rifaximin


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Related to rifaximin: Xifaxan

rifaximin

(ri-fax-i-min) ,

Xifaxan

(trade name)

Classification

Therapeutic: anti infectives
Pharmacologic: rifamycins
Pregnancy Category: C

Indications

Travelers' diarrhea due to noninvasive strains of Escherichia coli.Reduction in risk of overt hepatic encephalopathy recurrence.

Action

Inhibits bacterial RNA synthesis by binding to bacterial DNA-dependent RNA polymerase.

Therapeutic effects

Decreased severity of travelers' diarrhea.
Decreased episodes of overt hepatic encephalopathy.
Escherichia coli (enterotoxigenic and enteroaggregative strains).

Pharmacokinetics

Absorption: Poorly absorbed (<0.4%), action is primarily in GI tract.
Distribution: 80–90% concentrated in gut.
Metabolism and Excretion: Almost exclusively excreted unchanged in feces.
Half-life: 6 hr.

Time/action profile

ROUTEONSETPEAKDURATION
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Contraindications/Precautions

Contraindicated in: Hypersensitivity to rifaximin or other rifamycins;Diarrhea with fever or bloody stools;Diarrhea caused by other infections agents; Lactation: Potential for adverse effects in the infant. Switch to formula for duration of treatment.
Use Cautiously in: Obstetric: Use only if benefit to mother outweighs risk to fetus; Pediatric: Safety not established in children <18 yr (hepatic encephalopathy) or <12 yr (travelers' diarrhea).

Adverse Reactions/Side Effects

Central nervous system

  • dizziness (most frequent)

Cardiovascular

  • peripheral edema (most frequent)

Gastrointestinal

  • pseudomembranous colitis (life-threatening)

Interactions

Drug-Drug interaction

Although rifaximin induces the CYP 3A4 enzyme system, since it is not absorbed, drug interactions are unlikely.

Route/Dosage

Travelers' Diarrhea

Oral (Adults and Children ≥12 yr) 200 mg 3 times daily for 3 days.

Hepatic Encephalopathy

Oral (Adults) 550 mg twice daily.

Availability

Tablets: 200 mg, 550 mg

Nursing implications

Nursing assessment

  • Traveler's Diarrhea: Assess frequency and consistency of stools and bowel sounds prior to and during therapy.
  • Assess fluid and electrolyte balance and skin turgor for dehydration.
  • Hepatic Encephalopathy: Assess mental status periodically during therapy.
  • Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
  • Lab Test Considerations: May cause lymphocytosis, monocytosis, and neutropenia.

Potential Nursing Diagnoses

Diarrhea (Indications)
Risk for deficient fluid volume (Indications)

Implementation

  • Do not confuse rifaximin with rifampin.
  • Oral: Administer with or without food.

Patient/Family Teaching

  • Instruct patient to take rifaximin as directed and to complete therapy, even if feeling better. Caution patient to stop taking rifaximin if diarrhea symptoms get worse, persist more than 24–48 hr, or are accompanied by fever or blood in the stool. Consult health care professional if these occur. Advise patient not to treat diarrhea without consulting health care professional. May occur up to several weeks after discontinuation of medication.
  • May cause dizziness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
  • Advise female patients to notify health care professional if pregnant or if pregnancy is suspected, or if breast feeding.

Evaluation/Desired Outcomes

  • Decreased severity of travelers' diarrhea.
  • Reduction in risk of overt hepatic encephalopathy recurrence.

rifaximin

a miscellaneous antiinfective.
indication This drug is used to treat traveler's diarrhea caused by Escherichia coli in adults and children older than 12 years of age.
contraindications Known hypersensitivity to this drug prohibits its use.
adverse effects Adverse effects of this drug include abnormal dreams, dizziness, insomnia, and vomiting. Common side effects include abdominal pain, constipation, defecation urgency, flatulence, nausea, rectal tenesmus, headache, and pyrexia.
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References in periodicals archive ?
s) today announced that it has received Orphan Drug Designation from the United States Food and Drug Administration (FDA) for the use of Rifaximin to treat hepatic encephalopathy, a complication of acute and chronic liver disease.
MELD-based Comparison of Hospitalizations from Hepatic Encephalopathy in Patients with Advanced Liver Disease on Rifaximin and Lactulose Combination Therapy"
Rifaximin (Xifaxan), a nonabsorbable antibiotic with gastrointestinal specificity approved by the Food and Drug Administration for treating travelers' diarrhea, is approved in 17 other countries for management of hepatic encephalopathy.
Evaluation of Rifaximin Efficacy in Non C-IBS Patients by Baseline Disease Severity: Subanalysis of the TARGET 1 and TARGET 2 Studies"
Randomised clinical trial: rifaximin improves health-related quality of life in cirrhotic patients with hepatic encephalopathy - a double-blind placebo-controlled study.
In addition, 2 weeks of daily treatment with rifaximin, an antibiotic derived from rifamycin, had a minimal effect on native, enteric flora, Dr.
Poster Presentation: Su1334: The Effect of Concomitant Lactulose on Gastrointestinal Adverse Events in Cirrhotic Patients Treated with Rifaximin
The '115 patent provides protection for the TD indication for the rifaximin 200mg product that the Company markets in the United States under the trade name XIFAXAN([R]).
granted Salix exclusive worldwide rights (except for India) to exploit Lupin technology and technology jointly developed by Lupin and Salix for all rifaximin products for human use.
NASDAQ:SLXP) today announced that The International Liver Congress[TM] 2011 of the European Association for the Study of the Liver (EASL) served as the venue for a presentation describing the investigation of rifaximin, the Company's gut-selective antibiotic.
These findings show the potential of rifaximin to treat multiple symptoms of IBS and affect gut flora, an underlying cause of IBS, with a side effect profile comparable to placebo," said Bill Forbes, PharmD.
This analysis compared the long term effect of rifaximin by comparing survival in HE patients receiving rifaximin (long-term open label trial) versus patients awaiting liver transplantation (Organ Procurement and Transplant network).