Drug & supplement interaction

Sassafras + Rifampin

Rifampin brand names: Rifadin, Rimactane, Rifadin Injection, Rofactor.

Moderate Interaction
The bottom line Moderate

Sassafras has a moderate interaction with Rifampin. In vitro research suggests that cytochrome P450 1A2 (CYP1A2) inducers might increase the cytotoxicity of safrole.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sassafras and Rifampin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 1A2 (CYP1A2) INDUCERS

Why this applies to Rifampin

Rifampin falls under CYTOCHROME P450 1A2 (CYP1A2) INDUCERS — the group Sassafras interacts with.

In vitro research suggests that cytochrome P450 1A2 (CYP1A2) inducers might increase the cytotoxicity of safrole. So far, this interaction has not been reported in humans. Also, it is not known if CYP1A2 inducers increase the toxicity of sassafras. Inducers of CYP1A2 include omeprazole (Prilosec).
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the angle to keep in mind with this pairing. Rifampin is a powerful inducer, meaning it speeds up several of your liver's drug-processing enzymes, including CYP1A2. Safrole, the worrisome compound in sassafras, is thought to become more harmful once the liver turns it into reactive byproducts. So in theory, rifampin could ramp up that conversion and make any liver-damaging effect of sassafras worse.

I want to be honest about the strength of this, though. It comes only from lab and animal work, and it has never actually been reported in people. The bigger issue is that sassafras contains safrole, which the FDA banned in foods because of cancer and liver concerns. The safest move is simply avoiding sassafras (choose safrole-free products) and checking with your pharmacist or doctor before adding any supplement while on rifampin.

References
  1. Hu L, Wu F, He J, Zhong L, Song Y, Shao H. Cytotoxicity of safrole in HepaRG cells: studies on the role of CYP1A2-mediated ortho-quinone metabolic activation. Xenobiotica. 2019;49(12):1504-1515. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Sassafras Also Interacts With Other Medications

Sassafras has 274 moderate known drug interactions in our database — the Rifampin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Sassafras

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

From our Q&A

Questions About Sassafras or Rifampin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Sassafras or Rifampin, 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 Rifampin

This page covers Sassafras only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rifampin page lists 222 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Asarabacca (major), Beer (major) and Grapefruit (major).

By severity: 9 major · 172 moderate · 41 minor.

From our pharmacist’s overview on the Rifampin page

“Rifampin (Rifadin) is the backbone of tuberculosis treatment, taken daily for months, which is plenty of time to pick up a juice habit or a probiotic without a second thought. With 222 supplement and food entries on file and 9 rated major, this list calls for real care, starting with the majors.”

Reviewed by 2 · Jul 18, 2026

Open the Rifampin interaction page

One more smart check

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

We hold 11 real supplement products containing Sassafras, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sassafras. Your product may carry other ingredients that interact with Rifampin too, on top of Sassafras — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sassafras and Rifampin 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 Sassafras
Steady interest

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

29 days ago today
Medication Rifampin
Steady interest

#1,595 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.

Supplement

About Sassafras

What is Sassafras?

  • Digestive complaints
  • Cold and flu symptoms
  • Joint and muscle aches
  • Skin conditions (topical folk use)
  • As a flavoring agent (traditional root beer)

Sassafras is an aromatic North American tree whose root bark and oil were once popular in teas and as a flavoring, but it contains safrole, a compound the FDA has banned in foods because it can cause cancer and liver damage. There is no good evidence it safely treats any health condition, and most experts recommend avoiding internal use. If you want the flavor, choose products that are labeled safrole-free.

Read the full Sassafras monograph & all interactions
Medication

About Rifampin

What Is Rifampin Used For?

Brand names: Rifadin, Rimactane, Rifadin Injection, Rofactor

Rifampin treats all forms of tuberculosis (TB). It is almost always used in combination with other antibiotics — your doctor will build a multi-drug regimen tailored to your infection. Treatment usually runs for at least 6 months total.

Rifampin is also used to clear Neisseria meningitidis bacteria from the nose and throat in people who carry the germ without being sick themselves. It is not used to treat active meningococcal disease. The intravenous (IV) forms — Rifadin IV, Rifadin IV NOVAPLUS, and the injectable form of Rifampin — are specifically indicated when a patient cannot take the drug by mouth.

See full Rifampin drug information
Keep checking

Other Drugs & Sassafras

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

0Major
274Moderate
0Minor
2,555No known interaction
Moderate

274 interactions

Showing 60 of 274 moderate interactions — see all 274 on the Sassafras page.

No interaction 2,555 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Sassafras and Rifampin Together: Common Questions

Can you take Sassafras with Rifampin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Sassafras and Rifampin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Rifampin and Sassafras?

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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.