These changes occur when a toxin produced by certain bacteria in the gastrointestinal (GI) tract builds up and travels to the brain.
Xifaxan works by killing the bacteria that cause traveler’s diarrhea and IBS-D. For HE, Xifaxin kills the bacteria that produce the toxins responsible for symptoms.
This medication is available in tablet form.
What Is Xifaxan Used For?
The Food and Drug Administration (FDA) approved Xifaxan to treat several conditions, including:
Brand Name(s): Xifaxan
Administration Route(s): Oral
Drug Availability: Prescription
Therapeutic Classification: Antibiotic
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Rifaximin
Dosage Form(s): Tablet
Traveler’s diarrhea: Xifaxan treats traveler’s diarrhea caused by certain bacteria (Escherichia coli, or E. coli) in adults and children aged 12 years and older. Xifaxan should not be used to treat diarrhea if you have blood in your stool or a fever. Traveler’s diarrhea describes symptoms that occur within 10 days of traveling to an area with poor public hygiene. Consuming water or food contaminated with bacteria (or other microbes) can cause this condition. Traveling to developing countries in Asia, Africa, Central America and South America, and the Middle East often poses the greatest risk. Irritable bowel syndrome with diarrhea (IBS-D): Rifaxamin is prescribed for people with IBS-D, often when other treatments have failed. Several studies have shown a two-week trial of Xifaxan significantly improves diarrhea and bloating symptoms. To prevent HE in adults with liver disease: People with liver disease have trouble removing naturally occurring toxins from their bodies. When these toxins build up, they can travel to the brain and cause symptoms, including confusion, slurred speech, and reduced alertness.
How to Take Xifaxan
Xifaxan is often taken two to three times per day, depending on what you are treating. Space your doses evenly throughout the day. You can take this medication with or without food.
Storage
Store Xifaxan at room temperature. Keep Xifaxan and all your medications in a safe location, up high and out of the reach of children and pets.
Off-Label Uses
Your healthcare provider may prescribe Xifaxan for other uses that are not approved by the FDA. This is called off-label use.
Some off-label uses of Xifaxan include:
Pouchitis: A complication affecting the lining of the pouch created during surgery for ulcerative colitis Prevention of traveler’s diarrhea Small intestine bacterial overgrowth: A condition that commonly causes bloating, abdominal discomfort, and diarrhea Treatment of Clostridioides difficile (C. diff) infection after other treatments have failed Treatment of HE
What Are the Side Effects of Xifaxan?
This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.
As with other medications, Xifaxan can cause side effects. Let your healthcare provider know if you experience any side effects while taking this medication.
Common Side Effects
Xifaxan is a well-tolerated medication. Most people don’t experience any side effects.
However, the most common side effects include:
Dizziness HeadacheJoint painMuscle spasms NauseaNose or throat irritation Stomach painTiredness
Severe Side Effects
In rare cases, Xifaxan may cause severe side effects. Let your healthcare provider know right away if you develop any of the following reactions. Call 911 if your symptoms feel life-threatening.
Severe side effects of Xifaxan can include:
Swelling of the arms or legs (peripheral edema) Swelling of the belly (ascites) Signs of an allergic reaction, including rash, hives, difficulty breathing, or swelling of the mouth, face, lips, tongue, or throat Signs of C. diff infection, a severe and potentially life-threatening form of diarrhea: Let your healthcare provider know if you develop stomach pain, cramps, or very loose, watery, or bloody stools. Do not treat diarrhea with any over-the-counter (OTC) medications without talking with your provider first. OTC antidiarrheal products can cause severe complications if you have C. diff.
Long-Term Side Effects
Even though Xifaxan can be used to treat a C. diff infection, all antibiotics, including Xifaxan, can cause this condition. C. diff infection can occur while taking Xifaxan or months after stopping treatment. C. diff can sometimes cause severe, life-threatening bowel problems. Let your healthcare provider know right away if you develop stomach pain, cramps, or very loose, watery, or bloody stools.
Do not treat diarrhea without talking with a medical professional first.
Dosage: How Much Xifaxan Should I Take?
Missed Dose
If you miss a dose of Xifaxan, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and resume your normal dosing schedule. Do not double up or take extra.
If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (tablets): For treatment of irritable bowel syndrome with diarrhea: Adults—550 milligrams (mg) three times a day for 14 days. Children—Use and dose must be determined by your doctor. For treatment of traveler’s diarrhea: Adults and children 12 years of age and older—200 milligrams (mg) three times a day for 3 days. Children younger than 12 years of age—Use and dose must be determined by your doctor. For preventing hepatic encephalopathy: Adults—550 milligrams (mg) two times a day. Children—Use and dose must be determined by your doctor.
Overdose: What Happens If I Take Too Much Xifaxan?
Only a minimal amount of Xifaxan is absorbed from your GI tract and into your bloodstream. For this reason, an overdose of Xifaxan is not expected to cause any serious problems.
Precautions
What Are Reasons I Shouldn’t Take Xifaxan?
You should not take Xifaxan if you’ve had an allergic reaction to Xifaxan in the past or are allergic to other rifamycin antibiotics, including Rifadin or Rimactane (rifampin), Priftin (rifapentine), or Mycobutin (rifabutin).
If someone collapses or isn’t breathing after taking Xifaxan, call 911 immediately.
Check with your doctor right away if the diarrhea does not stop in 1 or 2 days or if you or your child develop a fever or have blood in your stool.
A person can become dehydrated if too much fluid is lost from the body with diarrhea. Make sure you or your child drink plenty of fluids while you have diarrhea. Check with your doctor right away if you or your child have more than one of the following symptoms: decreased urination, dizziness, dry mouth, increased thirst, or lightheadedness.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Other Medications Interact With Xifaxan?
Certain medications may interact with Xifaxan. Be sure to let your healthcare provider know all the medicines you take, including over-the-counter vitamins, supplements, and herbal products.
Medications that may interact with Xifaxan include:
Gengraf (cyclosporine) Coumadin (warfarin)
This is not a complete list of all the drugs that may interact with Xifaxan. Be sure to ask your doctor or pharmacist before starting anything new.
How Can I Stay Healthy While Taking Xifaxan?
Xifaxan primarily works in the gut, and very little is absorbed into other areas of the body. This makes Xifaxan a well-tolerated medication, and most people have no trouble taking it. However, all medicines carry some risk.
Dietary changes can also help with diarrhea symptoms and ease other symptoms associated with IBS-D. These include:
Eating smaller mealsStaying away from high-fat meals and fried mealsIdentifying and avoiding your IBS trigger foods
There are other lifestyle adjustments you can make to stay healthy, such as:
Limiting alcohol consumptionReducing exposure to toxinsExercising and maintaining a healthy weightSeeing your healthcare provider regularly
Let your healthcare provider know if you experience any signs of a serious reaction, including swelling of the legs, arms, or belly. Reporting any adverse reactions as soon as they occur will help keep you healthy and safe while taking Xifaxan or any other medication.
