Xifaxan (Rifaximin)
Medication information written by Dr. Conner Sheehy, PharmD, BCPS
Updated - March 10, 2021
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Xifaxan (Rifaximin) Medication Information
Uses
Your doctor may prescribe Xifaxan to treat conditions caused by a bacterial infection in the gastrointestinal tract. Xifaxan is approved for:
- The reduction in the risk of hepatic encephalopathy (HE) recurrence
- Treatment of Traveler's’ diarrhea (TD) caused by Escherichia coli in patients 12 years and older
- Treatment of irritable bowel syndrome with diarrhea in adults (IBS-D)
Xifaxan works by attacking an important enzyme in the growth and functioning of bacteria called DNA-dependent RNA polymerase. By attacking this important enzyme, Xifaxan prevents bacteria from making proteins that are critical for growth.
Dosage
The dosage of Xifaxan depends on what condition is being treated:
- HE: Take one 550 mg tablet twice daily.
- IBS-D: Take one 550 mg tablet three times a day for 14 days.
- TD: Take one 200 mg tablet by mouth three times a day for three days.
Take Xifaxan exactly as prescribed by your doctor.
Xifaxan can be taken with or without food.
Side Effects
Common adverse reactions to Xifaxan can include:
- Abdominal pain
- Anemia
- Arthralgia
- Ascites
- Depression
- Dizziness
- Dyspnea
- Fatigue
- Fever
- Headache
- Muscle spasm
- Myalgia
- Nasopharyngitis
- Nausea
- Peripheral edema
- Pruritus
- Skin rash
Precautions
Do not take Xifaxan if you have known hypersensitivity to rifamycin antibacterials.
Xifaxan should not be used to treat TD accompanied by a fever or blood in the stool. Xifaxan is not effective for infections other than E.coli.
Tell your doctor if you have worsening diarrhea after taking Xifaxan.
Tell your doctor if you have a history of liver problems before taking Xifaxan.
Interactions
There are many potential drug-drug interactions with Xifaxan. Tell your doctor and pharmacist about medications you are taking, including over-the-counter (OTCs), herbals, and supplements.
Common drug-drug interactions may include:
- Amiodarone
- Cholera vaccine
- Clarithromycin
- Colchicine
- Cyclosporine
- Digoxin
- Diltiazem
- Erythromycin
- Esomeprazole
- Felodipine
- Ketoconazole
- Lansoprazole
- Mifepristone
- Nifedipine
- Omeprazole
- Pantoprazole
- Reserpine
- Ritonavir
- Typhoid vaccine
- Verapamil
Storage
Store Xifaxan close to room temperature between 20° to 25°C (68° to 77°F).
Pharmacist Tips
- Antibacterial medications like Xifaxan cannot be used to treat viral infections like the common cold and influenza.
- Do not skip any doses or stop treatment without talking with your doctor first.
- Xifaxan may be taken with or without food.
Rifaximin FAQs
How long does it take for Xifaxan to work?
It depends on what is being treated. For TD, Xifaxan will begin working in approximately 2-3 days. For IBS-D, you will begin to experience relief after about two weeks of taking the medication. For HE prevention, Xifaxan reduces the time to breakthrough events by several months.
What if I miss a dose of Xifaxan?
Take it as soon as you remember, but do not double up.
Can Xifaxan worsen diarrhea?
Xifaxan and other antibacterial agents can increase the risk of Clostridium difficile-associated diarrhea. Tell your doctor if your diarrhea does not improve, if it gets worse, or if you develop bloody stool and fever.
Related Products
References
- Xifaxan [package insert]. Bridgewater, NJ: Valeant; 2017.
Author: Dr. Conor Sheehy, PharmD, BCPS
Dr. Sheehy is a board-certified pharmacotherapy specialist. He has worked in multiple practice settings, including retail and hospital pharmacies, and in medical clinics. He specializes in anticoagulation, psychiatric medications, and diabetes medications. He strives to empower his patients to understand their medications and improve their overall medical care.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.