Rifaximin is a non-aminoglycoside, semi-synthetic, non-systemic antibiotic derived from rifamycin. It acts by binding to the beta-subunit of bacterial DNA-dependent RNA polymerase, resulting in inhibition of bacterial RNA synthesis.
Due to its limited absorption, Rifaximin primarily exerts its effects within the gastrointestinal tract. It shows broad-spectrum bactericidal activity against a wide range of Gram-positive and Gram-negative, aerobic, and anaerobic bacteria.
Rifaximin is indicated for the treatment of:
Acute Infectious Diarrhea, including Travelers' Diarrhea
Diarrhea-predominant Irritable Bowel Syndrome (IBS-D)
Hepatic Encephalopathy (HE)
Rifaximin tablets can be administered orally with or without food.
Follow the prescribed dosage regimen as directed by a healthcare provider.
Rifaximin is contraindicated in patients with hypersensitivity to:
Rifaximin
Rifamycin antimicrobial agents
Any components of the tablet formulation
Renal Insufficiency:
The pharmacokinetics of Rifaximin in patients with impaired renal function have not been studied.
Hepatic Insufficiency:
No dosage adjustment is necessary due to its limited systemic absorption. However, caution is advised in patients with severe hepatic impairment.
While most individuals tolerate Rifaximin well, some may experience:
Dizziness
Gas
Headache
Nausea
Tiredness
Category C: Rifaximin should only be used during pregnancy if the potential benefits outweigh potential risks to the fetus.
Lactation:
It is unclear whether Rifaximin is excreted in human milk. A decision should be made to discontinue nursing or discontinue the drug, considering the drug's importance to the mother.
Children:
The safety and effectiveness of Rifaximin 200 mg in pediatric patients under 12 years for travelers’ diarrhea have not been established.
The safety and effectiveness of Rifaximin 550 mg for hepatic encephalopathy and IBS-D have not been established in patients under 18 years.
Adolescents:
Insufficient data exist to determine whether subjects aged 65 and over respond differently than younger individuals.
In vitro studies suggest potential interaction with cytochrome P450 (CYP3A4).
Clinical studies show Rifaximin does not significantly affect the pharmacokinetics of Midazolam or oral contraceptives containing ethinyl estradiol and norgestimate.
No significant drug interactions with human cytochrome P450 isozymes are expected.
Symptoms: At higher-than-recommended doses, adverse reactions were similar to those seen with placebo.
Management: Discontinue Rifaximin, treat symptomatically, and provide supportive care as required.
Store below 30°C in a dry place.
Protect from light.
