Rifaximin

Brands

DEA Class; Rx

Common Brand Names; Xifaxan

  • Antibiotics, Other; 
  • Antidiarrheals

Oral, non-systemically absorbed rifamycin antibiotic
Approved to treat traveler’s diarrhea (due to non-invasive strains of Escherichia coli), to reduce risk of hepatic encephalopathy recurrence, and treatment of irritable bowel syndrome with diarrhea (IBS-D)
No significant drug interactions since not systemically absorbed

Indicated for travelers’ diarrhea caused by noninvasive strains of Escherichia coli (E coli)

Indicated for irritable bowel syndrome with diarrhea (IBS-D) in adult men and women

For reduction in risk of overt hepatic encephalopathy recurrence.

Limitations of use: Not indicated or shown effective in patients with traveler’s diarrhea complicated by fever or bloody stool or due to pathogens other than non-invasive strains of E coli

Hypersensitivity to rifamycin antibiotics

  • Flatulence (11%)
  • Headache (10%)
  • Rectal tenesmus (7%)
  • Abdominal pain (7%)
  • Defecation urgency (6%)
  • Nausea (5%)
  • Constipation (4%)
  • Pyrexia (3%)
  • Vomiting (2%)

Not effective in diarrhea complicated by fever, hematochezia, or diarrhea due to pathogens other than Escherichia coli

Not effective against traveler’s diarrhea due to Campylobacter jejuni

Clostridium difficile-associated diarrhea has been reported

Efficacy against traveler’s diarrhea due to Shigella spp and Salmonella spp not proven

Discontinue if symptoms worsen or persist >24-48 hr

Possibility of pseudomembranous colitis

Monitor patients with severe hepatic impairment for increased systemic exposure

Coadministration with P-gp inhibitors substantially increases systemic exposure to rifaximin; coadministration of cyclosporine with rifaximin resulted in 83-fold and 124-fold increases in rifaximin mean Cmax and AUC in healthy subjects

Pregnancy category: C

Lactation: Do not use if nursing or do not nurse

Adults

600 mg/day PO for traveler’s diarrhea; 1100 mg/day PO for hepatic encephalopathy; 1650 mg/day for irritable bowel syndrome with diarrhea.

Geriatric

600 mg/day PO for traveler’s diarrhea; 1100 mg/day PO for hepatic encephalopathy; 1650 mg/day for irritable bowel syndrome with diarrhea.

Adolescents

600 mg/day PO for traveler’s diarrhea.

Children

>= 12 years: 600 mg/day PO for traveler’s diarrhea.
< 12 years: Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Rifaximin

tablet

  • 200mg
  • 550mg
Drugs Generic
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