precautions (5.3) ].
Tramadol Also Interacts With
- Safinamide major
- Carbamazepine moderate
- Phenytoin moderate
- Gabapentin minor
- Bupropion minor
Rifampin Also Interacts With
- Darunavir major
- Bictegravir/Emtricitabine/Tenofovir major
- Glecaprevir/Pibrentasvir major
- Nirmatrelvir/Ritonavir major
- Pitavastatin major
Frequently Asked Questions
Can I take Tramadol and Rifampin together?
This is a moderate interaction. Your doctor may need to adjust your dose of tramadol. Tell your healthcare provider if your pain is not being controlled.
How serious is the interaction between Tramadol and Rifampin?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Tramadol and Rifampin interact?
Rifampin speeds up the process of clearing the pain medicine from your body. This can lead to the pain medicine not working as well as it should.
Understanding the Tramadol and Rifampin Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Tramadol belongs to the Opioid Analgesic class and Rifampin belongs to the Rifamycin Antibiotic class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Rifampin speeds up the process of clearing the pain medicine from your body. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Tramadol has 38 total documented interactions on file in this dataset, and Rifampin has 137. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor may need to adjust your dose of tramadol. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Tramadol or Rifampin based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.