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Xifaxan (Rifaximin) is an antibiotic used primarily to treat traveler's diarrhea and irritable bowel syndrome with diarrhea (IBS-D). It works by stopping the growth of certain bacteria in the intestines. Unlike many antibiotics, Xifaxan is minimally absorbed into the bloodstream, focusing its effects in the gut. This targeted action reduces the risk of systemic side effects.

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Generic Xifaxan Information

Introduction

Xifaxan is an oral antibacterial medication whose active compound is rifaximin. It belongs to the antibacterial class and is manufactured by Salix Pharmaceuticals (part of Bausch Health). In the United Kingdom, Xifaxan is primarily prescribed for conditions that involve bacterial over‑growth in the gastrointestinal tract, such as traveller’s diarrhoea, hepatic encephalopathy and irritable bowel syndrome with diarrhoea (IBS‑D). The drug’s limited systemic absorption allows it to act locally within the gut while minimising systemic side effects.

What is Xifaxan?

Xifaxan is a tablet formulation that contains the single active ingredient rifaximin. Rifaximin is a semi‑synthetic, non‑systemic rifamycin antibiotic. The product is registered in the UK as a prescription‑only medicine (POM) and is supplied in 200 mg and 550 mg film‑coated tablets. The formulation also contains standard inactive excipients such as microcrystalline cellulose, lactose monohydrate, and magnesium stearate, which aid tablet integrity and disintegration.

How Xifaxan Works

Rifaximin inhibits bacterial RNA synthesis by binding to the β‑subunit of bacterial DNA‑dependent RNA polymerase. This binding blocks the initiation of transcription, thereby preventing bacterial protein production and leading to cell death. Because the molecule is poorly absorbed (<.5 % of the oral dose reaches the systemic circulation), therapeutic concentrations are achieved directly in the intestinal lumen where pathogenic bacteria reside. The rapid onset of actiontypically within a few hours after ingestion—correlates with the drug’s high local concentration and its bactericidal effect. Clearance occurs mainly via the fecal route; the small amount that is absorbed is eliminated unchanged in the urine.

Conditions Treated with Xifaxan

  • Traveller’s Diarrhoea (TD) – Caused most frequently by Escherichia coli and other enteric pathogens. In the UK, an estimated 10 % of overseas travellers develop TD, leading to significant discomfort and potential dehydration. Rifaximin shortens the duration of symptoms and reduces the need for re‑hydration therapy.
  • Hepatic Encephalopathy (HE) – A neuropsychiatric complication of cirrhosis linked to gut‑derived ammonia. Approximately 30 % of UK patients with cirrhosis experience at least one episode of HE. By reducing ammonia‑producing intestinal bacteria, rifaximin lowers blood ammonia levels and decreases recurrence rates.
  • Irritable Bowel Syndrome with Diarrhoea (IBS‑D) – A functional gastrointestinal disorder affecting around 11 % of UK adults. Dysbiosis is a recognised contributor to IBS‑D symptoms. Clinical trials have shown that a 14‑day course of rifaximin improves stool consistency and abdominal pain without significant adverse effects.

These indications are supported by European Medicines Agency (EMA)‑approved labeling and large‑scale randomized controlled trials (e.g., the TARGET and HELP studies).

Who is Xifaxan For?

  • Adults with confirmed or suspected traveller’s diarrhoea after a short‑course of antibiotics when rapid symptom relief is desired.
  • Patients with cirrhosis who have experienced at least one episode of overt hepatic encephalopathy and are at risk of recurrence.
  • Individuals diagnosed with IBS‑D who have not responded adequately to dietary modification, fibre supplementation, or antispasmodic therapy.

Xifaxan is not recommended for:

  • Children and adolescents (safety and efficacy have not been established).
  • Patients with known hypersensitivity to rifaximin, rifamycin derivatives, or any tablet excipients.
  • Individuals with severe hepatic impairment (Child‑Pugh class C) where the minute systemic absorption may become clinically relevant.

Risks, Side Effects, and Interactions

Common

  • Nausea
  • Abdominal pain or cramping
  • Flatulence
  • Diarrhoea (paradoxical)

These events are usually mild, transient, and resolve without discontinuation of therapy.

Rare

  • Headache
  • Dizziness
  • Rash or mild pruritus

If a rash spreads or is accompanied by fever, medical advice should be sought.

Serious

  • Clostridioides difficile‑associated diarrhoea (CDAD) – Although rifaximin is poorly absorbed, disruption of normal colonic flora can precipitate CDAD in susceptible individuals.
  • Severe allergic reactions (anaphylaxis, angio‑edema) – Immediate emergency treatment is required.

Drug‑Drug Interactions

Rifaximin’s minimal systemic absorption means clinically relevant interactions are uncommon. However:

  • Contraceptive steroids: Some case reports suggest reduced effectiveness of combined oral contraceptives when taken with rifaximin; barrier methods are advised as a backup.
  • CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): No significant interaction has been demonstrated, but concurrent use should be monitored for unexpected gastrointestinal effects.
  • Warfarin: Rifaximin does not affect INR, but routine monitoring remains best practice when initiating any new medication.

Practical Use: Dosing, Missed Dose, Overdose

  • Traveller’s Diarrhoea: 200 mg three times daily for 3 days (total 600 mg/day).
  • Hepatic Encephalopathy: 550 mg twice daily (110 mg/day) on a continuous basis.
  • IBS‑D: 550 mg three times daily for 14 days (total 165 mg/day).

General Guidance

  • Tablets may be taken with or without food; however, taking them with a light meal can reduce occasional nausea.
  • Swallow tablets whole; do not chew or crush.

Missed Dose

If a dose is forgotten and the next scheduled dose is more than 12 hours away, take the missed tablet as soon as remembered. If it is near the time of the next dose, skip the missed tablet and continue the regular schedule. Doubling doses is not advised.

Overdose

Because systemic exposure is low, overdose rarely leads to severe toxicity. Reported symptoms include abdominal discomfort and loose stools. In the event of a suspected overdose, contact the UK Poisons Information Service (111) or seek emergency medical care.

Precautions

  • Avoid alcohol excess, as it may exacerbate hepatic encephalopathy.
  • Patients with severe renal impairment should be monitored, although dose adjustment is generally unnecessary.

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FAQ

  • Is Xifaxan approved for use in children in the UK?
    No, Xifaxan is not licensed for paediatric use. Safety and efficacy data have only been established in adult populations, and a healthcare professional should be consulted for alternative treatments for children.

  • Can Xifaxan be stored in a bathroom cabinet?
    The medication should be kept at room temperature (15‑25 °C) away from moisture and direct sunlight. A bathroom cabinet may be too humid, which could degrade the tablets over time.

  • What does a Xifaxan tablet look like?
    Xifaxan tablets are film‑coated, round, and typically white (200 mg) or pinkish‑orange (550 mg). They are scored to allow easy division if a lower dose is required under medical supervision.

  • Does rifaximin have any effect on liver function tests?
    Rifaximin is not metabolised by the liver and does not directly alter liver enzyme levels. However, in patients with advanced liver disease, clinicians may monitor hepatic panels more closely when initiating any new medication.

  • Are there differences between the UK and US formulations of rifaximin?
    The active ingredient is identical, but excipient composition may vary slightly to meet regional regulatory requirements. Both formulations deliver the same therapeutic dose and bio‑activity.

  • Can Xifaxan be taken while travelling internationally?
    Yes, Xifaxan is approved for traveller’s diarrhoea and can be carried in personal luggage. It should be kept in its original packaging, with a copy of the prescription or a physician’s note if required by customs.

  • Is it safe to use Xifaxan together with probiotic supplements?
    Probiotics are not contraindicated. They may help restore normal gut flora after antibiotic therapy, but patients should discuss timing with a clinician to avoid potential antagonism.

  • What are the regulatory requirements for importing Xifaxan for personal use in the UK?
    TheRA allows individuals to import a three‑month supply of a prescription‑only medication for personal use, provided a valid UK prescription is presented. Our online pharmacy offers documentation that complies with these regulations.

  • Does rifaximin cross the blood‑brain barrier?
    Systemic absorption of rifaximin is less than .5 %, and the drug does not cross the blood‑brain barrier in clinically relevant amounts. Neurological side effects are therefore rare.

  • How long does it take for Xifaxan to clear from the body after the final dose?
    The majority of rifaximin is excreted unchanged in the feces within 24 hours. Any absorbed fraction is eliminated via the kidneys, with a terminal half‑life of approximately 2 hours.

  • Are there any specific warnings for patients of Asian ethnicity?
    No ethnicity‑specific contraindications are listed in the product information. However, clinicians may consider genetic variations in drug‑metabolising enzymes when prescribing concomitant systemic medications.

Glossary

Rifaximin
A semi‑synthetic antibiotic of the rifamycin class that acts locally in the gastrointestinal tract by inhibiting bacterial RNA polymerase.
Hepatic Encephalopathy
A neuropsychiatric syndrome caused by the accumulation of neurotoxins (primarily ammonia) in patients with advanced liver disease.
Irritable Bowel Syndrome with Diarrhoea (IBS‑D)
A functional bowel disorder characterised by recurrent abdominal pain and loose stools, without identifiable structural disease.
Systemic Absorption
The process by which a drug enters the bloodstream and is distributed throughout the body, as opposed to acting locally at the site of administration.

⚠️ Disclaimer

The information provided about Xifaxan is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Xifaxan for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.

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