rifiximin
rifiximin
Pharmacologic class: Rifampin-related antibiotic
Therapeutic class: Anti-infective
Pregnancy risk category C
Action
Binds to beta-subunit of bacterial DNA-dependent RNA polymerase, inhibiting bacterial RNA synthesis
Availability
Tablets: 200 mg, 550 mg
Indications and dosages
➣ Travelers' diarrhea caused by noninvasive strains of Escherichia coli
Adults and children age 12 and older: 200 mg P.O. three times daily for 3 days
➣ Reduction of risk of overt hepatic encephalopathy recurrence
Adults: 550 mg P.O. b.i.d.
Off-label uses
• Hepatic encephalopathy
Contraindications
• Hypersensitivity to drug, its components, or rifamycin anti-infectives
Precautions
Use cautiously in:
• elderly patients
• pregnant or breastfeeding patients
• children (safety and efficacy not established in those younger than age 12).
Administration
• Administer with or without food.
• Don't give to patients with diarrhea complicated by fever or blood in stool or to patients with suspected Campylobacter jejuni, Shigella, or Salmonella infection.
Adverse reactions
CNS: headache
GI: nausea, vomiting, constipation, flatulence, abdominal pain, rectal tenesmus, defecation urgency, pseudomembranous colitis
Other: pyrexia, overgrowth of susceptible organisms
Interactions
None
Patient monitoring
• Monitor for fever, blood in stools, and worsening of diarrhea.
• Monitor patient's fluid and electrolyte status.
• Monitor for new infections; if needed, consider alternative therapy.
Patient teaching
• Tell patient drug can be taken with or without food.
See Advise patient to stop drug and notify prescriber if diarrhea symptoms worsen or last beyond 48 hours.
• As appropriate, review all other significant or life-threatening adverse reactions.