Xifaxan

The active ingredient in Xifaxan is rifaximin. Xifaxan works by inhibiting the bacterial enzymes responsible for DNA replication and protein synthesis. Unlike traditional antibiotics, Xifaxan is not absorbed into the bloodstream to a significant extent. This means that it primarily acts locally in the intestines, minimizing the risk of systemic side effects.

• Specifically, Xifaxan is indicated for the following conditions:
• Treatment of travelers’ diarrhea due to Escherichia coli (E. coli) in patients 12 years of age or older.
• Treatment of Irritable bowel syndrome with diarrhea (IBS-D).
• IBS is defined as abdominal pain with either more than three bowel movements per day or less than three bowel movements per week.
• Symptom relief of IBS includes abdominal pain, bloating, flatulence, and other IBS symptoms.
• Preventative treatment of hepatic encephalopathy (HE) in adults.
• Off-label, it has been prescribed for small intestinal bacterial overgrowth (SIBO).

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Xifaxan. However, the following is a synopsis of the general guidelines for the use of Xifaxan:

• Take Xifaxan exactly as prescribed. Even if you begin to feel better, keep taking the medication as your healthcare professional tells you to do so. If not, the infection has a chance of coming back and will most likely be harder to treat.
• You can take Xifaxan with or without food. If your stomach hurts while taking the medication, try taking the medication with food.
• If you are being treated for traveler’s diarrhea, stop taking Xifaxan and get medical help immediately if you have diarrhea for more than one to two days, or if your diarrhea worsens. Get emergency care if you have bloody diarrhea or if you begin to be feverish.
• Tell your medical professional if you are pregnant, thinking of becoming pregnant, or are breastfeeding.
• If you miss a dose, take the missed dose as soon as possible. If it is closer to the time of your next dose, skip this dose and take your next dose at its scheduled time.

The most common side effects of Xifaxan seen in clinical trials include:

• Headache
• Nausea
• Dizziness
• Tiredness
• Swelling in feet and hands
• Extra stomach swelling and fluid
• Constipation

Some individuals may experience serious side effects while using Xifaxan. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Allergic reaction. Symptoms could include:
• Hives
• Swelling of the lips and face
• Trouble breathing
• C. difficile (Clostridium difficile)-related diarrhea. This could lead to colitis. Symptoms could include:
• Foul-smelling diarrhea
• Fever
• Rapid heart rate
• Frequent bowel movements (can be up to 15 times per day)

These are not all of the possible side effects of Xifaxan. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Xifaxan, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Known hypersensitivity or have had any previous side effects of rifaximin before
• You should not take Xifaxan if you are allergic to rifaximin or medications such as Mycobutin (rifabutin), Rifadin (rifampin), Priftin (rifapentine), or any of the rifamycin antimicrobial agents.
• Severe hepatic (liver) impairment.
• Severe liver disease.

A history of hypersensitivity to rifamycin antimicrobial agents, rifaximin, or any of the components of Xifaxan.

Xifaxan (rifaximin) typically begins working within 24-48 hours for conditions like traveler’s diarrhea, with noticeable symptom improvement during that time. For irritable bowel syndrome with diarrhea (IBS-D) or hepatic encephalopathy, it may take several days to weeks to see full benefits, depending on individual response. Always complete the prescribed course, even if symptoms improve, to ensure effectiveness and prevent recurrence.

When Xifaxan is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Warfarin
• Dose adjustments may be needed
• OATP inhibitors, such as cyclosporine

Xifaxan comes in a tablet form in the following dosage strengths:

• 200 mg tablets
• 550 mg tablets

The dosage and duration of Xifaxan treatment may vary depending on the condition being treated. It is important to follow the instructions provided by your healthcare provider.

For traveler's diarrhea, the usual dosage is 200 mg three times a day for three days. For IBS-D, the recommended dosage is 550 mg three times a day for 14 days. You can repeat this course of therapy for up to 2 times.

In the case of SIBO, the standard dosage is 550 mg three times a day for 10 days. For HE, the typical dose of Xifaxan is 550 mg twice daily.

Xifaxan should be stored at room temperature, which includes the range 20° to 25°C (68° to 77°F), with excursions permitted from 15° to 30°C (59° to 86°F).

It is manufactured by Salix Pharmaceuticals.

Currently, there is no lower-cost generic available on the market for the brand name Xifaxan.

To stop taking Xifaxan, follow your healthcare provider’s instructions, as discontinuation may depend on the condition being treated. If prescribed for a short-term issue like traveler’s diarrhea, simply finish the prescribed course. You do not need to taper. For longer-term conditions like IBS-D or hepatic encephalopathy, consult your doctor before stopping to discuss any alternative management strategies or potential symptoms to monitor.

Xifaxan is not recommended during pregnancy because of the potential risk of harm to the unborn baby. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

There is no current information regarding whether Xifaxan passes into breast milk or what the effects are on a nursing infant. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.