From the Guidelines
Rifaximin is indicated for the treatment of Irritable Bowel Syndrome with Diarrhea (IBS-D) and Hepatic Encephalopathy (HE).
Indications for Rifaximin
- Irritable Bowel Syndrome with Diarrhea (IBS-D): Rifaximin is suggested for use in patients with IBS-D, with a conditional recommendation and moderate certainty of evidence 1.
- Hepatic Encephalopathy (HE): Rifaximin may be combined with non-absorbable disaccharides to treat patients with HE, and is recommended as an add-on to lactulose for prevention of recurrent episodes of HE after the second episode 1.
Key Points
- The American Gastroenterological Association (AGA) suggests using rifaximin in patients with IBS-D, with a conditional recommendation and moderate certainty of evidence 1.
- Rifaximin has been shown to be effective in reducing symptoms of HE, and is recommended as an add-on to lactulose for prevention of recurrent episodes of HE 1.
- The European Association for the Study of the Liver and the American Association for the Study of Liver Diseases recommend rifaximin as an add-on to lactulose for prevention of recurrent episodes of HE after the second episode 1.
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 indications for Rifaximin are:
- Treatment of travelers’ diarrhea caused by noninvasive strains of Escherichia coli in adult and pediatric patients 12 years of age and older
- Reduction in risk of overt hepatic encephalopathy recurrence in adults
- Treatment of irritable bowel syndrome with diarrhea in adults 2
From the Research
Indications for Rifaximin
The indications for Rifaximin are varied and include:
- Hepatic encephalopathy (HE) prevention and treatment 3, 4, 5
- Traveler's diarrhea 4, 6, 7
- Irritable bowel syndrome (IBS), particularly diarrhea-predominant IBS 4, 5, 7
- Small intestine bacterial overgrowth (SIBO) 6, 7
- Inflammatory bowel disease (IBD) 4, 6
- Clostridium difficile infection (CDI) 5, 7
- Symptomatic uncomplicated diverticular disease 7
- Prevention of spontaneous bacterial peritonitis in liver cirrhosis patients 6
Potential Indications
Some potential indications for Rifaximin that are still being researched include: