section name header

Pronunciation ⬇

ri-FAX-i-min

Classifications ⬆ ⬇

Therapeutic Classification: anti-infectives

Pharmacologic Classification: rifamycins

Indications ⬆ ⬇

REMS

Action ⬆ ⬇

  • Inhibits bacterial RNA synthesis by binding to bacterial DNA-dependent RNA polymerase.
Therapeutic effects:
  • Decreased severity of travelers’ diarrhea.
  • Decreased episodes of overt hepatic encephalopathy.
  • Decreased signs/symptoms of irritable bowel syndrome with diarrhea.

Spectrum:

Pharmacokinetics ⬆ ⬇

Absorption: Poorly absorbed (<0.4%); action is primarily in GI tract.

Distribution: 80–90% concentrated in gut.

Metabolism/Excretion: Almost exclusively excreted unchanged in feces.

Half-Life: 6 hr.

Time/Action Profile ⬆ ⬇

ROUTEONSETPEAKDURATION
POunknownunknownunknown



Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: peripheral edema

GI: CLOSTRIDIOIDES DIFFICILE-­ASSOCIATED DIARRHEA (CDAD)

Neuro: dizziness

Interactions ⬆ ⬇

Drug-drug:

Route/Dosage ⬆ ⬇

Travelers’ Diarrhea

Hepatic Encephalopathy

Irritable Bowel Syndrome With Diarrhea

Availability ⬆ ⬇

(Generic available)
  • Tablets: 200 mg; 550 mg

Assessment ⬆ ⬇

  • Traveler’s Diarrhea: Assess frequency and consistency of stools and bowel sounds before and during therapy.
  • Assess fluid and electrolyte balance and skin turgor for dehydration.
  • Hepatic Encephalopathy: Assess mental status periodically during therapy.
  • Irritable Bowel Syndrome With Diarrhea: Assess frequency and consistency of stools and other irritable bowel syndrome symptoms (bloating, cramping) daily.
  • Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care provider promptly as a sign of CDAD. May begin up to several weeks following cessation of therapy.

Lab Test Considerations:

Implementation ⬆ ⬇

  • Do not confuse rifaximin with rifampin.
  • PO: Administer with or without food.

Patient/Family Teaching ⬆ ⬇

  • Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Instruct patient to take as directed and to complete therapy, even if feeling better.
  • Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
  • Advise patient to stop taking rifaximin if diarrhea symptoms get worse, persist >24–48 hr, or are accompanied by fever or blood in the stool. Consult health care provider if these occur. Advise patient not to treat diarrhea without consulting health care provider. May occur up to several weeks after discontinuation of medication.
  • May cause dizziness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
  • Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

  • Decreased severity of travelers’ diarrhea.
  • Decreased episodes of overt hepatic encephalopathy.
  • Decreased signs/symptoms of irritable bowel syndrome with diarrhea.

US Brand Names ⬆ ⬇

Xifaxan

Canadian Brand Names ⬆

Zaxine