Rifaximin Side Effects
Medically reviewed by Drugs.com. Last updated on Sep 26, 2022.
Commonly reported side effects of rifaximin include: flatulence. Other side effects include: abdominal pain, bowel urgency, headache, nausea, and rectal tenesmus. Continue reading for a comprehensive list of adverse effects.
Applies to rifaximin: oral tablets.
Side effects include:
Hepatic encephalopathy: Peripheral edema, nausea, dizziness, fatigue, ascites, muscle spasms, pruritus, abdominal pain, anemia, depression, nasopharyngitis, upper abdominal pain, arthralgia, dyspnea, pyrexia, rash.
IBS with diarrhea: Nausea, increased ALT concentrations.
Travelers' diarrhea: Headache.
For Healthcare Professionals
Applies to rifaximin: oral tablet.
When used for the treatment of travelers' diarrhea, the most common side effect was headache. This drug was discontinued due to side effects in 0.4% of patients; such side effects were taste loss, dysentery, decreased weight, anorexia, nausea, and nasal passage irritation.
When used for reduction in risk of overt hepatic encephalopathy recurrence, the most common side effects were peripheral edema, nausea, dizziness, fatigue, and ascites.
When used for the treatment of irritable bowel syndrome with diarrhea, the most common side effects were nausea and increased ALT.[Ref]
Very common (10% or more): Nausea (up to 14.3%), ascites (11.4%), flatulence (up to 11%)
Common (1% to 10%): Abdominal pain, abdominal distension, rectal tenesmus, upper abdominal pain, defecation urgency, constipation, stomach discomfort, vomiting, lower abdominal pain, abdominal tenderness, dry mouth, esophageal variceal bleed, diarrhea, bloating and distension, nausea and vomiting symptoms
Uncommon (0.1% to 1%): Dry lips, dyspepsia, gastrointestinal motility disorder, hard feces, hematochezia, mucous stools, taste disorders
Frequency not reported: Blood in stool, dysentery, fecal abnormality, gingival disorder, inguinal hernia, straining, bad taste in mouth, Clostridium colitis
Postmarketing reports: Clostridioides difficile-associated colitis[Ref]
Very common (10% or more): Peripheral edema (15%), fatigue (up to 12.1%)
Common (1% to 10%): Pyrexia, chest pain, pain, generalized edema, influenza-like illness, contusion, fall, procedural pain
Uncommon (0.1% to 1%): Ear pain, candidiasis, hot flush, edema, herpes simplex, asthenic conditions, pain and discomfort, chills
Rare (less than 0.1%): Asthenia
Frequency not reported: Motion sickness, malaise, hot flashes
Postmarketing reports: Clostridial infections (C difficile)[Ref]
Very common (10% or more): Dizziness (up to 13%), headache (10%)
Common (1% to 10%): Vertigo, amnesia, disturbance in attention, hypoesthesia, memory impairment, tremor
Uncommon (0.1% to 1%): Balance disorders, convulsion, attention disorders, migraine, paresthesia, sinus headache, somnolence
Frequency not reported: Syncope, tinnitus, loss of taste
Postmarketing reports: Presyncope, syncope[Ref]
Hypersensitivity reactions have occurred as early as within 15 minutes of drug administration.[Ref]
Frequency not reported: Anaphylactic reactions
Postmarketing reports: Hypersensitivity reactions (including exfoliative dermatitis, rash, angioneurotic edema [swelling of face and tongue and difficulty swallowing], urticaria, pruritus, flushing, anaphylaxis), anaphylactic responses, angioedemas, hypersensitivity[Ref]
Common (1% to 10%): Pruritus, rash, cellulitis
Uncommon (0.1% to 1%): Eruptions and exanthemas, sunburn, hyperhidrosis/increased sweating, cold sweat
Frequency not reported: Clamminess
Postmarketing reports: Angioedema, dermatitis, exfoliative dermatitis, eczema, erythemas, pruritus, purpura, urticarias[Ref]
Rhabdomyolysis has been reported in patients with cirrhosis (with and without concurrent statin use).[Ref]
Common (1% to 10%): Muscle spasms, arthralgia, back pain, myalgia, pain in extremity
Uncommon (0.1% to 1%): Neck pain, muscular weakness
Frequency not reported: Increased blood creatine phosphokinase
Postmarketing reports: Rhabdomyolysis[Ref]
Common (1% to 10%): Anemia
Uncommon (0.1% to 1%): Lymphocytosis, monocytosis, neutropenia
Postmarketing reports: Thrombocytopenia, INR abnormalities[Ref]
Common (1% to 10%): Cough, nasopharyngitis, dyspnea, upper respiratory tract infection, rhinitis, pneumonia, epistaxis
Uncommon (0.1% to 1%): Pleural effusion, pharyngitis, oropharyngeal pain, rhinorrhea, dry throat, nasal congestion
Rare (less than 0.1%): Chronic obstructive pulmonary disease
Frequency not reported: Respiratory tract infection, nasal passage irritation, pharyngolaryngeal pain[Ref]
Common (1% to 10%): Depression, insomnia, confusional state
Uncommon (0.1% to 1%): Anxiety, hypersomnia, abnormal dreams, depressed mood, nervousness[Ref]
Common (1% to 10%): Increased weight, anorexia, dehydration, hyperglycemia, hyperkalemia, hypoglycemia, hyponatremia
Uncommon (0.1% to 1%): Decreased appetite
Frequency not reported: Decreased weight[Ref]
Common (1% to 10%): Hypotension
Uncommon (0.1% to 1%): Palpitations, increased blood pressure
Rare (less than 0.1%): Hypertension[Ref]
Uncommon (0.1% to 1%): Urinary tract infection, dysuria, polyuria, proteinuria, pollakiuria, blood in urine present, glycosuria, polymenorrhea
Frequency not reported: Choluria, hematuria, urinary frequency[Ref]
Common (1% to 10%): Increased ALT
Uncommon (0.1% to 1%): Increased AST
Postmarketing reports: Liver function test abnormalities[Ref]
Uncommon (0.1% to 1%): Diplopia[Ref]
More about rifaximin
- Check interactions
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- Reviews (147)
- Dosage information
- During pregnancy
- Drug class: miscellaneous antibiotics
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Related treatment guides
1. "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals (2004):
2. Cerner Multum, Inc. "Australian Product Information." O 0
3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
4. Pimentel M, Park S, Mirocha J, Kane SV, Kong Y "The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial." Ann Intern Med 145 (2006): 557-63
5. Trapnell CB, Connolly M, Pentikis H, Forbes B, Bettenhausen DK "Absence of effect of oral rifaximin on the pharmacokinetics of ethinyl estradiol/norgestimate in healthy females." Ann Pharmacother 41 (2007): 222-8
6. Juillerat P, Pittet V, Felley C, et al. "Drug safety in Crohn's disease therapy." Digestion 76 (2007): 161-8
7. Garey KW, Salazar M, Shah D, Rodrigue R, Dupont HL "Rifamycin antibiotics for treatment of Clostridium difficile-associated diarrhea." Ann Pharmacother 42 (2008): 827-35
8. "Rifaximin (Xifaxan 550) for hepatic encephalopathy." Med Lett Drugs Ther 52 (2010): 87
9. Hynicka LM, Silva KN "Probable rifaximin-induced neutropenia." Am J Health Syst Pharm 69 (2012): 583-6
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.