Rifaximin (Xifaxan) and Ketamine Therapy | Tovani Health
Xifaxan (Rifaximin) — Non-absorbable rifamycin (IBS-D, hepatic encephalopathy)
Verdict at Tovani Health
Fully compatible; non-absorbable so the CYP induction concern from rifampin does not apply.
Rifaximin and ketamine have no clinically significant interaction. Although rifaximin is in the rifamycin family (rifampin, rifabutin), its <0.4% systemic absorption means the CYP3A4 induction that makes rifampin a 🟡 case-by-case drug doesn't apply here. Used for traveler's diarrhea, IBS with diarrhea, and hepatic encephalopathy.
If you take Xifaxan regularly and are considering at-home ketamine therapy, the combination is generally safe at therapeutic doses. This page covers the brief pharmacologic context and what we do at intake.
How Xifaxan interacts with ketamine
Rifaximin inhibits bacterial RNA polymerase but stays in the gut lumen with negligible systemic absorption. No clinically meaningful CYP3A4 induction in vivo.
What we do at intake
Continue your course as prescribed.
Bottom line
Rifaximin and ketamine have no clinically significant interaction. Although rifaximin is in the rifamycin family (rifampin, rifabutin), its <0.4% systemic absorption means the CYP3A4 induction that makes rifampin a 🟡 case-by-case drug doesn't apply here. Used for traveler's diarrhea, IBS with diarrhea, and hepatic encephalopathy.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Xifaxan (Rifaximin) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 22, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.