Rifaximin

What is Rifaximin

Rifaximin (Xifaxan) is an oral rifamycin antibiotic structurally related to rifampin.

The drug is indicated to treat patients with traveler’s diarrhea caused by noninvasive strains of Escherichia coli, irritable bowel syndrome with diarrhea, and to reduce the risk of hepatic encephalopathy recurrence.

The antimicrobial spectrum of activity includes various gram-positive and gram-negative aerobes and anaerobes.

Coverage against gram-positive cocci is better than its coverage against Enterobacteriaceae.

Rifaximin has virtually no systemic bioavailability after oral administration; thus, unlike other rifamycins, rifaximin is unlikely to cause metabolic-based drug interactions in vivo. Rifaximin has been marketed in Italy under the name ‘Normix’ since 1988. In Mexico, the drug is marketed as ‘RedActiv’ and ‘Flonorm’.

Rifaximin received final FDA approval for treatment of traveler’s diarrhea caused by noninvasive strains of Escherichia coli on May 26, 2004; rifaximin also received approval for reducing the risk of overt hepatic encephalopathy recurrence in March 2010.

In May 2015, it was approved to treat irritable bowel syndrome with diarrhea.

Brand Name

Xifaxan

Indications

  1. Crohn’s disease
  2. diverticulitis
  3. Escherichia coli
  4. hepatic encephalopathy
  5. irritable bowel syndrome
  6. pseudomembranous colitis
  7. traveler’s diarrhea
  8. traveler’s diarrhea prophylaxis

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • breast-feeding
  • children
  • colitis
  • diarrhea
  • dysentery
  • fever
  • geriatric
  • GI bleeding
  • GI disease
  • hepatic disease
  • infants
  • inflammatory bowel disease
  • neonates
  • pregnancy
  • pseudomembranous colitis
  • rifamycin hypersensitivity
  • ulcerative colitis

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Amiodarone
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Avapritinib
  • Axitinib
  • Bepridil
  • Boceprevir
  • Bosutinib
  • Brigatinib
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Cabozantinib
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Clarithromycin
  • Cobicistat
  • Cobimetinib
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Conivaptan
  • Cyclophosphamide
  • Cyclosporine
  • Dabigatran
  • Daclatasvir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deflazacort
  • Dextromethorphan; Quinidine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Doravirine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Doxorubicin
  • Dronabinol
  • Dronedarone
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elexacaftor; tezacaftor; ivacaftor
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Entrectinib
  • Erdafitinib
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Etravirine
  • Fedratinib
  • Gemfibrozil
  • Glasdegib
  • Glecaprevir; Pibrentasvir
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibuprofen; Oxycodone
  • Itraconazole
  • Ivacaftor
  • Ketoconazole
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lapatinib
  • Ledipasvir; Sofosbuvir
  • Lefamulin
  • Lemborexant
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Maraviroc
  • Mefloquine
  • Midazolam
  • Nelfinavir
  • Neratinib
  • Obeticholic Acid
  • Olaparib
  • Ombitasvir; Paritaprevir; Ritonavir
  • Osimertinib
  • Oxycodone
  • Posaconazole
  • Propafenone
  • Quinidine
  • Ranolazine
  • Rimegepant
  • Ritonavir
  • Rivaroxaban
  • Romidepsin
  • Sapropterin
  • Saquinavir
  • Selumetinib
  • Simeprevir
  • Siponimod
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Sonidegib
  • Sorafenib
  • Sufentanil
  • Tazemetostat
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temsirolimus
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Teriflunomide
  • Testosterone
  • Tezacaftor; Ivacaftor
  • Ticagrelor
  • Trandolapril; Verapamil
  • Tucatinib
  • Ubrogepant
  • Vemurafenib
  • Verapamil
  • Vincristine
  • Vincristine Liposomal
  • Voxelotor
  • Warfarin
  • Zanubrutinib
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