What is Xifaxan Uses, warnings & interactions
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Xifaxan (rifaximin) is a prescription rifamycin antibacterial medication that is manufactured by Salix Pharmaceuticals. It was approved in 2004 by the U.S. Food and Drug Administration (FDA) to treat diarrhea due to irritable bowel syndrome (IBS-D) and diarrhea caused by the bacteria Escherichia coli (E. coli). It is also used to reduce certain complications from liver disease.
If your doctor has prescribed Xifaxan to you, you may want to know more about what it is and how it works. Here we’ll explain what Xifaxan is used for, how it works, its side effects, and more.
What is Xifaxan used for?
Xifaxan (rifaximin) is an antibiotic that is used for:
- Treatment of traveler’s diarrhea that is caused by E. coli in adults and pediatric patients 12 years of age and older.
- Prevention of hepatic encephalopathy in adults.
- Treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.
Xifaxan should not be used if you have diarrhea with fever, blood in your stool, or diarrhea from a bacteria other than E. coli.
How does Xifaxan work?
The active ingredient of Xifaxan, rifaximin, is a synthetic antibiotic that was derived from rifampin. Following oral administration, Xifaxan passes through your stomach without being absorbed into your bloodstream. It is only active in your gastrointestinal tract so it cannot be used for infections in other parts of your body. Xifaxan stops the growth of bacteria by blocking their ability to make certain proteins they need to survive.
What are the most commonly prescribed doses of Xifaxan?
- 200 mg tablet
- 550 mg tablet
Before taking Xifaxan
Before beginning Xifaxan, tell your healthcare provider about your medical conditions, including if you:
- have an allergy to Xifaxan, any rifamycin antimicrobial agents, or any of its inactive ingredients.
- have liver impairment.
- have diarrhea with fever or blood in your stool.
- are scheduled to receive any live bacterial vaccines.
- are pregnant or plan to become pregnant.
- are breastfeeding or plan to breastfeed.
How to take Xifaxan
- Read the Full Prescribing Information, Patient Information, and Medication Guide that comes with this medication.
- Use Xifaxan exactly as your doctor prescribes it to you. Do not change your dose without discussing it with them.
- Xifaxan is typically taken 2 to 3 times a day with or without food, depending on the condition being treated. You should not stop taking Xifaxan even if you start feeling better. Not finishing your treatment can cause your symptoms to return or lead to bacterial resistance.
- If you are taking Xifaxan to treat traveler’s diarrhea and your symptoms do not improve or if they worsen in the first 48 hours, call your doctor.
- Store Xifaxan at room temperature between 59°F and 77°F (15°C and 25°C) away from light and moisture.
You should not use Xifaxan if you are allergic to rifaximin, rifamycin antibiotics, or any other ingredients in Xifaxan.
- Antibiotics such as Xifaxan can cause a severe intestinal condition due to the bacteria Clostridium difficile (C. difficile). Symptoms can range from worsening diarrhea to life-threatening colitis. Notify your doctor if your diarrhea does not improve or gets worse after starting this medication.
- Xifaxan is not effective against traveler’s diarrhea caused by bacterial infections other than E. coli. If your symptoms don’t improve or get worse after 24 to 48 hours, call your doctor.
- Caution should be used if you have severe liver impairment (Child-Pugh Class C).
- The use of P-glycoprotein (P-gp) inhibitors such as cyclosporine can increase the amount of Xifaxan your body absorbs. Caution should be used if these medications are taken together.
Xifaxan drug interactions
When Xifaxan is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, supplements, and herbal products you take may interact with this medication, including:
Xifaxan side effects
The most common side effects of Xifaxan in clinical trials when compared to placebo include:
- Stomach pain
- Swelling in your hands and feet
- Increase in liver enzymes
Xifaxan can sometimes cause more serious side effects, including:
- Severe allergic reactions (hives, angioedema, and trouble breathing)
- Ascites (buildup of fluid in your stomach)
- Clostridium difficile-associated diarrhea
Contact your healthcare professional for medical advice about any possible side effects you experience while taking Xifaxan. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your healthcare professional can prescribe other medications for your condition if Xifaxan is not right for you. These other treatment options will vary by different factors such as the condition being treated, side effects and costs. Some FDA-approved alternatives to Xifaxan include:
- Lotronex (alosetron)
- Viberzi (eluxadoline)
- Cipro (ciprofloxacin)
- Aemcolo (rifamycin)
- Duphalac (lactulose)
- Zithromax (azithromycin)
Can you take Xifaxan while you are pregnant or breastfeeding?
Xifaxan is considered a pregnancy category C. There aren’t any controlled studies on the use of Xifaxan in pregnant women, but animal studies showed it may cause harm to your unborn baby. There is no data on whether this medication is found in breast milk or the effects it may have on your infant. You should only use Xifaxan if the benefits outweigh the risks. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
How does Xifaxan work for IBS-D?
It is thought that IBS-D could be due to an overgrowth or imbalance of gut bacteria. Xifaxan reduces symptoms of IBS-D by inhibiting the growth of bacteria in your gut.
Can I take Xifaxan again if my IBS-D symptoms come back?
After 2 weeks of Xifaxan, you can have up to 6 months of symptom relief from IBS-D. If your symptoms return, your doctor may choose to treat you again. You can be retreated 2 times if your IBS-D symptoms come back.
How long does it take Xifaxan to work?
The condition you are being treated for will determine how long it will take Xifaxan to work. The majority of people being treated for traveler’s diarrhea began to see improvements within 24 to 48 hours. A 2-week course of Xifaxan in a clinical trial showed 6 to 24 weeks of relief from symptoms of IBS-D such as abdominal pain and diarrhea. To reduce the risk of hepatic encephalopathy, Xifaxan will need to be taken long-term.
Will Xifaxan work for small intestinal bacterial overgrowth (SIBO)?
SIBO occurs when the normal bacteria in your intestines is disrupted. This can lead to symptoms such as diarrhea, stomach pain, and bloating. It is not understood what causes this to happen. Treatment for SIBO typically includes dietary changes and a 2-week course of Xifaxan.
What is the cost of Xifaxan?
The average cost for #42 of Xifaxan 550mg tablets is almost $2,300.
Is there a generic for Xifaxan?
Currently, there is no generic Xifaxan available on the market. However, you can still save on brand-name drugs like Xifaxan through NiceRx if eligible for assistance.