RIFAXIMIN

Rifaximin is used for the treatment of diarrhea which is caused by a bacteria named E.coli. Rifaximin is an antibiotic which treats bacterial infections which cause diarrhea.

Generic Xifaxan

Rifaximin

Torfix, Rcifax, Rifagut, Rifaclean and other generic brands

10,100

Lupin, Torrent Pharma, Sun Pharma, Emcure Pharmaceuticals and others

Tablet

200 mg, 400 mg, 550 mg

India

RIFAXIMIN

I. Introduction

Brief Overview of Rifaximin

Rifaximin, an antibiotic that is partly made in a laboratory has quickly become a medication in the field of therapy. It is mainly used to treat disorders related to the system and holds a prominent position in modern pharmacology.

The Importance of Antibiotics in Healthcare

In today's healthcare landscape, antibiotics play a role in the treatment of bacterial infections. They not only reduce illness but also significantly lower mortality rates. The emergence of antibiotics such as rifaximin has revolutionized the field of science.

Scope of the Article

This article aims to provide an overview of rifaximin. It covers aspects such, as its chemical makeup, how it works, approved and off-label uses recommended dosages, and important considerations related to side effects and potential interactions.

II. Composition of Rifaximin

Active and Inactive Ingredients

The main component in this medication is rifaximin while other ingredients include colloidal silicon dioxide, disodium edetate, and microcrystalline cellulose.

Pharmaceutical Formulations

Rifaximin is mainly found in the form of tablets, which makes it easy to take and encourages patients to follow the treatment.

Bioavailability and Absorption

When compared to antibiotics rifaximin is absorbed very little by the body, which means it mainly works in a specific area. This special way that it behaves in the body makes it commonly used for treating problems related to the system.

III. How Rifaximin Works

Mechanism of Action

Rifaximin works by blocking the synthesis of RNA. It attaches to the RNA polymerase, which is responsible for transcribing DNA into RNA, and interrupts this process. As a result, it hinders the growth of bacteria.

The Role in Treating Gastrointestinal Infections

Regarding infections, rifaximin works effectively because it specifically targets and eliminates harmful bacteria without causing significant harm to the beneficial bacteria, in the gut.

Spectrum of Activity: What Organisms Are Affected

Rifaximin is effective against a range of bacteria, including both Gram positive and Gram negative aerobic and anaerobic bacteria. This broad effectiveness makes it useful, for treating gastrointestinal conditions.

IV. Approved Uses of Rifaximin

Treatment of Traveler’s Diarrhea

Rifaximin is a non-absorbed antibiotic used to treat travelers’ diarrhea caused by non-invasive strains of Escherichia coli (E. coli) in adults and children at least 12 years old 1234.

1: Rifaximin Uses, Side Effects & Warnings. Drugs.com. Link 2: Rifaximin (Xifaxan) for Traveler’s Diarrhea. American Family Physician. Link 3: FDA approves new drug to treat travelers’ diarrhea. FDA. Link 4: Travelers’ Diarrhea. Centers for Disease Control and Prevention. Link

Management of Hepatic Encephalopathy

Rifaximin is a non-absorbed antibiotic used to treat travelers’ diarrhea caused by non-invasive strains of Escherichia coli (E. coli) in adults and children at least 12 years old 1234.

In hepatic encephalopathy (HE), rifaximin reduces the colony count of ammonia-producing gut flora and decreases the systemic absorption of ammonia from the intestinal lumen 5Rifaximin has been shown to improve hyperammonemia and cognitive function in patients with liver disease who have recurrent HE 6.

1: Rifaximin Uses, Side Effects & Warnings. Drugs.com. Link 2: Rifaximin (Xifaxan) for Traveler’s Diarrhea. American Family Physician. Link 3: FDA approves new drug to treat travelers’ diarrhea. FDA. Link 4: Travelers’ Diarrhea. Centers for Disease Control and Prevention. Link 5: Guidelines for the Prescribing of Rifaximin for Hepatic Encephalopathy. Hull University Teaching Hospitals NHS Trust. Link 6: Rifaximin Modulates the Gut Microbiota to Prevent Hepatic Encephalopathy in Liver Cirrhosis Without Impacting the Resistome. Frontiers in Cellular and Infection Microbiology. Link

Treatment of Irritable Bowel Syndrome with Diarrhea (IBS-D)

Rifaximin is a non-absorbed antibiotic that has shown potential in alleviating symptoms for individuals with irritable bowel syndrome with diarrhea (IBS-D) by regulating the balance of bacteria in the gut and decreasing inflammation within the intestines 1234.

1: Rifaximin (Xifaxan) for Irritable Bowel Syndrome | AAFP. Link 2: Rifaximin (XIFAXAN) for Irritable Bowel Syndrome with Diarrhea. VA. Link 3: The efficacy and safety of rifaximin in adults with IBS-D was established in three multicenter, double-blind, placebo-controlled randomized clinical trials (RCTs).15 In addition, a dose-comparative, Phase IIb RCT provided further efficacy and safety data. Link 4: Rifaximin (XIFAXAN) in Symptomatic Small Intestinal Bacterial Overgrowth (SIBO) and Irritable Bowel Syndrome with Diarrhea (IBS-D). VA. Link

V. Off-Label Uses of Rifaximin

Small Intestinal Bacterial Overgrowth (SIBO)

Rifaximin is a minimally absorbed antibiotic with high luminal activity, used to treat various gastrointestinal diseases. Although rifaximin has been proposed as first line treatment for small intestinal bacterial overgrowth (SIBO), few data are available regarding its efficacy in non-IBS subjects 1Rifaximin is almost completely non-absorbable, which means it stays in the intestines, having a local action and doesn’t cause systemic side effects, such as urinary tract infections 22: Antibiotics - SIBO - Small Intestinal Bacterial Overgrowth. Link 1: Rifaximin for small intestinal bacterial overgrowth in non-IBS subjects: A prospective study. Link

Clostridium Difficile Infections

Rifaximin is a non-absorbed antibiotic that has shown promise in treating individuals with recurrent Clostridium difficile infections, especially in cases where the primary treatment has not been effective 12345.

1: Rifaximin Shows Promise in Patients With C Diff Infection That Does Not Respond to Metronidazole. Pharmacy Times. Link 2: Rifaximin Is Effective for Clostridium difficile-Associated Diarrhea: An Uncontrolled Pilot Study. Journal of Clinical Gastroenterology. Link 3: Rifaximin in the treatment of recurrent Clostridium difficile infection. Europe PMC. Link 4: Rifaximin Effective in Treating Non-Responsive C Difficile Infections. HCPLive. Link 5: Treatment issues in recurrent Clostridioides difficile infections and the possible role of germinants. FEMS Microbes. Link

Crohn’s Disease

Rifaximin, a non-absorbed antibiotic, has shown promise in treating Crohn’s disease 1234It has been suggested that rifaximin may help lower the amount and change the composition of bacteria in the intestines, which may relieve symptoms 1Rifaximin has been used to treat irritable bowel-like symptoms (diarrhea/bloating) in the setting of IBD in adults 5.

1: Rifaximin and Crohn’s Disease: A New Solution to an Old Problem? | SpringerLink. Link 5: RIFAXIMIN | Crohn’s & Colitis Foundation. Link 2: Rifaximin Shows Promise in Patients With C Diff Infection That Does Not Respond to Metronidazole. Pharmacy Times. Link 3: Rifaximin and Crohn’s disease - ResearchGate. Link 4: Therapeutic Role of Rifaximin in Inflammatory Bowel Disease: Clinical Implication of Human Pregnane X Receptor Activation. Journal of Pharmacology and Experimental Therapeutics. Link

Diverticulitis

Rifaximin, a non-absorbed antibiotic, has shown promise in treating Crohn’s disease 12 . It has been suggested that rifaximin may help lower the amount and change the composition of bacteria in the intestines, which may relieve symptoms 1Rifaximin has been used to treat irritable bowel-like symptoms (diarrhea/bloating) in the setting of IBD in adults 3.

Regarding diverticulitis, although there have been observations that indicate the effectiveness of rifaximin in treating diverticulitis, there is currently insufficient evidence to support its use 134.

1: Rifaximin and Crohn’s Disease: A New Solution to an Old Problem? | SpringerLink. Link 3: RIFAXIMIN | Crohn’s & Colitis Foundation. Link 4: Conservative Treatment of Acute Colonic Diverticulitis | Current Infectious Disease Reports. Springer. Link

VI. Dosage and Administration

Standard Dosing Guidelines

For traveler's diarrhea, take 200 mg three times a day for three days. For encephalopathy, the recommended dosage is 550 mg twice daily.

Administration Routes and Forms

Rifaximin is usually taken as a tablet by mouth. The medication is designed to endure stomach acid and break down in the intestines.

Adjustments for Specific Populations

Sometimes certain groups like children or older adults well as people with liver problems may require adjustments, to their medication dosage.

VII. Common Side Effects

Mild Side Effects: Nausea, Fatigue, etc.

  • Nausea
  • Fatigue
  • Abdominal pain

How to Manage Common Side Effects

Usually, mild side effects are temporary. Typically, they don't need any medical attention. You can try drinking plenty of fluids and taking, over-the-counter antacids to relieve the symptoms.

When to Consult a Healthcare Provider

If the side effects continue or worsen, it would be wise to seek treatment advice from a healthcare professional.

VIII. Serious Side Effects and Warnings

Severe Allergic Reactions

If you experience signs of anaphylaxis or skin reactions, it is crucial to seek immediate medical attention. In some situations, it is necessary to stop taking the medication right away.

Risk of Antibiotic Resistance

Excessive utilization could lead to the development of resistance, which can make future treatment more challenging.

Hepatic Impairment Concerns

Doctors should carefully evaluate the safety and effectiveness of rifaximin in patients with liver disease and cirrhosis.

IX. Drug Interactions with Rifaximin

Medications to Avoid

Using Rifaximin with certain medications like other antibiotics and anticoagulants can make side effects worse or reduce their effectiveness. Some examples of drugs include Warfarin, Cyclosporine, and certain antiretrovirals.

Interaction with Alcohol and Foods

It's essential to be cautious when drinking alcohol or consuming foods, such as grapefruit, while taking Rifaximin. These substances can sometimes have interactions, with the medication leading to gastrointestinal issues or impacting liver function.

Role of Liver Enzymes in Drug Interaction

The liver enzymes have an impact on how Rifaximin is broken down in the body, which can affect how it interacts with other drugs. Understanding the P450 system is essential for uncovering these interactions.

X. Contraindications and Careful Administration

Contraindications for Patients with Certain Conditions

Patients who have liver problems or are known to have an allergic reaction to rifamycin antimicrobial drugs should refrain from using Rifaximin.

Patients Requiring Special Consideration (Liver Diseases, Kidney Impairment)

It is crucial to monitor patients with liver diseases or renal insufficiency and make necessary adjustments, to their medication dosage if needed.

Risk-Benefit Analysis in Special Cases

It is crucial for healthcare professionals to carefully evaluate the risks and benefits for patients who have other medical conditions or are on multiple medications.

XI. Important Precautions

Avoiding Overuse

Excessive use of Rifaximin may lead to the development of resistance. It is crucial to follow the prescribed treatment plan.

Monitoring Liver Function

To ensure the safety and effectiveness of long-term treatment, it is recommended to monitor liver function due to its affinity for the liver.

Importance of Following Prescribed Dose

Not following the recommended dosage may reduce the effectiveness of the treatment. Increase the risk of experiencing adverse side effects.

XII. Administration to Special Populations

a. Administration to Elderly

Dose Adjustment and Precautions

Elderly patients might need to have their dosage adjusted. It is essential to keep an eye on their kidney function.

Monitoring for Side Effects

Older individuals are vulnerable to experiencing adverse effects from medication, particularly complications, in the gastrointestinal system.

b. Administration to Pregnant Women and Nursing Mothers

FDA Pregnancy Category

Rifaximin is classified as FDA Pregnancy Category C, which means that there is a possibility of risk to the fetus that cannot be completely ruled out.

Lactation Concerns

Nursing mothers should be careful as it is still uncertain if Rifaximin is passed into breast milk.

c. Administration to Children

Pediatric Dosage and Safety Profile

Pediatric dosage guidelines are still being developed, It is essential to approach them with caution.

XIII. Overdose and Its Management

Symptoms of Overdose

Symptoms can vary from experiencing gastrointestinal issues to liver damage.

Immediate Steps for Management

Seeking medical attention is crucial. It may be worth considering lavage as a potential option in addition to providing supportive care.

Long-term Consequences

There could be repercussions in the long run, such as harm to the liver and the development of antibiotic resistance.

XIV. Storage Guidelines for Rifaximin

Optimal Storage Conditions

Keep the product in a dry place, at average room temperature. Make sure to protect it from any moisture or heat sources.

Shelf Life

Usually, Rifaximin has a lifespan of two years starting from the manufacturing date.

Disposal Guidelines

It is important to follow regulations when disposing of tablets that have expired or are no longer being used.

XV. Handling Precautions

Safe Handling in Healthcare Settings

Healthcare professionals are expected to follow procedures when it comes to handling pharmaceuticals, which include the use of gloves.

Safety Precautions at Home

Please ensure that this product is kept away from children and pets to prevent ingestion.

What to Do in Case of Spills or Contamination

If there are any spills, it is essential to clean them up using the proper disinfectants to avoid any accidental exposure.

Rated: 5.0 / 5 based on 5.0 customer reviews.

Posted by Bob Mack on Jan 21, 2019 Verified Purchase

good product

product worked as advertised. good, fair & honest company to deal with. am a regular customer & will remain so.

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