Drug Interaction Report

Rifampin and Edoxaban: Interaction Details

A pharmacist-reviewed analysis of the Rifampin and Edoxaban interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Rifampin

Rifadin
+

Edoxaban

Savaysa Savaysa®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 176 documented Rifampin interactions, 130 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
established
Severity
Major

What happens

Decreased edoxaban concentration

Interaction Deep Dive

Avoid coadministration of edoxaban (a P-gp substrate) and rifampin (a P-gp inducer)1. Edoxaban AUC decreased when coadministered with rifampin 2.

Why it happens (mechanism)

Induction of P-glycoprotein-mediated edoxaban efflux transport

Literature reports

1 report — tap to read

a) Concurrent administration of edoxaban and rifampin led to a 34% decrease in edoxaban AUC, but an increase in Cmax and exposure of edoxaban active metabolites compared with edoxaban administration alone; prothrombin time and aPTT was minimally affected. The study compared results obtained from 2 phases in 34 healthy adults. In phase 1, subjects received a single oral edoxaban 60 mg dose; during phase 2 they received oral rifampin 600 mg daily for 7 days with a concomitant oral dose of edoxaban 60 mg on day 7 2.

Common questions

Can I take Rifampin and Edoxaban together?

Decreased edoxaban concentration Always confirm with your pharmacist or prescriber before making any change.

How serious is the Rifampin and Edoxaban 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 "established". Well documented — supported by controlled studies or strong clinical data.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Rifampin or Edoxaban 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 (2)

  1. Product Information: SAVAYSA(TM) oral tablets, edoxaban oral tablets. Daiichi Sankyo, Inc. (per FDA), Parsippany, NJ, 2015. DailyMed
  2. Mendell J, Chen S, He L, et al: The effect of rifampin on the pharmacokinetics of edoxaban in healthy adults. Clin Drug Investig 2015; 35(7):447-453. PubMed
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Rifampin

Keep reading about Rifampin

All Rifampin interactions (176)
Also serious with: Aficamten Fostemsavir Doravirine Nifedipine
Edoxaban

Keep reading about Edoxaban

All Edoxaban interactions (244) Edoxaban drug information
Also serious with: Defibrotide Defibrotide Injection Piketoprofen Oxaliplatin Injection
Beyond drug–drug

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:

Rifampin + Activated Charcoal Apple Asarabacca Beer Grapefruit Siberian Cocklebur St. John's Wort Sweet Orange + 214 more
Edoxaban + Activated Charcoal Danshen Piracetam Aconite Allspice Aloe Alpha-lipoic Acid Andrographis + 210 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.