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Related to rifaximin: Xifaxan


(ri-fax-i-min) ,


(trade name)


Therapeutic: anti infectives
Pharmacologic: rifamycins
Pregnancy Category: C


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.

Therapeutic effects

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.

Time/action profile



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 interaction

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


Travelers' Diarrhea

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

Hepatic Encephalopathy

Oral (Adults) 550 mg twice daily.


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)


  • 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.


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 ?
In TARGET 1 and TARGET 2, patients affected by IBS without constipation (N=1258) received either rifaximin 550 mg or placebo 3 times daily for 2 weeks, then were followed for an additional 10 weeks.
Regarding the efficacy, rifaximin plus lactulose was effective in 45(74%) patients while lactulose alone was effective in 32(53%) patients with hepatic encephalopathy.
This is the first study that demonstrates that rifaximin is efficacious in the treatment of functional dyspepsia, particularly for global dyspeptic symptoms, bloating, and possibly belching," Dr.
Mainly prescribed as a treatment for traveler's diarrhea, rifaximin also has been found to suppress gastrointestinal flora in the small intestine (Frederick, 2011; Karch, 2011).
For diarrhoea forms of the condition, they evaluated tricyclic antidepressants; alosetron, a drug that slows movement of stool in the gut; and rifaximin, an antibiotic that stays in the gut and is used to treat traveller's diarrhoea and hepatic encephalopathy.
Previous studies have shown a relationship between gastrointestinal bacteria and various skin disorders such as scleroderma; a small case series showed that rosacea improved when patients with small intestinal bacterial overgrowth (SIBO) were treated with rifaximin, Dr.
Patients with diarrhea-predominant IBS who were treated with 550 milligrams of rifaximin three times a day for two weeks experienced symptom relief, including less bloating, less abdominal pain, and improved stool consistency, for up to 10 weeks after they stopped taking the drug.
The benefits of rifaximin lingered for 10 weeks after the two-week treatment.
Although the data were not included in the poster, 19 of the 26 IBS patients with RLS were treated with the antibiotic rifaximin, with 9 reporting relief of their RLS symptoms, Dr.
The two companies will collaborate in the development and commercialization of an extended-release product that incorporates Rifaximin and uses Lupin's proprietary bioadhesive technology.
NASDAQ:SLXP) has announced the Food and Drug Administration (FDA) has accepted for filing and designated for Priority Review the Company's New Drug Application (NDA) for rifaximin tablets 550 mg for the maintenance of remission of hepatic encephalopathy (HE).
The experimental antibiotic treatment regimen included: rifaximin 1,200 mg day for ten days followed by tegaserod 3 mg, long-term; one month of zinc 220 mg per day; and once-daily probiotic or rifaximin monotherapy.