RIFAXIMIN

RIFAXIMIN (ri-fax'i-min) Xifaxan Classifications: rifamycin antibiotic; Therapeutic: antibiotic Prototype: Rifampin Pregnancy Category: C

Availability

200 mg tablets

Action

A rifamycin antibiotic structurally related to rifampin. Inhibits bacterial RNA synthesis by binding to DNA-dependent RNA polymerase, thereby blocking RNA transcription.

Therapeutic Effect

Its spectrum of activity includes gram-positive and gram-negative aerobes and anaerobes.

Uses

Treatment of traveler's diarrhea cause by noninvasive strains of E. coli.

Contraindications

Hypersensitivity to rifaximin, other rifamycin antimicrobial agents or to any of its components; ulcerative intestinal disease; dysentery; children <12 y; pregnancy (category C); lactation.

Cautious Use

Diarrhea with fever and/or blood in the stool, or diarrhea due to organisms other than E. coli; worsening diarrhea or diarrhea persisting for >24–48 h.

Route & Dosage

Traveler's Diarrhea Adult: PO 200 mg t.i.d. for 3 d

Administration

Oral

• May be given without regard to food.
• Store at 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

Body as a Whole: Fever. CNS: Headache. GI: Flatulence, abdominal pain, rectal tenesmus, defecation urgency, nausea, constipation, vomiting.

Pharmacokinetics

Absorption: <0.4% absorbed orally. Peak: 1.21 h. Elimination: In feces. Half-Life: 5.85 h.

Nursing Implications

Assessment & Drug Effects

• Withhold drug and notify physician if symptoms worsen or last >48 h after starting drug; an alternative treatment should be considered.
• Report promptly the appearance of blood in the stool.

Patient & Family Education

• Report promptly any of the following: fever; difficulty breathing; skin rash, itching, or hives; worsening diarrhea during or after treatment or blood in the stool.

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Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug