Rifaximin
About
Rifaximin belongs to the group of medicines called 'antibiotics' or 'antibacterials' used to treat infectious traveller's diarrhoea (in adults and children above 12 years of age) caused by E.coli bacteria, hepatic encephalopathy (decreased brain function due to liver disease) and irritable bowel syndrome with diarrhoea (IBS-D). Traveller’s diarrhoea is an infection in which there is a passage of unformed stools. Hepatic encephalopathy causes loss of brain function when a damaged liver is unable to remove toxins from the blood. Irritable bowel syndrome is a condition which affects the large intestine.
Rifaximin contains ‘Rifaximin’ that works by working on the bowel and preventing the spread of infections caused due to the loss of the beneficial gut bacteria. Thus, Rifaximin helps in relieving abdominal pain and diarrhoea. Rifaximin should not be used in the patients with diarrhoea complicated by fever or blood in the stool and diarrhoea due to pathogens other than Escherichia coli (E.coli).
Take Rifaximin with or without food. In some cases, you may experience certain common side-effects such as headache, peripheral oedema (leg swelling), nausea, dizziness, fatigue, ascites (excess fluid build-up in the abdomen), increased liver enzymes (ALT), and nausea. Most of these side-effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side-effects persistently.
Before starting Rifaximin, please inform your doctor if you have any allergy (against any antibiotic), kidney or liver problems. Do not take Rifaximin for more than 3 days unless prescribed; if there is no symptomatic improvement, consult your doctor. Avoid taking Rifaximin if you are pregnant or breastfeeding; talk to your doctor, he/she may prescribe you alternate medicine. Rifaximin is not recommended for children as efficacy and safety have not been established. Inform your doctor about all the medicines you are taking and about your health condition to rule out any unpleasant side-effects.
Uses of Rifaximin
Medicinal Benefits
Rifaximin belongs to the group of medicines called antibiotics used to treat infectious travellers diarrhoea, hepatic encephalopathy (decrease in brain function due to liver disease) and irritable bowel syndrome (IBS). Rifaximin is used to treat traveller’s diarrhoea caused by non-invasive strains of E.coli. Rifaximin is a broad-spectrum antibiotic that is effective against gram-positive and gram-negative bacteria, aerobic and anaerobic bacteria, and ammonia producing bacteria. Rifaximin is a gastrointestinal-selective antibiotic with a broad spectrum of antimicrobial activity. Rifaximin is bactericidal in nature and works by killing the bacteria that cause infections. Thereby, helps in treating and preventing the spread of infections.
Directions for Use
Storage
Side Effects of Rifaximin
- Headache
- Peripheral oedema (leg swelling)
- Nausea
- Dizziness
- Fatigue
- Ascites (excess fluid build-up in the abdomen)
- Increased liver enzymes (ALT)
In-Depth Precautions and Warning
Drug Warnings
Do not take Rifaximin if you are allergic to any of its contents, if you have a fever, blood in stools, passed 8 or more unformed stools in last 24 hours, constipation, vomiting, and abdominal pain caused by blockage of the bowel. Talk to your doctor if your condition does not improve, symptoms continue or re-appear even after taking Rifaximin for 3 days. Do not take Rifaximin for more than 3 days unless prescribed; if there is no symptomatic improvement, consult your doctor. Avoid taking Rifaximin if you are pregnant or breastfeeding; talk to your doctor, he/she may prescribe you with alternate medicine. Rifaximin is not recommended for children below 12 years of age as the efficacy and safety have not been established. Inform your doctor about all the medicines you are taking and about your health condition to rule out any unpleasant side-effects. Patients with liver complications should avoid taking Rifaximin or consult a doctor before using Rifaximin.
Drug Interactions
Drug-Drug Interactions: Rifaximin may interact with the immune system affecting drugs (cyclosporine) and blood thinners (warfarin).
Drug-Food Interactions: No interactions found/established.
Drug-Disease Interactions: Rifaximin should not be taken by the people with colitis (inflammation in the lining of the colon), liver disease and diahhorea caused by other than E coli bacteria.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionPlease consult your doctor as it is not known whether alcohol affects the working of Rifaximin. However, you are advised to limit or avoid alcohol consumption to prevent unpleasant side-effects.
Pregnancy
cautionIt is not recommended to take Rifaximin while you are pregnant. Please consult your doctor if you have any concerns regarding this, your doctor will decide whether Rifaximin can be given to pregnant women or not.
Breast Feeding
cautionPlease consult your doctor if you have any concerns regarding this, your doctor will decide whether Rifaximin can be given to breastfeeding mothers or not.
Driving
safe if prescribedRifaximin does not affect your ability to drive. However, do not drive or operate heavy machinery if you feel dizzy.
Liver
cautionPlease consult your doctor if you have any concerns regarding this or if you have liver impairment/liver disease before taking Rifaximin.
Kidney
cautionPlease consult your doctor if you have any concerns regarding this or if you have kidney impairment/kidney disease before taking Rifaximin.
Children
unsafeRifaximin should not be used by children, as the efficacy and safety have not been established.
Habit Forming
Diet & Lifestyle Advise
- Antibiotics can alter the useful bacteria in the stomach, which help indigestion. Therefore, you are advised to take foods rich in probiotics such as yoghurt/curd, kefir, sauerkraut, tempeh, kimchi, miso, kombucha, buttermilk, natto and cheese.
- Eat fibre rich food like whole grains, beans, lentils, berries, broccoli, peas and bananas.
- Avoid foods rich in calcium, grapefruit and grapefruit juice as they might hinder the absorption of antibiotics.
- Avoid consumption of alcohol to treat your condition effectively.
- Avoid usage of tobacco.
Special Advise
- Prolonged intake of Rifaximin may cause diarrhoea caused by an overgrowth of bacteria known as C. difficile. This can cause mild to severe diarrhoea to life-threatening colitis (colon inflammation).
- Monitor bleeding time parameters like INR and prothrombin time while using Rifaximin.
Patients Concern
Disease/Condition Glossary
Traveller’s diarrhoea: It is an intestinal infection in which there is the passage of unformed stools due to eating or drinking contaminated food or water while travelling. Symptoms include nausea, vomiting, bloating, fever, gas, loss of appetite, and the urgent need to poop.
Hepatic/liver encephalopathy: It is a decrease in brain function due to liver disease. The liver cannot remove toxins from the body adequately, which results in a buildup of toxins in the blood, thereby leads to brain damage. Symptoms include confusion, forgetfulness, difficulty thinking, low concentration, personality changes, and problems with small hand movements.
Irritable bowel syndrome (IBS): It is a condition which affects the large intestine. Symptoms include abdominal pain, cramps, gas, constipation, and diarrhoea.
FAQs
Rifaximin is bactericidal in nature and works by killing the harmful bacteria that cause infections in the gut or intestine like E coli bacteria. Thereby, helps in treating/preventing the spread of infections and diarrhoea with abdominal pain.
It is recommended to complete the course of Rifaximin even if you feel better as it is an antibiotic, and leaving it in between may lead to even severe infection that will, in fact, stop responding to the antibiotic as well (antibiotic resistance).
Do not take Rifaximin on your own as self-medication may lead to antibiotic-resistance in which antibiotics fail to act against specific bacterial infections. Take Rifaximin only if prescribed by a doctor.
Rifaximin may affect blood tests and liver function tests with increased liver enzymes. Inform the person or doctor before performing the tests that you are taking Rifaximin.
For treating traveller’s diarrhoea, Rifaximin is generally prescribed for 3 days. For irritable bowel syndrome, Rifaximin is prescribed for 14 days. However, it is better to take Rifaximin only as prescribed by your doctor.
No, Rifaximin may affect the activity and working of warfarin when taken together. So tell your doctor before using Rifaximin that you are taking a blood thinner (warfarin). Your doctor might adjust the dose of warfarin to maintain the proper blood-thinning effect and prevent drug interaction.
