Rifaximin

(Xifaxan®)

Rifaximin

Drug updated on 11/4/2024

Dosage FormTablet (oral; 200 mg, 550 mg)
Drug ClassRifamycin antibacterials
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of travelers diarrhea (TD) caused by noninvasive strains of Escherichia coli in adult and pediatric patients 12 years of age and older
  • Indicated for reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults
  • Indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

Latest News

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Summary
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  • This summary is based on the review of 16 systematic review(s)/meta-analysis(es). [1-16]
  • Travelers' Diarrhea (TD): Rifaximin showed a lower incidence of TD compared to placebo, vaccines, and probiotics, with high confidence in effectiveness over other treatments. Bismuth subsalicylate (BSS) was effective but associated with a higher rate of adverse events. Rifaximin had a lower adverse event rate compared to BSS.
  • Hepatic Encephalopathy (HE): Rifaximin significantly reduced the incidence in primary prevention (OR: 0.66), lowered recurrence in secondary prevention (OR: 0.38), and reduced progression to overt HE in minimal HE (OR: 0.17), though it did not significantly reduce mortality. Combination with lactulose further reduced HE occurrence and mortality compared to lactulose alone. Rifaximin did not increase the risk of adverse effects (OR: 0.96), and combination therapy with lactulose was associated with a lower risk of serious adverse events compared to lactulose alone.
  • Irritable Bowel Syndrome (IBS): Rifaximin provided symptom relief, particularly for abdominal distension, with no significant differences in adverse effects compared to control.
  • Small Intestinal Bacterial Overgrowth (SIBO) in Systemic Sclerosis (SSc): Rifaximin was more effective than rotating antibiotics for SIBO eradication in SSc patients.
  • There is no population types or subgroups information available in the reviewed studies.

Product Monograph / Prescribing Information

Document TitleYearSource
Xifaxan (rifaximin) Prescribing Information.2023Salix Pharmaceuticals, Bridgewater, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Bismuth subsalicylate, probiotics, rifaximin and vaccines for the prevention of travelers' diarrhea: a systematic review and network meta-analysis2024Frontiers in Pharmacology
Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential application dosages and strategies: a network meta-analysis2024Bmc Gastroenterology
Efficacy of Rifaximin in Patients With Abdominal Bloating or Distension: A Systematic Review and Meta-analysis2024Journal of Clinical Gastroenterology
Effectiveness of Rifaximin on the Outcomes of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials2023Cureus
Primary prevention of hepatic encephalopathy post-TIPS: A systematic review and meta-analysis2023Medicine
Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis2023The Cochrane Database of Systematic Reviews
Efficacy and Safety of Rifaximin in the Prevention of Recurrent Episodes of Hepatic Encephalopathy: A Systematic Review and Meta-analysis2023The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society
Small Intestinal Bacterial Overgrowth Complicating Gastrointestinal Manifestations of Systemic Sclerosis: A Systematic Review and Meta-analysis2023Journal of Neurogastroenterology and Motility
Comparative Efficacy of Treatment Options for the Prevention of Post-TIPS Hepatic Encephalopathy: A Systematic Review and Network Meta-analysis2023Journal of Gastrointestinal and Liver Diseases : Jgld
Systematic Review and Meta-Analysis on the Effects of Lactulose and Rifaximin on Patient-Reported Outcomes in Hepatic Encephalopathy2023The American Journal of Gastroenterology
Probiotics and rifaximin for the prevention of travelers' diarrhea: A systematic review and network meta-analysis2022Medicine
Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review - Are They Potential Eradication Regimens?2022Infection and Drug Resistance
Combination therapy with rifaximin and lactulose in hepatic encephalopathy: A systematic review and meta-analysis2022Plos One
Is rifaximin better than nonabsorbable disaccharides in hepatic encephalopathy?: A meta-analysis2021Medicine
Effect of poorly absorbable antibiotics on hepatic venous pressure gradient in cirrhosis: A systematic review and meta-analysis2020Digestive and Liver Disease : Official Journal of the Italian Society of
Comparative Efficacy of Treatment Options for Minimal Hepatic Encephalopathy: A Systematic Review and Network Meta-Analysis2020Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal

Clinical Practice Guidelines