Rifampin and Vitamin K interaction

Rifampin and Vitamin K: the Rifampin prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

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

Major

Postmarketing reports suggest that concomitant administration of high doses of cefazolin and rifampin may prolong the prothrombin time, leading to severe vitamin K–dependent coagulation disorders that may be life-threatening or fatal.

Warningsnames Vitamin KView label on DailyMed
Moderate

Rifampin may cause vitamin K–dependent coagulation disorders and bleeding (see ADVERSE REACTIONS ).

Warningsnames Vitamin KView label on DailyMed
Moderate

Monitor coagulation tests during rifampin treatment (prothrombin time and other coagulation tests) in patients at risk of vitamin K deficiency (such as those with chronic liver disease, poor nutritional status, on prolonged antibacterial drugs or anticoagulants).

Warningsnames Vitamin KView label on DailyMed
Moderate

Supplemental vitamin K administration should be considered when appropriate.

Warningsnames Vitamin KView label on DailyMed
Moderate

If no alternative treatment options are available, closely monitor prothrombin time and other coagulation tests, and administer vitamin K as indicated.

Warningsnames Vitamin KView label on DailyMed

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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.