What should I do if I experience dizziness after taking rifaximin (Xifaxan) 550?

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From the Guidelines

If you experience dizziness after taking rifaximin (Xifaxan) 550 mg, you should contact your healthcare provider promptly. Dizziness is not among the most common side effects of rifaximin but could indicate an adverse reaction that needs medical attention 1. While waiting to speak with your provider, ensure you're staying hydrated and avoid activities that require alertness such as driving or operating machinery.

Possible Causes and Recommendations

  • Your doctor may recommend temporarily stopping the medication, adjusting the dosage, or taking it with food to reduce side effects.
  • They might also want to evaluate whether the dizziness is related to the underlying condition being treated (such as hepatic encephalopathy or irritable bowel syndrome) rather than the medication itself.
  • Rifaximin works by inhibiting bacterial RNA synthesis in the gut with minimal systemic absorption, so significant central nervous system effects are unusual, which makes unexpected dizziness worth reporting 1.
  • Never discontinue prescription medication without medical advice, as the benefits of treatment may outweigh temporary side effects.

Key Considerations

  • The most recent and highest quality study on rifaximin for irritable bowel syndrome (IBS-D) found that it was more efficacious than placebo for the FDA composite end point for IBS-D, but with modest efficacy and concerns over potential adverse events 1.
  • However, the primary concern in this scenario is the patient's safety and well-being, particularly if experiencing dizziness, which necessitates prompt medical evaluation.
  • The evidence from 1 and 1 supports the use of rifaximin in specific conditions but also highlights the importance of monitoring for side effects and adjusting treatment as necessary.

From the FDA Drug Label

Dizziness 18 (13%) 13 (8%) The adverse reactions that occurred at an incidence ≥5% are provided in Table 2

  • Adverse reactions that occurred in ≥5% of XIFAXAN-treated patients and greater than in patients who received placebo include Dizziness. If you experience dizziness after taking rifaximin (Xifaxan) 550, you should stop taking the medication and consult your doctor 2.

From the Research

Dizziness after Taking Rifaximin 550

If you experience dizziness after taking rifaximin (Xifaxan) 550, it is essential to understand that this is a known side effect of the medication.

  • Dizziness is listed as one of the common adverse events occurring in 10% to 15% of patients taking rifaximin for the prevention of recurrent hepatic encephalopathy 3.
  • The safety profile of rifaximin in clinical trials for prevention of recurrent hepatic encephalopathy and for nonconstipated irritable bowel syndrome (IBS) was comparable to placebo, with dizziness being one of the adverse events reported 3.
  • Long-term use of rifaximin (550 mg, twice daily) for maintenance of remission from overt hepatic encephalopathy has been shown to have a safety profile similar to that observed in shorter-term trials, without an increase in adverse events such as dizziness 4.

Management of Dizziness

While the provided studies do not offer specific guidance on managing dizziness caused by rifaximin, general advice for managing dizziness includes:

  • Sitting or lying down if feeling dizzy
  • Avoiding driving or operating heavy machinery
  • Staying hydrated
  • Avoiding standing up too quickly

Importance of Medical Consultation

It is crucial to consult a healthcare provider if you experience dizziness or any other side effects while taking rifaximin. They can provide personalized advice and help manage any adverse effects.

  • The decision to continue or adjust treatment should be made under the guidance of a healthcare professional, considering the benefits and risks of rifaximin therapy for your specific condition 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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