What foods to avoid while taking Xifaxan

Xifaxan is an antibacterial prescription drug recommended by the American College of Gastroenterology. It’s the most popular medication used for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

While there are no specific foods that you must avoid while taking Xifaxan, there are certain recommendations you can follow that are suggested for people with irritable bowel syndrome (IBS) and traveler’s diarrhea.

Digestion and food triggers are different from person to person. Some people with IBS can tolerate some foods that others cannot. It’s recommended to get to know your body and learn which foods make you feel good and limit the foods that cause uncomfortable symptoms. You may consider keeping a food and symptom diary to help you identify which foods you should be eating and avoiding.

What is Xifaxan (rifaximin)?

Xifaxan is an FDA-approved prescription drug manufactured by Salix Pharmaceuticals and is used for the treatment of the following medical conditions:

  • irritable bowel syndrome with diarrhea (IBS-D) in adults
  • traveler’s diarrhea caused by Escherichia coli (E. coli) in adults and children who are at least 12 years old
  • hepatic encephalopathy by stopping the growth of bacteria that produce toxins and that could potentially worsen liver disease, and lower the risk of a decline in brain function in adults with liver failure

The active ingredient in Xifaxam is rifaximin. Rifaximin is in a class of drugs called antibiotics (antibacterial medications) that fights bacteria in the intestines. It comes in tablet form for oral administration and can be taken with or without food.

Xifaxan requires adherence to the prescribed dosing schedule. Missing doses of this medication will not only reduce the effectiveness of the antibiotic treatment but will also increase the risk of bacteria becoming resistant to drug treatment. If a dose of this medication is missed, take it as soon as possible. Do not take two doses at the same time. If it is near the time of the next dose, skip the missed dose.

Xifaxan can also be used to relieve bloating from health conditions such as small intestinal bacterial overgrowth (SIBO). Unlike the large intestine (also known as the colon or gut), which has most of your gut bacteria, the small intestine should not contain large amounts of bacteria.

What are the most common side effects of Xifaxan?

The most common side effects of Xifaxan in clinical trials, when used for the treatment of IBS-D, are nausea and an increase in liver enzymes. Constipation was only observed in around 0.5% of people who took Xifaxan.

Other common side effects of Xarelto include swelling in your hands or feet, dizziness, headache, tiredness, or abnormal liver function tests.

Xifaxan may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) as a result of a type of resistant bacteria.

With antibiotics like Xifaxan, there is a chance you could experience diarrhea caused by an overgrowth of bacteria that may cause symptoms that range in severity from mild diarrhea to life-threatening colitis.

If you have very watery diarrhea several times a day, cramping, bad stomach pains, fast heart rate, fever, nausea, or blood in your stool, call your healthcare provider right away.

If you experience any of these side effects or experience an allergic reaction when taking Xifaxan, call your healthcare professional or seek emergency medical attention right away.

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What foods should I avoid while on Xifaxan?

While there are no specific foods that you cannot eat while taking Xifaxan, people with IBS are advised to avoid:

  • Insoluble fiber, such as whole grains, vegetables and some fruit (apples, cherries, pears and peaches)
  • Gluten, such as rye, wheat and barley
  • Dairy products, such as milk, yogurt and ice ream
  • Fried foods
  • Beans and legumes
  • Caffeinated drinks, such as coffee, sodas, and energy drinks
  • Processed foods, such as chips, premade frozen meals, deep-fried foods and processed meats
  • Sugar-free sweeteners, which are commonly included in sugarless candy, gum, mouthwash and diet drinks
  • Wheat-based products such as cereal, bread and crackers
  • Chocolate
  • Alcohol
  • Garlic and onions
  • Broccoli and cauliflower

People with traveler’s diarrhea are advised not to eat:

  • Unpeeled or unwashed fruits and vegetables
  • Raw leafy vegetables, such as lettuce, spinach and cabbage
  • Raw or rare meats
  • Uncooked or undercooked shellfish

If you have any questions about what foods to avoid while on Xifaxan, get medical advice from your healthcare professional or speak to a dietitian about setting up a diet plan that is right for you.

What are the best foods to eat with Xifaxan?

While there are no specific foods that you need to eat with Xifaxan, people with IBS and SIBO are recommended to follow a low FODMAP diet that includes:

  • Eggs and meat
  • Fish
  • Certain cheeses such as brie, cheddar and feta
  • Almond milk
  • Grains like rice, oats, cornmeal and quinoa
  • Vegetables like eggplant, tomatoes, potatoes, cucumbers and zucchini
  • Fruits such as oranges, grapes, bananas, blueberries, kiwi, strawberries, and pineapple
  • Firm and medium tofu
  • Pumpkin seeds, sunflower seeds and sesame seeds

In general, any foods that don’t contain carbohydrates (carbs) or are low in FODMAPS are suggested in this diet.

Who can take Xifaxan?

Do not take Xifaxan if you are allergic to rifaximin, any of the rifamycin antimicrobial agents, any of the components in Xifaxan, or medications such as rifabutin (Mycobutin), rifampin (Rifater, Rifadin, Rifamate), or rifapentine (Priftin).

Before you take Xifaxan, tell your doctor if you have severe liver disease, diarrhea with fever, or diarrhea that is watery or has blood in it.

If you are pregnant or planning on becoming pregnant, or breastfeeding, speak with your healthcare provider before taking Xifaxan as the medication may cause harm to a nursing infant or unborn baby.

Speak with your healthcare provider before taking this medication if you have a severe hepatic (liver) impairment, as this may cause increased effects of the medicine.

Can I take Xifaxan with other medications?

Tell your doctor if you are currently taking any medications called P-glycoprotein and/or OATPs inhibitors (such as cyclosporine) because taking these drugs with Xifaxan could lead to an increased amount of Xifaxan absorbed by your body.

Xifaxan can also affect warfarin activity when taken together. Tell your doctor if you are taking warfarin as well, because the prescribed dose of warfarin may need to be adjusted in order to maintain the correct blood-thinning effect.

Speak with your doctor about any possible drug interactions with Xifaxan and the other medications, over-the-counter products, supplements and herbal products you are taking.

The treatment with Xifaxan followed by probiotics has shown to reduce the urinary and gastrointestinal symptoms with good compliance.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.

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Sources (7)

  1. Xifaxan - official website

  2. Medlineplus - rifaximin

  3. National Library of Medicine - Symptom Severity Following Rifaximin and the Probiotic VSL#3 in Patients with Chronic Pelvic Pain Syndrome (Due to Inflammatory Prostatitis) Plus Irritable Bowel Syndrome

  4. Drugs.com - Xifaxan

  5. Healthline - 12 foods to avoid with IBS

  6. Hopkins Medicine - FODMAP diet - what you need to know

  7. Medlineplus - Traveler’s diarrhea diet

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.