Levothyroxine and Rifampin interaction

Levothyroxine and Rifampin: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Levothyroxine (Levothyroxine Sodium) label · effective 2024-07-10

Moderate

Drug or Drug Class Effect Phenobarbital Rifampin Phenobarbital has been shown to reduce the response to thyroxine.

Drug interactionsnames RifampinView label on DailyMed
Minor

Rifampin has been shown to accelerate the metabolism of levothyroxine.

Drug interactionsnames RifampinView label on DailyMed

From the Rifampin (Rifadin IV) label · effective 2026-05-27

Moderate

Substitute non-enzyme inducing therapies at least 2 weeks prior to initiation of irinotecan therapy Decrease irinotecan and active metabolite exposure Levothyroxine Decrease exposure Losartan Parent Decrease AUC by 30% Active metabolite (E3174) Decrease AUC by 40% Methadone In patients well-stabilized on methadone, concomitant administration of rifampin resulted…

Drug interactionsnames LevothyroxineView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.