From the Guidelines
Xifaxan (rifaximin) is an antibiotic primarily used to treat irritable bowel syndrome with diarrhea (IBS-D), traveler's diarrhea, and hepatic encephalopathy, with a typical dosage of 550 mg taken three times daily for 14 days for IBS-D, 200 mg taken three times daily for 3 days for traveler's diarrhea, and 550 mg taken twice daily for maintenance therapy for hepatic encephalopathy. The use of Xifaxan is supported by recent guidelines, including the British Society of Gastroenterology guidelines on the management of irritable bowel syndrome, which recommends rifaximin as a second-line treatment for IBS-D 1. Additionally, the French recommendations for the diagnosis and management of hepatic encephalopathy suggest the use of rifaximin to prevent recurrence of hepatic encephalopathy in patients with cirrhosis 1.
Some key points to consider when using Xifaxan include:
- Xifaxan works by reducing gut bacteria that produce ammonia and other substances that can worsen these conditions.
- It's minimally absorbed into the bloodstream, allowing it to target intestinal bacteria while causing fewer systemic side effects than other antibiotics.
- Common side effects include nausea, bloating, and headache.
- Patients should complete the full prescribed course even if symptoms improve and should inform their doctor of all other medications they're taking, as interactions can occur.
- Those with severe liver impairment may require dosage adjustments.
The most recent and highest quality study on the use of Xifaxan for traveler's diarrhea, published in 2017, recommends rifaximin as an acceptable alternative for treatment of moderate traveler's diarrhea, however, it should be used with caution in areas where invasive pathogens are likely to be encountered 1. Overall, Xifaxan is a valuable treatment option for IBS-D, traveler's diarrhea, and hepatic encephalopathy, with a favorable safety profile and efficacy in reducing symptoms.
From the FDA Drug Label
XIFAXAN is a rifamycin antibacterial indicated for: • Treatment of travelers’ diarrhea (TD) caused by noninvasive strains of Escherichia coli in adult and pediatric patients 12 years of age and older (1.1) • Reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults (1.2) • Treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults (1.3)
The use of Xifaxan (Rifaximin) is for the treatment of:
- Travelers’ diarrhea caused by noninvasive strains of Escherichia coli in adults and pediatric patients 12 years of age and older
- Reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults
- Treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults 2
From the Research
Uses of Xifaxan (Rifaximin)
- Xifaxan (Rifaximin) is used for the treatment of travelers' diarrhea caused by noninvasive strains of Escherichia coli in patients aged 12 years and older 3
- It is also used for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in patients aged 18 years or older 3, 4, 5
- Rifaximin has been shown to be effective in preventing diarrhea in individuals traveling to south and southeast Asia 6
- It is used for the treatment of hepatic encephalopathy, with studies demonstrating its efficacy and safety in improving neurologic signs and symptoms and reducing blood ammonia levels 4, 5
- Rifaximin is also used for the treatment of other gastrointestinal infections, including acute and chronic infections, bacterial diarrhea, and pre- and postsurgical prophylaxis 3
Benefits of Rifaximin
- Rifaximin has a favorable efficacy, tolerability, and safety profile, making it a promising treatment option for various gastrointestinal infections 3, 6, 4, 5, 7
- It has minimal potential for development of bacterial resistance and cytochrome P450-mediated drug-drug interactions 7
- Rifaximin demonstrates a good tolerability profile in patients with hepatic encephalopathy, with few side effects reported 4, 5