Tuesday August 22, 2006
Xifaxan (Rifaximin)

Rifaximin is in use in other countries since last 2 decades but has been approved by FDA in USA just couple of years ago. Rifaximin was invented initially in Italy for the treatment of travelers' diarrhea but quickly found its way for improvement in hepatic encephalopathy instead or beside lactulose and neomycin 1, 2,5,6,7. Some new studies showed that it may be more effective than lactulose 3 or neomycin 4.

Atleast one multi-center trial is underway 8, as well as other trials looking at Rifaximin's efficacy in Irritable Bowel Syndrome, Clostridium Difficile-Associated Diarrhea and Ulcerative Colitis 8.

Rifaximin is an oral, semi-synthetic, nonsystemic antibiotic. The recommended dosage in hepatic encephalopathy is 1200 mg a day in divided doses.


References: click to get abstract/article

1. Rifaximin in the treatment of chronic hepatic encephalopathy - Curr Med Res Opin. 1995;13(5):274-81.
2. Rifaximin, a non-absorbable rifamycin, for the treatment of hepatic encephalopathy. A double-blind, randomised trial. - Curr Med Res Opin. 1997;13(10):593-601.
3. Comparison of rifaximin and lactitol in the treatment of acute hepatic encephalopathy: results of a randomized, double-blind, double-dummy, controlled clinical trial - J Hepatol. 2003 Jan;38(1):51-8
4. Neomycin should not be used to treat hepatic encephalopathy - BMJ 2001;323:233 ( 28 July )
5. Management of Hepatic Encephalopathy: Role of Rifaximin - Chemotherapy 2005;51 (Suppl. 1):90-95
6. Evaluation of the efficacy and safety of rifaximin in the treatment of hepatic encephalopathy: a double-blind, randomized, dose-finding multi-centre study. Eur J Gastroenterol Hepatol 2000; 12: 203-208
7. Rifaximin, a nonabsorbed oral antibiotic, in the treatment of hepatic encephalopathy: antimicrobial activity, efficacy and safety. Reviews in Gastroenterological Disorders, 5 (Supplement 1). S10-S18.
8. Rifaximin trials - clinicaltrials.gov