Summary

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• Aemcolo (rifamycin) is indicated for the treatment of travelers’ diarrhea caused by non-invasive strains of Escherichia coli in adults.
• This summary is based on the review of two systematic review(s)/meta-analysis(es). ^[1-2]
• Coadministration of rifampin with warfarin led to a reduction in warfarin AUC by 15%-74%, necessitating warfarin dose increases of 3-5 times to maintain therapeutic coagulation parameters.
• Rifampin reduced the AUC of direct oral anticoagulants (DOACs) by 20%-67%, indicating a significant reduction in their effectiveness.
• The effectiveness of antiplatelet agents varied with rifampin: clopidogrel's active metabolite increased significantly, while ticagrelor's effectiveness decreased, and prasugrel remained largely unaffected.
• The primary safety concern is the interaction between rifamycins and anticoagulant/antiplatelet (AC/AP) agents, which may lead to risks of thrombosis or bleeding due to changes in drug concentration and efficacy.
• Significant safety risks include the need for dose adjustments of warfarin when coadministered with rifampin, the potential for under-anticoagulation with direct oral anticoagulants (DOACs), and an increased risk of bleeding with clopidogrel due to increased metabolite concentrations.
• There is no population types or subgroups information available in the reviewed studies.