Amlodipine and Rifampin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rifampin
Amlodipine
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced amLODIPine exposure
Interaction Deep Dive
RifAMPin induces certain CYP450 enzymes and has been reported to accelerate the metabolism of some calcium channel blockers3. Serum concentration of amLODIPine was reduced in all patients with chronic kidney disease initiating rifAMPin and loss of hypertensive control required dosage increases in most 4. Monitor blood pressure when amLODIPine is coadministered with CYP3A inducers 21. Dosages of drugs metabolized by these enzymes may require adjustment when starting or stopping concomitantly administered rifAMPin 3 or use an alternative to rifAMPin, when possible 4.
Why it happens (mechanism)
Induction of CYP3A-mediated metabolism of amLODIPine
Literature reports
1 report — tap to read
a) In a cohort study in patients with chronic kidney disease stage 5 and hypertension controlled by stable antihypertensive therapy (N=24), addition of rifAMPin 450 or 600 mg/day for treatment of newly diagnosed TB as part of a standard 4-drug protocol necessitated a significant dosage increase of antihypertensive medication in 83.3% of patients to maintain blood pressure (BP) of 140/90 mm Hg or less. A hypertensive crisis occurred in 46% of patients, including hypertensive emergency in 3 patients. Mean time to first dosage increase was 6.5 days and mean time to crisis was 9.1 days. RifAMPin had to be withdrawn in 2 patients who could not achieve BP control despite maximal doses. There was a mean 81.7% decrease in serum amLODIPine levels in 16 patients with available serum concentrations. AmLODIPine levels became undetectable in 8 of the patients. Initial amLODIPine doses were 5 mg/day (n=5) and 10 mg/day (n=11). The mean baseline serum levels were 109.7 nanograms/mL (ng/mL) at 5 mg/day and 95.5 ng/mL with 10 mg/day 4.
Common questions
Can I take Amlodipine and Rifampin together?
Reduced amLODIPine exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amlodipine and Rifampin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amlodipine or Rifampin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (4)
- Product Information: NORVASC(R) oral tablets, amlodipine besylate oral tablets. Pfizer Labs (per FDA), New York, NY, 2017. DailyMed
- Product Information: WIDAPLIK(TM) oral tablets, telmisartan amlodipine indapamide oral tablets. George Medicines Pty Limited (per FDA), Pithampur, Pradesh, India, 2025. DailyMed
- Product Information: RIFADIN(R) oral capsules, rifampin oral capsules. sanofi-aventis US LLC (per DailyMed), Bridgewater, NJ, 2018. DailyMed
- Agrawal A, Agarwal SK, Kaleekal T, et al: Rifampicin and anti-hypertensive drugs in chronic kidney disease: pharmacokinetic interactions and their clinical impact. Indian J Nephrol 2016; 26(5):322-328. PubMed
Keep reading about Rifampin
Keep reading about Amlodipine
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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