Xifaxan (rifaximin) Disease Interactions
There are 2 disease interactions with Xifaxan (rifaximin):
Antibiotics (Includes Xifaxan) ↔ Colitis
Moderate Potential Hazard, Moderate plausibility
Applies to: Colitis/Enteritis (Noninfectious)
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
- Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
- Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
- Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
Rifaximin (Includes Xifaxan) ↔ Liver Disease
Moderate Potential Hazard, High plausibility
Applies to: Liver Disease
Rifaximin is metabolized by the liver. Following administration of rifaximin 550 mg twice daily to patients with a history of hepatic encephalopathy, systemic exposure (AUC) was about 10-, 13- and 20- fold higher in patients with mild (Child-Pugh A), moderate (Child-Pugh B) and severe (Child-Pugh C) hepatic impairment, respectively, compared to that in healthy volunteers. Animal toxicity studies did not achieve systemic exposures that were seen in patients with severe hepatic impairment, thus clinical significance is unknown. No dosage adjustment is recommended because systemic absorption of rifaximin is presumably limited. Nonetheless, therapy with rifaximin should be administered cautiously in patients with severe hepatic impairment.
Xifaxan (rifaximin) drug Interactions
There are 11 drug interactions with Xifaxan (rifaximin)
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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