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.
Drug Guide, © 2015 Farlex and Partners
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References in periodicals archive ?
Rifaximin in Subjects with Hepatic Cirrhosis and a History of Prior Episodes of Hepatic Encephalopathy.' The study will include adult men and non-pregnant women with hepatic cirrhosis who have a history of at least two or more documented episodes of HE in the last 12 months - with one in the last six months - and who present with hyperammonemia at the time of screening.
They found that in patients that received rifaximin, which stays in the bowel and has a low risk for inducing bacterial resistance, early liver failure was significantly delayed or stopped..
Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia.
(5.) Esposito G, et al, Rifaximin Improves Clostridium difficile Toxin A-lnduced Toxicity in Caco-2 Cells by the PXR-Dependent TLR4/MyD88/NF-KB Pathway.
Another choice is rifaximin (weak recommendation, moderate LOE), although one should exercise caution for empirical therapy in regions in which being at high risk of invasive pathogens is anticipated.
Review article: the potential mechanisms of action of rifaximin in the management of inflammatory
(36) Rifaximin, an oral, nonsystemic antibiotic with a low bacterial-resistance profile and a favorable side-effect profile, was approved in May 2015 for treating adults with nonconstipation IBS, including IBS-D.
RIFAXIMIN, a poorly absorbed antibiotic with excellent tolerability, has shown high eradication rates of bacterial overgrowth.
Previously, Taylor served as CMO at VaxInnate Corp., where he focused on the development of recombinant vaccines for influenza and other infectious diseases, and CMO and vice president of medical and safety at Salix Pharmaceuticals, where he developed Rifaximin (Xifaxan) for the treatment of traveller's diarrhea and headed medical affairs and pharmacovigilance.
If we think you have SIBO, you do a course of rifaximin. And you can do the same," she told her audience of rheumatologists.
review the interaction of rifaximin with several components of the gut immunological niche that explain its ability to reduce intestinal dysbiosis and to inhibit the release of proinflammatory mediators.
Treatments that have proven to be effective in both minimal HE (MHE), detected through changes in neuropsychometric tests, and in overt HE (OHE) include nonabsorbable disaccharides such as lactulose, antibiotic that acts in intestinal lumen such as rifaximin, and drugs favoring extrahepatic metabolism of ammonium such as L-ornithine L-aspartate (LOLA) [2-5].