Xifaxan (rifaximin) for IBS-D and IBS without constipation


Xifaxan (rifaximin) is an FDA-approved antibiotic for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), traveler's diarrhea , and for the prevention of hepatic encephalopathy. Xifaxan has also been used to treat small intestine bacterial overgrowth ( SIBO ).

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How does Xifaxan work?

For ISB-D, xifaxan is taken by mouth three times a day for a period of two weeks. If adequate symptom relief is not achieved, the medication can be safely repeated for another 1-2 14-day courses.

Xifaxan is not absorbed from the stomach and therefore it is believed to act on bacteria found in the small and large intestines. Lack of absorption of xifaxan results in minimal effects on the body as a whole .

Side effects

Xifaxan is generally well tolerated. In clinical trials, the side effects are usually the same as the side effects of a placebo . Minor side effects have been reported:

  • Constipation
  • Dizziness
  • Headache
  • Nausea and / or vomiting
  • Fatigue

If you experience any of the following side effects while taking Xifaxan, you should contact your healthcare professional immediately:

  • Allergic symptoms such as shortness of breath; hives, itching, or rash; or swelling of the lips, face, or tongue
  • Hot
  • Watery or bloody diarrhea

The FDA recommends that if a drug aggravates diarrhea symptoms, you should be tested for C. difficile infection.

Xifaxan should not be used if you have severe liver damage or if you have diarrhea caused by pathogens other than E. coli.

Is xifaxan effective for irritable bowel syndrome?

To date, clinical trials have shown that xifaxan is more effective than placebo in relieving symptoms of abdominal pain and improving stool consistency. Research to date has shown that xifaxan is well tolerated and safe for short-term use. Some people may need more than one course of treatment to achieve the desired results .

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