Generic
Rifaximin
28 brands available in the market
At a glance
Rifaximin is a semisynthetic, rifamycin-based non-systemic antibiotic used for traveler's diarrhea, reduction in risk of overt hepatic encephalopathy, and bacterial overgrowth of irritable bowel syndrome.
Description
Rifaximin is a non-systemic antibiotic that acts locally in the GI tract. It inhibits bacterial RNA synthesis by binding to the beta-subunit of DNA-dependent RNA polymerase. Very little is absorbed, making it effective against intestinal bacteria without systemic side effects.
Indications
- Traveler's diarrhea (E. coli)
- Reduction in risk of overt hepatic encephalopathy
- Bacterial overgrowth of irritable bowel syndrome
Therapeutic class
4-Quinolone preparations
Pharmacological class
Rifamycin Antibiotic (Non-systemic)
Pharmacology
Rifaximin is a non-systemic antibiotic that works locally in the GI tract. It inhibits bacterial RNA synthesis by binding to the beta-subunit of DNA-dependent RNA polymerase. With minimal absorption, it is effective against intestinal bacteria without systemic side effects.
Mechanism of action
Reduces intestinal bacteria by inhibiting bacterial RNA synthesis.
Dosage
Adult Dose (Oral):
- Traveler's diarrhea: 200 mg every 8 hours for 3 days
- Hepatic encephalopathy maintenance: 550 mg every 12 hours
- IBS-D: 550 mg every 8 hours for 14 days; may repeat up to 2 times
- Bacterial overgrowth: 400 mg 3 times daily for 10 days OR 550 mg 3 times daily for 14 days
Pediatric Dose (≥12 years):
- Traveler's diarrhea: 200 mg every 8 hours for 3 days
Administration
- May be taken with or without food; take at a fixed time
- Swallow tablet whole; do not chew, crush, or break
Missed dose
If you miss a dose, take it as soon as possible; if almost time for next dose, skip it; do not double the dose.
Side effects
Side Effects:
- Flatulence
- Headache
- Abdominal pain
- Rectal tenesmus
- Defecation urgency
- Nausea
- Constipation
- Pyrexia
- Vomiting
- Anaphylaxis (rare)
Precautions & warnings
- Not effective in diarrhea complicated by fever and/or blood in stools
- Discontinue if no improvement or worsening within 24-48 hours
- Pseudomembranous colitis may occur
- Caution in pregnancy and lactation
Contraindications
- Hypersensitivity to rifaximin, any rifamycin antimicrobial agent, or any component
Drug interactions
- CYP3A4 inducers: Potential in vitro but not expected at recommended doses
Food interactions
It is not known whether it is safe to consume alcohol with Rifaximin.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; Pregnancy Category C; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited human data suggests no significant risk; unknown if excreted in human milk.
Pediatric use
Safety not established in children under 12 years.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; dose adjustment may not be needed; pharmacokinetics not studied in renal impairment; consult your doctor.
Hepatic Impairment: Caution in severe liver disease; systemic exposure markedly elevated in hepatic impairment; dose adjustment may be needed; consult your doctor.
Overdose effects
Overdose: No specific information; discontinue, treat symptomatically and institute supportive measures as required.
Storage conditions
Keep below 30°C, away from light and moisture; keep out of reach of children.
Chemical structure
Rifaximin