Uses of Rifaximin

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1. Effects of Rifaximin

Rifaximin is indicated for use in reducing the risk of recurrence of hepatic encephalopathy, in combination in the treatment of hyperammonemia, chronic and acute protracted intestinal infections caused by gram-positive and gram-negative bacteria. ; diarrheal syndrome.
Rifaximin is also used to treat diarrhea due to a change in the balance of bacteria in the intestinal tract, to prevent infectious complications before and after surgery in the intestinal tract.
Rifaximin 200 mg tablets are used to treat traveler's diarrhea caused by certain bacteria in adults and children over 12 years of age. Rifaximin 550 mg tablets are used to prevent episodes of hepatic encephalopathy in adults with liver disease and to treat bowel syndromes in adults.
Rifaximin is in a group of drugs known as antibiotics. Rifaximin is used to treat travelers' diarrhea and irritable bowel syndrome by stopping the growth of bacteria that cause diarrhea.
Rifaximin is used to treat hepatic encephalopathy by stopping the growth of bacteria. Rifaximin will not be effective in treating traveler's bloody diarrhea or fever.
The antibiotic rifaximin is also ineffective against colds, flu, and other viral infections. Taking antibiotics when they are not needed increases the risk of future infections that cannot be treated with antibiotics.

2. How to use Rifaximin

Rifaximin comes in tablet form, which can be taken with or without food. When rifaximin is used to treat traveler's diarrhea, it is usually given 3 times a day for 3 days.
When rifaximin is used to prevent episodes of hepatic encephalopathy, it is usually given twice a day.
When rifaximin is used to treat irritable bowel syndrome, it is taken 3 times a day for 14 days.
To help the patient remember to take rifaximin, take it at the same time each day. Follow the directions on the medicine label carefully and ask your doctor or pharmacist to explain any part you do not understand. Take rifaximin exactly as directed. Do not take more or less of it, or take it more often than prescribed by your doctor.
If you are taking rifaximin to treat traveler's diarrhea, your symptoms should improve within 24 to 48 hours after you start taking it. If your symptoms do not go away or get worse, or if you have a fever or bloody diarrhea, call your doctor.
If you are taking rifamycin to treat irritable bowel syndrome and your symptoms return after finishing treatment, call your doctor.
Take rifaximin as directed, even if the person feels better. If you are taking rifaximin to treat traveler's diarrhea or irritable bowel syndrome and you stop taking it too soon or if you skip doses, the infection may not be completely cured and the bacteria may become infected. antibiotic resistance. If you are taking rifaximin to prevent hepatic encephalopathy, do not stop taking it without talking to your doctor as you are most likely to experience symptoms of encephalopathy.
How to use :
This medicine can be taken with or without food.
Dosage:
Combination treatment of hyperammonemia
Adults and children over 12 years old: 2 tablets of 200mg every 8 hours.
Treatment of diarrhea
Adults and children over 12 years: 1 200mg tablet every 6 hours.
Treatment before and after surgery
Adults and children over 12 years old: 2 tablets of 200mg every 12 hours.
Dosage and frequency of administration may vary depending on the doctor's prescription. Unless otherwise recommended, the course of treatment with rifaximin should not exceed 7 days.
Elderly: The pharmacokinetics of rifaximin have not been studied in the elderly; however, no dose adjustment is necessary as the efficacy and safety data of rifaximin do not show differences between elderly and elderly patients. young.
Hepatic impairment: No dose adjustment is required for patients with impaired liver function.
Renal Impairment: Although no dose adjustment is recommended, caution should be exercised in patients with impaired renal function.
Children: The efficacy and safety of rifaximin in children under 12 years of age have not been established.

3. Contraindications of Rifaximin

Rifaximin is contraindicated in the following cases:
Hypersensitivity to rifaximin, rifampicin derivatives or to any of the excipients. Cases of intestinal obstruction. Interaction with other drugs. There are no data on the use of rifaximin in patients receiving other rifamycins for the treatment of systemic infections.
In healthy subjects, clinical drug-drug interaction studies showed that rifaximin did not significantly affect the kinetics of CYP3A4 metabolites. However, rifaximin may decrease concentrations of drugs metabolised by CYP3A4 in patients with hepatic impairment when administered concomitantly (eg, warfarin, antiepileptic agents, antiarrhythmics) due to systemic exposure in these patients. This is higher than healthy people.
One study also showed that rifaximin is a medium substrate of glycoprotein P (P-gp) and is metabolised by CYP3A4. It is not known whether co-administration of CYP3A4 inhibitors can increase systemic exposure.
In healthy subjects, co-administration of a single dose of cyclosporin (600 mg), a potent P-glycoprotein inhibitor, and a single dose of rifaximin (550 mg) resulted in increased rifaximin peak concentration and AUC, respectively. 83 times and 124 times. The clinical significance of this increased concentration is unknown.
Studies suggest that clinical interactions between rifaximin and other compounds transported via P-gp and other transport proteins (MDR1, MRP2, MRP4, BCRP and BSEP) are less likely. Patients should take rifaximin at least 2 hours after taking activated charcoal.

4. Notes when using Rifaximin

4.1. Before taking Rifaximin. Tell your doctor and pharmacist if you are allergic to rifaximin, rifabutin (Mycobutin), rifampin (Rifadin, Rifamate, Rifater, Rimactane), rifapentine (Priftin), any other medications, or any of the ingredients. in rifaximin capsules. Ask your doctor or pharmacist for a list of ingredients. Also tell your doctor and pharmacist what prescription and over-the-counter medicines you take, such as all vitamins, nutritional supplements and herbal products, etc., that you are taking or have taken. recently used. From there, the doctor may have to change the patient's dose of medication, carefully monitor the patient's side effects, or treat the patient's diarrhea differently. Tell your doctor if you have or have ever had liver disease. Tell your doctor if you are pregnant, plan to become pregnant or are breast-feeding. If you become pregnant while taking rifaximin, call your doctor for more information. 4.2. General Precautions while taking Rifaximin C. difficile infection (CDI) and C. difficile colitis and diarrhea (CDAD; also known as antibiotic-associated diarrhea and colitis or pseudomembranous colitis) reported with nearly all anti-infectives, including rifaximin, and can range in severity from mild diarrhea to fatal colitis. If symptoms worsen, treatment with rifaximin should be discontinued. Not suitable for the treatment of systemic infections because rifaximin plasma concentrations are low and variable after oral administration. Patients should be informed that although absorption is negligible (less than 1%), like all rifamycin derivatives, rifaximin may cause a slight reddish coloration of the urine. Use with caution in patients with severe hepatic impairment (Child-Pugh C) and patients with a MELD (Model for End-Stage Liver Disease) score > 25. Rifaximin should not be used in patients receiving a rifamycin antibacterial agent. other for the treatment of systemic bacterial infections. If symptoms do not improve after 3 days of treatment, or recur soon thereafter, a second course of rifaximin should not be used. 4.3. Cautions for certain populations Pregnant women There are no data on the use of the drug in pregnant women. Teratogenic effects (eg, malformations of eyes, mouth and maxillofacial, heart and lumbar spine) were observed in animal reproduction studies in rats and rabbits. The use of rifaximin during pregnancy is not recommended.
Cautions for nursing women It is not known whether rifaximin/metabolites are excreted in human milk. A decision to discontinue breast-feeding or to discontinue/withdraw rifaximin treatment must be made taking into account the benefit of breastfeeding to the infant and the benefit of treatment to the woman.
Note when driving and operating machines Rifaximin may cause dizziness, but has little effect on the ability to drive and use machines.
4.4. Rifaximin Overdose and Overdosage Overdose and Management
No cases of overdose have been reported.
In clinical trials with patients with traveler's diarrhea, doses up to 1800 mg/day were tolerated without any serious clinical signs.
Even in normal microbiota patients/subjects rifaximin at doses up to 2400 mg/day for 7 days did not produce any clinically relevant symptoms associated with high doses.
How to handle an overdose
In case of accidental overdose, treat symptomatically and provide supportive care.
Missed dose and treatment
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take twice the prescribed dose.

5. Rifaximin side effects

The drug has some unwanted side effects:
Infections and parasites:
Uncommon such as Candida infections, Herpes simplex, nasopharyngitis, pharyngitis, upper respiratory tract infections.
Unknown: Clostridial infection.
Blood and lymphatic system:
Uncommon: Lymphocytosis, monocytosis, neutropenia.
Not known: Thrombocytopenia.
Immune system: Not known: Anaphylactic reactions, hypersensitivity.
Metabolism and nutrition : Uncommon: Anorexia, dehydration.
Psychiatric: Uncommon: Insomnia, restless sleep, depression, stress.
Central nervous system:
Common: Dizziness, headache.
Uncommon: Migraine, hypoesthesia, paresthesia, sinus headache, somnolence.
Eyes : Uncommon: Dizziness.
Ear : Uncommon: Loss of balance, ear pain.
Cardiovascular: Uncommon: Tachycardia, increased blood pressure, hot flashes.
Respiratory, chest and mediastinum : Uncommon: Shortness of breath, stuffy nose, dry throat, sore throat, cough, runny nose.
Digestive:
Common: Constipation, abdominal pain, flatulence and distension, diarrhea, flatulence, nausea, rectal strain, acute defecation, vomiting symptoms.
Uncommon: Ascites, dyspepsia, gastrointestinal motility disorders, upper abdominal pain, bloody stools, mucus stools, hard stools, dry lips, taste disturbances, blood in stools.
Hepatobiliary:
Uncommon: Increased aspartate aminotransferase.
Unknown: Abnormal liver function tests.
Skin and subcutaneous tissue:
Uncommon: Erythema, erythema and erythema, sunburn.
Not known: Angioedema, dermatitis, exfoliative dermatitis, eczema, erythema, purpura, pruritus, urticaria.
Musculoskeletal and connective tissue: Uncommon: Back pain, muscle weakness, muscle spasms, neck pain, myalgia.
Kidney and urinary tract: Uncommon: Blood in urine, glucose in urine, polyuria, polyuria, proteinuria.
Reproductive system : Uncommon: Menstrual disorders.
General disorders and local reactions:
Common: Fever.
Uncommon: Asthenia, chills, cold sweats, pain and discomfort, peripheral edema, flu-like illness, increased sweating.
Inform the doctor about the unwanted effects encountered when using the drug.

6. How to store Rifaximin?

Keep this medicine in the container, tightly covered and out of the reach of children.
Store at room temperature, avoid extreme heat and humidity (not in the bathroom).
Unnecessary drugs should be handled in special ways to ensure that pets, children and others cannot consume them.
However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medication is through a drug recall program.
The most important thing is to keep all medicines out of the sight and reach of children because many containers (such as weekly dispensers and eye drops, creams, patches and inhalers) are not Children and young children can open them easily.

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