rifiximin

rifiximin

Pharmacologic class: Rifampin-related antibiotic

Therapeutic class: Anti-infective

Pregnancy risk category C

Action

Binds to beta-subunit of bacterial DNA-dependent RNA polymerase, inhibiting bacterial RNA synthesis

Availability

Tablets: 200 mg, 550 mg

Indications and dosages

Travelers' diarrhea caused by noninvasive strains of Escherichia coli

Adults and children age 12 and older: 200 mg P.O. three times daily for 3 days

Reduction of risk of overt hepatic encephalopathy recurrence

Adults: 550 mg P.O. b.i.d.

Off-label uses

• Hepatic encephalopathy

Contraindications

• Hypersensitivity to drug, its components, or rifamycin anti-infectives

Precautions

Use cautiously in:
• elderly patients
• pregnant or breastfeeding patients
• children (safety and efficacy not established in those younger than age 12).

Administration

• Administer with or without food.
• Don't give to patients with diarrhea complicated by fever or blood in stool or to patients with suspected Campylobacter jejuni, Shigella, or Salmonella infection.

Adverse reactions

CNS: headache

GI: nausea, vomiting, constipation, flatulence, abdominal pain, rectal tenesmus, defecation urgency, pseudomembranous colitis

Other: pyrexia, overgrowth of susceptible organisms

Interactions

None

Patient monitoring

• Monitor for fever, blood in stools, and worsening of diarrhea.
• Monitor patient's fluid and electrolyte status.
• Monitor for new infections; if needed, consider alternative therapy.

Patient teaching

• Tell patient drug can be taken with or without food.

Advise patient to stop drug and notify prescriber if diarrhea symptoms worsen or last beyond 48 hours.
• As appropriate, review all other significant or life-threatening adverse reactions.