Drug & supplement interaction

Kratom + Rifaximin

Rifaximin brand name: Xifaxan.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Kratom and Rifaximin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Kratom and Rifaximin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Rifaximin and Kratom in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Kratom safety at a glance

Kratom overall Avoid Kratom carries risks of dependence, serious side effects, and contaminated products, and is not regulated as a safe supplement.
Pregnancy Possibly Unsafe When used orally. There have been multiple case reports of neonatal abstinence syndrome in the infants of those who used kratom during pregnancy. Animal researc... Read the full pregnancy detail
Breastfeeding Avoid Kratom compounds may pass into breast milk and should be avoided while nursing.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rifaximin and Kratom? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Rifaximin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Rifaximin is filed under 2 classifications — antibiotic drugs, oral drugs. Kratom has documented interactions with 11 drug classes — the most serious being cns depressants (moderate), cytochrome p450 1a2 (cyp1a2) substrates (moderate) and cytochrome p450 2d6 (cyp2d6) substrates (moderate) — and none of Rifaximin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Kratom Does Interact With Other Medications

Kratom has 983 moderate, 12 minor known drug interactions in our database — Rifaximin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 983 Minor 12 No known interaction 1,835 (incl. Rifaximin)
Taking anything else?

Check Another of Your Medications Against Kratom

Covers the 2,830 medications we’ve checked against Kratom. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Kratom and Rifaximin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 4 of them are worth acting on rather than waiting out — marked below.

  • Severe muscle breakdown Worth acting on Additional detail

    Kratom

    “Observational research has found that habitual intake of kratom is associated with withdrawal symptoms, including arthralgias, lower extremity hyperreflexia, muscle pain, rigidity, spasms, and tremors.

    In a case report, a 45-year-old adult who had used kratom intermittently for 10 months experienced mild rhabdomyolysis and generalized seizures.”

    Kratom · Natural Medicines adverse-effect record, reported in epilepsy.

    6 sources cited
    1. 27115. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. PubMed
    2. 27130. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
    3. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    4. 113061. Hong S, Zimmerman PE, Rao V, Markwalter DW. Buprenorphine-Naloxone in the Setting of Kratom Withdrawal, Opioid Use Disorder, and Stage IV Lung Adenocarcinoma. J Palliat Med 2023;26(5):734-736. PubMed
    5. 113080. Smith KE, Feldman JD, Dunn KE, et al. Examining the paradoxical effects of kratom: a narrative inquiry. Front Pharmacol 2023;14:1174139. PubMed
    6. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Low mood Worth acting on Additional detail

    Kratom

    “Orally, kratom has been linked to respiratory depression, particularly when used in combination with other mu-opioid agonists. In one case report, a 36-year-old male with a history of substance abuse and smoking was diagnosed with kratom-induced acute respiratory distress syndrome (ARDS) after presenting with progressive respiratory failure, hypoxemia, and bilateral lung infiltrates.”

    Kratom · Natural Medicines adverse-effect record, reported in acute respiratory distress syndrome (ards).

    6 sources cited
    1. 27119. Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197.
    2. 27120. Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. PubMed
    3. 27136. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
    4. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    5. 108565. Graves JM, Dilley JA, Terpak L, et al. Kratom exposures among older adults reported to U.S. poison centers, 2014-2019. J Am Geriatr Soc 2021;69(8):2176-2184. PubMed
    6. 113071. Peran D, Stern M, Cernohorsky P, Sykora R, Popela S, Duska F. Mitragyna speciosa (Kratom) poisoning: Findings from ten cases. Toxicon 2023;225:107054. PubMed

    “Orally, kratom has been associated with aggression, agitation, altered mental status, anxiety, delusions, depression, hallucinations, insomnia, irritability, paranoia, restlessness, sedation, and suicidal ideation, in case reports and case series.”

    Kratom · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 27136. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
    2. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
    3. 113067. Li X, Ndungu P, Taneja SB, et al. An evaluation of adverse drug reactions and outcomes attributed to kratom in the US Food and Drug Administration Adverse Event Reporting System from January 2004 through September 2021. Clin Transl Sci 2023.
    4. 113071. Peran D, Stern M, Cernohorsky P, Sykora R, Popela S, Duska F. Mitragyna speciosa (Kratom) poisoning: Findings from ten cases. Toxicon 2023;225:107054. PubMed
    5. 113079. Settle AG, Yang C. A Case of Severe Kratom Addiction Contributing to a Suicide Attempt. Cureus 2022;14(9):e29698. PubMed
    6. 113080. Smith KE, Feldman JD, Dunn KE, et al. Examining the paradoxical effects of kratom: a narrative inquiry. Front Pharmacol 2023;14:1174139. PubMed

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Kidney problems Worth acting on Additional detail

    Kratom

    “Orally, kratom has been associated with cases of liver damage. Between 2003 and 2019, there were 11 cases of liver injury reported in the Drug-Induced Liver Injury Network (DILIN) with definite, highly likely, or probable causality attributed to kratom. Of these cases, 8 were reported between 2017 and 2019. The median time from kratom use to the onset of symptoms was 14 days.”

    Kratom · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 104634. Ahmad J, Odin JA, Hayashi PH, et al. Liver injury associated with kratom, a popular opioid-like product: Experience from the U.S. drug induced liver injury network and a review of the literature. Drug Alcohol Depend. 2021;218:108426. PubMed
    2. 103216. Schimmel J, Dart RC. Kratom (Mitragyna speciosa) liver injury: a comprehensive review. Drugs. 2020;80(3):263-83. PubMed
    3. 113075. Reich N, Salvo G, Leong D, Wan V, Kosatsky T. Kratom exposures managed by the British Columbia poison centre, 2012-2019: a descriptive analysis. CMAJ Open 2022;10(3):E755-E761. PubMed
    4. 27133. Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. PubMed
    5. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
    6. 101703. Aldyab M, Ells PF, Bui R, Chapman TD, Lee H. Kratom-Induced Cholestatic Liver Injury Mimicking Anti-Mitochondrial Antibody-Negative Primary Biliary Cholangitis: A Case Report and Review of Literature. Gastroenterology Res. 2019 Aug;12(4):211-215. PubMed

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Shortness of breath Worth acting on Additional detail

    Kratom

    Recorded for Kratom in the same Natural Medicines adverse-effect record shown under Low mood above.

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Flushing / Fever Additional detail

    Kratom

    “In one Poison Control Center report of 3484 exposures to kratom, the majority of which involved oral single-substance exposures, 75% of cases reported neurologic effects, including agitation, coma, confusion, dizziness, drowsiness, hallucinations, seizures, and tremor.”

    Kratom · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 108565. Graves JM, Dilley JA, Terpak L, et al. Kratom exposures among older adults reported to U.S. poison centers, 2014-2019. J Am Geriatr Soc 2021;69(8):2176-2184. PubMed
    2. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
    3. 101707. Eggleston W, Stoppacher R, Suen K, Marraffa JM, Nelson LS. Kratom Use and Toxicities in the United States. Pharmacotherapy. 2019 Jul;39(7):775-777. doi: 10.1002/phar.2280. Epub 2019 Jun 13. PubMed
    4. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    5. 113071. Peran D, Stern M, Cernohorsky P, Sykora R, Popela S, Duska F. Mitragyna speciosa (Kratom) poisoning: Findings from ten cases. Toxicon 2023;225:107054. PubMed
    6. 103214. Afzal H, Esang M, Rahman S. A case of kratom-induced seizures. Cureus. 2020;12(1):e6588. PubMed

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Anxiety or restlessness Additional detail

    Kratom

    Recorded for Kratom in the same Natural Medicines adverse-effect record shown under Flushing / Fever above.

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Reduced appetite Additional detail

    Kratom

    “Kratom ingestion has been associated with nausea, vomiting, dry mouth, tongue numbness, increased appetite, and constipation. In one Poison Control Center report of 3484 exposures to kratom, the majority of which involved oral single-substance exposures, 25% of cases reported gastrointestinal effects.”

    Kratom · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 27130. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
    2. 27136. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
    3. 95797. Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. PubMed
    4. 95818. Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. PubMed
    5. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    6. 113067. Li X, Ndungu P, Taneja SB, et al. An evaluation of adverse drug reactions and outcomes attributed to kratom in the US Food and Drug Administration Adverse Event Reporting System from January 2004 through September 2021. Clin Transl Sci 2023.

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Muscle pain Additional detail

    Kratom

    Recorded for Kratom in the same Natural Medicines adverse-effect record shown under Severe muscle breakdown above.

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

  • Trouble sleeping Additional detail

    Kratom

    Recorded for Kratom in the same Natural Medicines adverse-effect record shown under Severe muscle breakdown above.

    Rifaximin

    Listed in the ADVERSE REACTIONS section of the FDA label for Rifaximin. Read the label on DailyMed ›

Showing the 10 most notable of 18 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Kratom but not commonly for Rifaximin: liver problems, raised blood pressure, dependence or withdrawal symptoms and confusion.

Effects for Rifaximin come from the ADVERSE REACTIONS section of its FDA label; effects for Kratom come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 20,331 voluntary FDA FAERS reports for Rifaximin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Kratom in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. There have been multiple case reports of neonatal abstinence syndrome in the infants of those who used kratom during pregnancy. Animal research suggests that kratom crosses the placenta.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Rifaximin Is Prescribed For, and What Kratom Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Rifaximin is a prescription medicine with approved uses on its FDA label. Kratom is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Rifaximin is prescribed for: Xifaxan (rifaximin) tablets treat three distinct conditions. For travelers' diarrhea caused by Escherichia coli, it is approved for adults and children 12 and older. For irritable bowel syndrome with diarrhea (IBS-D), it is approved for adults. It is also used in adults to reduce the chance that hepatic encephalopathy (confusion and other brain symptoms caused by liver disease) will come back.

Read the rest of what Rifaximin is prescribed for

Important limits apply: Xifaxan should not be used for travelers' diarrhea that comes with fever, blood in the stool, or when a pathogen other than E. coli is suspected. It is also not suitable for bacterial infections outside the gut, because very little of the drug is absorbed into the bloodstream.

Kratom has been studied for:

  • Diarrhea studied, not established Kratom has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Kratom for diarrhea

    Although there has been interest in using oral kratom for diarrhea, there is insufficient reliable information about the clinical effects of kratom for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Rifaximin on your own; if you are taking Kratom for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Kratom or Rifaximin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Kratom or Rifaximin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Rifaximin

This page covers Kratom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rifaximin page lists 44 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Bacillus Coagulans (moderate), Bacillus Subtilis (moderate), Bifidobacterium Animalis Subsp. Lactis (moderate) and Bifidobacterium Bifidum (moderate).

By severity: 1 major · 33 moderate · 10 minor.

From our pharmacist’s overview on the Rifaximin page

“Activated charcoal is the one entry here I would treat as a hard stop while taking rifaximin (Xifaxan). Charcoal binds drugs in the gut and can cut how much gets absorbed, and it carries the only major rating among the 44 supplements on this page.”

Reviewed by 2 · Jul 18, 2026

Open the Rifaximin interaction page

One more smart check

Taking Kratom as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Kratom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kratom. Even though Kratom itself has no known interaction with Rifaximin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Kratom and Rifaximin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Kratom
Top half

#366 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Rifaximin
Top half

#1,082 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Kratom reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Kratom and Rifaximin records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Kratom

What is Kratom?

Kratom
  • Pain relief
  • Opioid withdrawal symptoms
  • Anxiety and stress
  • Low energy or fatigue
  • Mood enhancement

Kratom is a Southeast Asian plant whose leaves act on the brain's opioid receptors and can produce both stimulant-like and opioid-like effects. It is not approved or proven safe by health regulators, carries real risks of dependence and serious harm, and its legal status varies widely. Talk to a pharmacist or doctor before considering it.

Mitragyna speciosa · Rubiaceae · Leaves · Dried leaf powder, capsules, tablets, brewed tea, liquid extracts, and concentrated gummies

An interaction check asks whether these two react with each other — it does not ask whether Kratom is a good idea for someone in your situation. Here is what our Kratom record says about it on its own.

Kratom: dosing

There is no established safe or standardized dose for kratom. The strength of products varies widely, and the amount of active compounds can differ greatly from one batch to another, even within the same brand.Because of these unknowns and the real risks of dependence and harm, we cannot recommend a specific amount. Avoid mixing it with alcohol, opioids, sedatives, or other substances.

From our Kratom monograph — the full record covers uses, side effects and every documented interaction.

Read the full Kratom monograph & all interactions
Medication

About Rifaximin

What Is Rifaximin Used For?

Brand name: Xifaxan

Xifaxan (rifaximin) tablets treat three distinct conditions. For travelers' diarrhea caused by Escherichia coli, it is approved for adults and children 12 and older. For irritable bowel syndrome with diarrhea (IBS-D), it is approved for adults. It is also used in adults to reduce the chance that hepatic encephalopathy (confusion and other brain symptoms caused by liver disease) will come back.

Important limits apply: Xifaxan should not be used for travelers' diarrhea that comes with fever, blood in the stool, or when a pathogen other than E. coli is suspected. It is also not suitable for bacterial infections outside the gut, because very little of the drug is absorbed into the bloodstream.

See full Rifaximin drug information
Keep checking

Other Drugs & Kratom

Browse every other medication we’ve checked against Kratom — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
983Moderate
12Minor
1,834No known interaction
983 Moderate 12 Minor 1,834 No interaction
Moderate

983 interactions

Showing 60 of 983 moderate interactions — see all 983 on the Kratom page.

Minor

12 interactions

No interaction 1,834 drugs checked — show the list

We also checked Kratom against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,834 medications checked with no known interaction — see the full Kratom list.

See the full Kratom interactions page
See every supplement checked against Rifaximin, ranked by severity
Evidence & sources

Kratom References

The 77 references that drive our Kratom monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. PubMed
  2. Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197.
  3. Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. PubMed
  4. Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction 2008;103(6):1048-1050.
  5. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
  6. Nelsen JL, Lapoint J, Hodgman MJ, Aldous KM. Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure. J Med Toxicol 2010;6(4):424-426. PubMed
  7. Sheleg SV, Collins GB. A coincidence of addiction to "Kratom" and severe primary hypothyroidism. J Addict Med 2011;5(4):300-301. PubMed
  8. Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. PubMed
  9. Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356. PubMed
  10. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
  11. Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. PubMed
  12. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
  13. FDA Adverse Event Reporting System: Kratom Deaths. February 6, 2018. https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/CDERFOIAElectronicReadingRoom/UCM595575.pdf. Accessed March 6, 2018.
  14. Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. PubMed
  15. Kruegel AC, Grundmann O. The medicinal chemistry and neuropharmacology of kratom: A preliminary discussion of a promising medicinal plant and analysis of its potential for abuse.Neuropharmacology. 2017. pii: S0028-3908(17)30393-3. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Kratom and Rifaximin Together: Common Questions

Is it safe to take Kratom with Rifaximin?
We do not list a known interaction between Kratom and Rifaximin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Kratom and Rifaximin have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Kratom and Rifaximin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Kratom in each. That is a conversation for your prescriber, especially if Rifaximin is being adjusted to a target.
How was the Kratom and Rifaximin combination checked?
Interactions in our licensed database are recorded against drug classes. Rifaximin is filed under 2 classifications, and Kratom has documented interactions with 11 drug classes — none of Rifaximin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Kratom interact with any other medications?
Yes. Kratom has 995 documented drug interactions in our database — Rifaximin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Rifaximin interact with any supplements?
Yes. Rifaximin has documented interactions with 44 supplements in our database — Kratom is not one of them. The Rifaximin interaction page linked on this page lists every one, ranked by severity.

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Kratom monograph Uses, safety profile, and every drug interaction in one place Rifaximin drug information The full plain-English guide to this medication Rifaximin supplement interactions Every supplement checked against Rifaximin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 77 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.