Xifaxanta

Basic Xifaxanta information

• INN (international nonproprietary name): Rifaximin
• Brand names available in the United Kingdom: Xifaxanta (200 mg); Targaxan (550 mg)
• ATC code: A07AA11
• Forms and dosages: Oral tablets 200 mg and 550 mg
• Manufacturers in the United Kingdom: Norgine
• Registration status in the United Kingdom: Prescription-only medicine (POM)
• OTC / Rx classification: Prescription-only medicine (POM)

Everyday use and best practices

Xifaxanta, known as rifaximin, plays an essential role in managing specific gastrointestinal conditions. To maximise its benefits, understanding proper usage is crucial.

Morning vs evening dosing

A typical dosing schedule includes:

• For travellers’ diarrhoea, 200 mg three times a day for three days.
• For hepatic encephalopathy (Targaxan 550 mg), 550 mg twice daily for chronic management.
• For IBS-D (off-label), courses of 550 mg three times a day have been used under specialist direction.

Morning or evening dosing can depend on individual routines. However, adhering to the prescribed regimen is vital, and setting reminders can be helpful in maintaining consistency.

Taking with or without meals

Xifaxanta can be taken with or without food. For many, taking the medication with food helps avoid gastrointestinal discomfort. Patients can discuss how to fit the medication into their daily routine with their pharmacist.

Safety priorities

Who should avoid it

Specific groups should avoid xifaxanta to prevent adverse effects:

• Individuals with hypersensitivity to rifaximin or related rifamycins.
• Those with a history of Clostridium difficile infections, as antibiotics can increase risks associated with such conditions.

A healthcare professional should be consulted, especially by those who have pre-existing health conditions or are on multiple medications.

Activities to limit (driving, work safety)

Use of xifaxanta may lead to dizziness or fatigue, which can affect daily activities.

• Driving: If feeling dizzy or excessively tired, it is essential to avoid driving until these effects wear off.
• Operating machinery: Engaging in tasks that require full attention or precision, like operating heavy machinery, should be approached with caution.

If difficulties arise, defer these activities until you feel completely capable.

Dosage and adjustments

General regimen (NHS guidance)

For travellers' diarrhoea caused by E. coli, the standard dose is 200 mg three times a day for three days. For reducing the recurrence of hepatic encephalopathy, the recommended dose (Targaxan 550 mg) is 550 mg twice daily. Use in irritable bowel syndrome with diarrhoea (IBS-D) is off-label and should only follow specialist advice.

Consult a healthcare professional if there is any uncertainty about dosages.

Special cases (elderly, comorbidities)

Certain populations need extra care when it comes to dosage adjustments. For the elderly, while no specific adjustment is required, monitoring of liver function is advisable as the risk of complications can increase. In patients with severe liver impairment (Child-Pugh Class C), caution is paramount; adjustments may be necessary depending on individual circumstances. This can also include regular monitoring for potential symptoms related to hepatic encephalopathy.

• Check liver function regularly for elderly patients.
• Dosing for those with liver impairment is based on the individual's health status.