Xifaxan (rifaximin) is a rifamycin antibiotic. It's used to treat people 12 years and older with travelers' diarrhea caused by Escherichia coli (E. coli). It can also treat irritable bowel syndrome with diarrhea (IBS-D) in adults. In addition, this medication can help prevent hepatic encephalopathy (HE) in adults. Xifaxan (rifaximin) is a tablet that's taken by mouth a few times per day. Side effects generally include swelling, dizziness, and fatigue.
Xifaxan (rifaximin) is a rifamycin antibiotic. It works by stopping bacteria in your gut from making the proteins they need to live. This lessens the amount of bacteria in your body.
Depending on why you're taking Xifaxan (rifaximin), the medication helps your body in different ways.
| Common Brands | Xifaxan |
|---|---|
| Drug Class | Rifamycin antibiotic |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Travelers' diarrhea:
IBS-D:
HE:
HE:
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Black, tarry stools
dizziness or lightheadedness
rapid breathing
shortness of breath
trouble sleeping
Less common
Blood in the urine
bloody nose
continuing ringing or buzzing or other unexplained noise in the ears
fainting
feeling of constant movement of self or surroundings
increased heart rate
sensation of spinning
sunken eyes
ulcers, sores, or white spots in the mouth
unusual bleeding or bruising
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bloated
difficulty with moving
excess air or gas in the stomach or intestines
frequent urge to defecate
full feeling
headache
lower back or side pain
muscle pain or stiffness
pain in the joints
passing gas
stomach pain
straining while passing stool
swelling of the hands, ankles, feet, or lower legs
Less common
Abnormal dreams
blurred vision
chills
confusion
decreased urination
difficulty having a bowel movement (stool)
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
dry lips
ear pain
feeling of warmth
hearing loss
lightheadedness
loss of appetite
loss of taste
painful or difficult urination
pale skin
redness of the face, neck, arms, and occasionally, upper chest
sweating
swollen glands
thirst
vomiting
wrinkled skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Xifaxan (rifaximin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Xifaxan (rifaximin) only works to treat travelers' diarrhea caused by a specific type of bacteria called E. coli. This is the most common cause, but other germs can also cause this type of diarrhea. Xifaxan (rifaximin) doesn't work against other germs, so it might not help in those cases.
If your diarrhea continues for more than 1 to 2 days or gets worse, stop taking Xifaxan (rifaximin) and get medical help. Also get urgent care right away if you have a fever or blood in your stool. These could be signs that you need a different medication or more medical attention.
Antibiotics including Xifaxan (rifaximin) can sometimes cause a Clostridioides difficile (C. diff) infection. This happens when antibiotics change the normal bacteria in your gut. This lets harmful bacteria called C. diff grow too much in the gut and cause diarrhea. This can be mild to serious to life-threatening. It can also happen over 2 months after stopping Xifaxan (rifaximin).
Diarrhea from a C. diff infection is a medical emergency. It can cause a fever, fast heartbeat, foul-smelling diarrhea, and frequent bowel movements (even up to 15 times a day). Get medical help right away if this happens while taking Xifaxan (rifaximin) or after you've stopped. C. diff-related diarrhea should get treated as soon as possible.
In studies, people with severe liver problems had higher levels of Xifaxan (rifaximin) in their body. It's not clear if this can raise the risk of side effects.
To be safe, tell your prescriber if you have liver problems, especially if they're severe. Your care team will monitor you more closely during treatment.
Certain medications can raise the level of Xifaxan (rifaximin) in your body. This might raise your risk of side effects. Some of these medications are cyclosporine (Gengraf, Neoral, Sandimmune), amiodarone (Pacerone), and carvedilol (Coreg).
Tell your prescriber and pharmacist about all the medications you take. They can check for these interactions and watch you more closely if needed.
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 200mg | 9 tablets | $119.24 | $13.25 |
| 550mg | 42 tablets | $2,717.43 | $64.70 |
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Xifaxan (rifaximin) will not be safe for you to take.
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Yes, Xifaxan is a rifamycin antibiotic. It stops bacteria from growing and spreading by preventing bacteria from making proteins they need to survive.
How long Xifaxan takes to work will depend on what medical condition you're using the medication for. Clinical studies show that people who took Xifaxan for travelers' diarrhea had improved symptoms within a day or two (32 hours). But people who took Xifaxan for HE or for IBS-D started to see improvement in their symptoms within a month of starting their treatment course. Speak with your prescriber if you have questions about how long you should expect Xifaxan to start working for you.
It takes a little more than a day (30 hours) for most of Xifaxan to leave the body after one dose. This time frame is based on the medication's half-life, which is a measure of the time it takes to get rid of the medication from the body. Since the liver helps break down and get rid of the medication from the body, Xifaxan might stay longer in the body if you have liver problems (i.e., your liver isn't working as well).
Side effects from Xifaxan, such as headache or nausea, can last for as long as it takes for the medication to clear from your body. This can be about a day after your last dose. It might also depend on what specific side effect you have. It's best to contact a healthcare professional to examine you if you have severe side effects or side effects from Xifaxan that aren't going away.
Alcohol doesn't appear to interact with Xifaxan. But you shouldn't drink alcohol while you're taking Xifaxan because it can worsen the medical condition you're using the medication to treat. For example, it's best to avoid alcohol while you're taking Xifaxan for hepatic encephalopathy (HE), or problems with brain function due to liver problems. Alcohol can also cause liver damage, and drinking alcohol with this medication while you're getting treated for HE can raise the risk that your liver problems get worse. Talk with your prescriber about your drinking habits and whether Xifaxan is an appropriate option for you.
The manufacturer doesn't say whether or not Xifaxan can be crushed. To be safe, don't crush Xifaxan tablets because it might affect how well the medication works. Let the prescriber or your pharmacist know if you're having trouble swallowing the tablets whole. Some studies show that it's possible for them to ask a compounding pharmacy to make a special suspension of the medication that you can drink.
Xifaxan isn't approved to treat small intestine bacterial overgrowth (SIBO) (too much bacteria growing in the small intestine that causes stomach upset). But a 2017 systematic review and meta-analysis found that Xifaxan was safe and worked well for treating of SIBO. This is considered an off-label use of Xifaxan since the medication isn't FDA approved for SIBO. Speak with your healthcare team about your treatment options if you have SIBO.
