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rifaximin

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Brand names: Xifaxan

Non-Systemic Antibiotic (IBS-D) Rx

Xifaxan is an antibiotic medicine. It helps treat traveler's diarrhea and irritable bowel syndrome with diarrhea (IBS-D). It also lowers the risk of hepatic encephalopathy (HE) coming back.

Drug Pricing (NADAC)

Brand Price

$52.22/unit

Generic Available

No

SALIX PHARMS

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Xifaxan can treat traveler's diarrhea caused by certain germs in adults and kids 12 and older.

Common side effects

Headache, Swelling in your legs or ankles, Nausea

Key warnings

Xifaxan may not work if you have a fever or blood in your stool.

How It Works

Xifaxan is an antibiotic that works in your gut. It stops the growth of certain bacteria that can cause diarrhea or other problems. It also reduces the amount of ammonia in your body, which can help with HE.

How to Take It

For traveler's diarrhea, take 200 mg three times a day for 3 days. For HE, take 550 mg two times a day. For IBS-D, take 550 mg three times a day for 14 days. You can take Xifaxan with or without food.

Pregnancy & Breastfeeding

Xifaxan may harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known if Xifaxan passes into breast milk, so talk to your doctor about the best way to feed your baby if you take Xifaxan.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store Xifaxan tablets at room temperature (68° to 77°F).

Side Effects (from patient reports)

Based on 12,888 FDA adverse event reports.

Death
3,982
Hospitalization
1,704
Diarrhea
1,193
Using the medicine for a condition it is not approved for
1,133
Treatment stopped
989
Increased ammonia levels
831
Nausea
802
Tiredness
779
Hepatic encephalopathy
762
Medicine not working
713

FDA Adverse Event Report Analysis

Detailed analysis of 19,891 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

19,891

Death-Related Reports

5,855

Hospitalization Reports

7,784

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 9,942 (52%)
Male 9,087 (48%)

Age Distribution

0–17 254
18–44 1,356
45–64 5,220
65–74 4,728
75+ 2,637

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DEATH 3,982
2 HOSPITALISATION 1,704
3 DIARRHOEA 1,193
4 OFF LABEL USE 1,133
5 THERAPY INTERRUPTED 989
6 AMMONIA INCREASED 831
7 NAUSEA 802
8 FATIGUE 779
9 HEPATIC ENCEPHALOPATHY 762
10 DRUG INEFFECTIVE 713
11 CONFUSIONAL STATE 711
12 INABILITY TO AFFORD MEDICATION 679
13 HEPATIC CIRRHOSIS 657
14 INSURANCE ISSUE 623
15 FALL 607

Reactions in Death Reports

DEATH 3,977
HEPATIC CIRRHOSIS 378
HEPATIC FAILURE 329
RENAL FAILURE 251
HOSPITALISATION 208
LIVER DISORDER 176
THERAPY INTERRUPTED 170
HEPATIC ENCEPHALOPATHY 161
HOSPICE CARE 160
PNEUMONIA 144

Reactions in Hospitalization Reports

HOSPITALISATION 1,697
AMMONIA INCREASED 696
THERAPY INTERRUPTED 628
HEPATIC ENCEPHALOPATHY 618
CONFUSIONAL STATE 473
FALL 445
INABILITY TO AFFORD MEDICATION 399
DIARRHOEA 398
DEATH 390
INSURANCE ISSUE 358

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Xifaxan may not work if you have a fever or blood in your stool. It may also not work for diarrhea caused by germs other than E. coli. If your diarrhea gets worse or lasts more than 1-2 days, stop taking Xifaxan and talk to your doctor. Diarrhea caused by C. difficile can happen with almost all antibiotics, including Xifaxan. Use Xifaxan with caution if you have severe liver problems.

Known Drug Interactions

( 7.2 ) 7.1 P-glycoprotein Inhibitors Concomitant administration of cyclosporine, an inhibitor of P-gp and OATPs significantly increased the systemic exposure of rifaximin. Caution should be exercised when concomitant use of XIFAXAN and a P-gp inhibitor such as cyclosporine is needed [see Warnings and Precautions ( 5.5 ), Clinical Pharmacology ( 12.3 )].

Mechanism: Cyclosporine stops certain proteins from removing rifaximin from the body, which causes rifaximin levels to rise.

What to do: Use this combination with caution and report any new symptoms to your healthcare provider.

7 DRUG INTERACTIONS Warfarin: Monitor INR and prothrombin time; dose adjustment of warfarin may be needed to maintain target INR range. 7.2 Warfarin Changes in INR have been reported postmarketing in patients receiving rifaximin and warfarin concomitantly. Dose adjustment of warfarin may be needed to maintain target INR range.

Mechanism: Rifaximin can affect how your body processes blood thinners, which may change your risk of bleeding or how quickly your blood clots.

What to do: Your doctor should check your blood clotting tests often and may need to adjust your warfarin dose to keep it in the safe range.

Common Questions

Can I take Xifaxan if I'm allergic to rifampin?
No, you should not take Xifaxan if you are allergic to rifaximin, rifamycin medicines, or any of the ingredients in Xifaxan.
What should I tell my doctor before taking Xifaxan?
Tell your doctor if you are allergic to any medicines, have liver problems, or are taking other medicines, especially warfarin or cyclosporine.
Can Xifaxan cause other problems?
Yes, Xifaxan can cause diarrhea, including diarrhea caused by C. difficile. Tell your doctor right away if you have diarrhea while taking Xifaxan or soon after you stop.
How long should I take Xifaxan?
Take Xifaxan for as long as your doctor tells you to. Do not stop taking it early, even if you feel better.
Can I drink alcohol while taking Xifaxan?
Talk to your doctor about drinking alcohol while taking Xifaxan.
What if my IBS-D symptoms come back after treatment?
You can be retreated with Xifaxan up to 2 times.
Does Xifaxan interact with other medications?
Yes, Xifaxan can interact with warfarin and cyclosporine. Your doctor may need to adjust your warfarin dose.
Can children take Xifaxan?
Xifaxan is approved for traveler's diarrhea in children 12 years and older. It is not approved for HE or IBS-D in children.
What are the symptoms of hepatic encephalopathy?
Symptoms can include confusion, changes in personality, and problems with movement.
What if I accidentally take too much Xifaxan?
Call your doctor or go to the nearest emergency room right away.
What are the common side effects of rifaximin?
The most commonly reported side effects of rifaximin include Headache, Swelling in your legs or ankles, Nausea, Constipation, Dizziness. Based on 12,888 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does rifaximin interact with other medications?
Yes, rifaximin has 2 known drug interactions. Notable interactions include cyclosporine, warfarin. Always inform your doctor about all medications you are taking.
What drug class is rifaximin?
rifaximin belongs to the Non-Systemic Antibiotic (IBS-D) drug class. It requires a prescription (Rx). Xifaxan can treat traveler's diarrhea caused by certain germs in adults and kids 12 and older.
Is rifaximin safe during pregnancy?
Xifaxan may harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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Related Health & Safety Data

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What the FDA Data Shows for rifaximin

The FDA label for rifaximin (sold under brand names such as Xifaxan) classifies it as a prescription-only medication in the Non-Systemic Antibiotic (IBS-D) class. Xifaxan can treat traveler's diarrhea caused by certain germs in adults and kids 12 and older. Official labeling lists 12 commonly reported side effects, including Headache, Swelling in your legs or ankles, Nausea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 12,888 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: August 27, 2025

All federal data sources used on this page