MODERATE — Monitor Closely
CAUTION — monitor for depression breakthrough
Evidence level: MODERATE
Rifampin may reduce Prozac effectiveness.
Rifampin induces CYP enzymes. Fluoxetine partially metabolized by CYP3A4. May reduce fluoxetine levels.
Monitor mood during rifampin therapy. Dose adjustment may be needed.
Take Fluoxetine and Rifampin at their usual prescribed times. Some antibiotics (linezolid especially) have serotonergic properties and should never be combined with SSRIs — if you are on linezolid, confirm this combination with your prescriber. Standard antibiotics like amoxicillin or azithromycin are generally safe alongside SSRIs.
Active depression
Worsening depression, anxiety
Inform both prescribers.
Discuss this combination with your prescriber. They may adjust timing, dosing, or switch to an alternative with fewer interaction risks. Never stop an antidepressant abruptly — taper under medical guidance.
Rifampin may reduce Prozac effectiveness.
Take Fluoxetine and Rifampin at their usual prescribed times. Some antibiotics (linezolid especially) have serotonergic properties and should never be combined with SSRIs — if you are on linezolid, confirm this combination with your prescriber. Standard antibiotics like amoxicillin or azithromycin are generally safe alongside SSRIs.
Worsening depression, anxiety
Discuss this combination with your prescriber. They may adjust timing, dosing, or switch to an alternative with fewer interaction risks. Never stop an antidepressant abruptly — taper under medical guidance.
Inform both prescribers.
Or browse the full interaction database (121,000+ pairs).