My daughter has been prescribed 55mg Xifaxan, but cannot swallow pills. Is it OK to crush the tablets and take it with food such as apple sauce?
Is it OK to crush a 550mg Xifaxan tablet for someone who cannot swallow any pills?
Question posted by fordaughter on 25 Dec 2014
Last updated on 6 September 2021 by asafta
Answers
asafta
6 Sep 2021
Oral Administration
Oral Solid Formulations
Rifaximin tablets may be taken with or without food.
Extemporaneous Compounding-Oral
Extemporaneous 20 mg/ml rifaximin oral suspension:
NOTE: Rifaximin oral suspension is not an FDA approved formulation.
With a mortar and pestle, crush six 200 mg rifaximin tablets into a fine powder.
Mix 30 ml Ora-Plus with either 30 ml Ora-Sweet or 30 ml Ora-Sweet Sugar Free and stir vigorously.
Levigate 30 ml of the Ora-Plus/Ora-Sweet mixture into the rifaximin powder via geometric dilution until a smooth suspension is formed.
Transfer the mixture into a 2 ounce amber plastic bottle.
Rinse the mortar with the remainder of the Ora-Plus/Ora-Sweet mixture and add to the amber plastic bottle to bring the final volume to 60 ml.
Shake well before each use. This suspension is stable 60 days at room temperature (23—25 degrees C).
kaismama
25 Dec 2014
It should not be crushed. What about putting the pill on a spoonful of applesauce? Could the patient swallow it that way?
fordaughter
25 Dec 2014
kaismama: unfortunately, the issue is an inability to swallow anything unchewed, so whole pills in applesauce and all other "tricks" for taking pills are not an option. The doc says the manufacturer just never tested the efficacy of crushing the pill first. Reading about Xifaxan indicates it has a low absorption rate into the blood stream, remaining more in the gut which is where it is targeted. Is there something about how it is supposed to work that indicates is shouldn't be crushed; or alternatively, anything that indicates adverse effects from taking it in crushed form?
Stephen Treloar
25 Dec 2014
It is not meant to be crushed as it has a coating that specifically enables it to pass through the stomach and into your lower digestive tract where it is active. The active ingredients might be neutralised, weakened or cause strange side effects if allowed to mix with stomach acid first.
Related topics
Further information
- Xifaxan uses and safety info
- Xifaxan prescribing info & package insert (for Health Professionals)
- Side effects of Xifaxan (detailed)
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