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Related to rifaximin: Xifaxan
Pregnancy Category: C
ClassificationTherapeutic: anti infectives
Travelers' diarrhea due to noninvasive strains of Escherichia coli.Reduction in risk of overt hepatic encephalopathy recurrence.
Inhibits bacterial RNA synthesis by binding to bacterial DNA-dependent RNA polymerase.
Decreased severity of travelers' diarrhea.
Decreased episodes of overt hepatic encephalopathy.Escherichia coli (enterotoxigenic and enteroaggregative strains).
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.
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)
- peripheral edema (most frequent)
- pseudomembranous colitis (life-threatening)
Drug-Drug interactionAlthough rifaximin induces the CYP 3A4 enzyme system, since it is not absorbed, drug interactions are unlikely.
Oral (Adults and Children ≥12 yr) 200 mg 3 times daily for 3 days.
Oral (Adults) 550 mg twice daily.
Tablets: 200 mg, 550 mg
- 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 DiagnosesDiarrhea (Indications)
Risk for deficient fluid volume (Indications)
- Do not confuse rifaximin with rifampin.
- Oral: Administer with or without food.
- 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.
- Decreased severity of travelers' diarrhea.
- Reduction in risk of overt hepatic encephalopathy recurrence.