Rifaximin Dosage

Usual Adult Dose for Traveler's Diarrhea

200 mg orally 3 times a day for 3 days

Comments:
-Should not use in patients with diarrhea complicated by fever and/or blood in the stool or diarrhea caused by pathogens other than Escherichia coli

Use: For the treatment of travelers' diarrhea due to noninvasive strains of E coli

Usual Adult Dose for Hepatic Encephalopathy

550 mg orally twice a day

Comments:
-In trials, lactulose was used concomitantly in 91% of patients; differences in treatment effect of patients not using concomitant lactulose could not be assessed.

Use: For reduction in risk of overt hepatic encephalopathy recurrence

Usual Adult Dose for Irritable Bowel Syndrome

550 mg orally 3 times a day for 14 days

Comments:
-If symptoms recur, patients can be retreated up to 2 times with the same dose regimen.

Use: For the treatment of irritable bowel syndrome with diarrhea

Usual Pediatric Dose for Traveler's Diarrhea

12 years or older: 200 mg orally 3 times a day for 3 days

Comments:
-Should not use in patients with diarrhea complicated by fever and/or blood in the stool or diarrhea caused by pathogens other than E coli

Use: For the treatment of travelers' diarrhea due to noninvasive strains of E coli

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Mild or moderate liver dysfunction (Child-Pugh A or B): No adjustment recommended.
Severe liver dysfunction (Child-Pugh C): Caution is recommended.

Comments:
-This drug was not studied in hepatic encephalopathy patients with Model for End-stage Liver Disease (MELD) scores greater than 25; in the controlled trial, only 8.6% of patients had MELD scores over 19.
-Systemic exposure increased with more severe liver dysfunction.

Precautions

Travelers' diarrhea: Safety and efficacy have not been established in patients younger than 12 years.
Hepatic encephalopathy, irritable bowel syndrome with diarrhea: Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-May administer with or without food

General:
-Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.

Patient advice:
-If using for travelers' diarrhea, seek medical attention for fever and/or blood in the stool.
-Avoid missing doses and complete the entire course of therapy.