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 strengths: oral tablets 200 mg and 550 mg
• OTC / Rx classification: Prescription-only medicine (Rx)

Legal status and availability in the UK

In our online pharmacy, Xifaxanta is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.

Clinical effectiveness in the UK

Many patients want to know how rifaximin performs in everyday NHS practice compared with trial results.

Rifaximin is sometimes used off‑label for IBS‑D after lifestyle measures and first‑line agents have failed, often in secondary care or via GP referral to specialists.

For hepatic encephalopathy, rifaximin 550 mg twice daily is widely used as an add‑on to lactulose to reduce recurrence of overt HE and to lower hospital admission rates.

Use of rifaximin for travellers’ diarrhoea (200 mg three times daily for three days) is less common on NHS formularies and tends to be prescribed in private travel clinics instead.

Indications and expanded uses

Patients commonly ask, "What is rifaximin licensed for, and where might it be used off‑label?"

• Travellers’ diarrhoea: 200 mg orally three times daily for 3 days for non‑invasive E. coli‑related illness; evidence and approval support this regimen.
• IBS‑D (off‑label in the UK): 550 mg orally three times daily for 14 days per course; responders typically have predominant diarrhoea and urgency.
• Hepatic encephalopathy: 550 mg orally twice daily as maintenance therapy to reduce recurrence of overt HE; used together with lactulose.
• Other off‑label uses: small intestinal bacterial overgrowth (SIBO) and refractory chronic diarrhoea are sometimes treated after multidisciplinary review, but evidence is mixed and local formularies may restrict funding.
• Paediatric limits: Studied and approved in some contexts at ≥12 years; safety not established in younger children.

Consult the Summary of Product Characteristics and local MHRA advisories for the most current prescribing information and national formulary decisions.

Composition and brand landscape

People often ask which brand to expect when a prescription says rifaximin.

The active ingredient is rifaximin, INN, classified under ATC code A07AA11 for intestinal anti‑infectives.

In the UK, rifaximin is available as 200 mg tablets (Xifaxanta) and 550 mg tablets (Targaxan).

Rifaximin shows low systemic absorption and minimal CYP interactions, which distinguishes it pharmacokinetically from many systemic antibiotics.

Contraindications and special precautions

Before starting treatment, patients often worry about allergies and serious warnings.

• Absolute contraindications: Hypersensitivity to rifaximin or other rifamycin antibiotics such as rifampicin, rifabutin or rifapentine, and treatment of diarrhoea with fever or bloody stools.
• Relative contraindications: History of C. difficile infection, as all antibiotics carry a risk of recurrence.
• Hepatic impairment: Use caution in severe hepatic impairment (Child‑Pugh C); monitor closely, particularly when used for hepatic encephalopathy.
• Elderly: No formal dose reduction, but monitor for dehydration and hepatic function.
• Pregnancy and lactation: Human data are limited; avoid routine use for non‑life‑threatening conditions and assess risk/benefit.
• Driving and machinery: Dizziness has been reported; advise caution.

Dosage guidelines (NHS‑recommended)

Patients often ask, "How and when should I take my tablets?"

If a dose is missed, take it when remembered unless the next dose is near, and never double doses.

In overdose, management is supportive because of minimal systemic absorption.

Store tablets at room temperature and protect from moisture.

Interactions overview

Common patient concerns include drug‑drug and food interactions while taking rifaximin.

Low systemic absorption means clinically significant interactions are uncommon.

Rifaximin is not a significant cytochrome P450 inducer or inhibitor according to manufacturer data.

Co‑administration with other rifamycin antibiotics is contraindicated due to cross‑sensitivity risks.

Food does not require strict timing, but consistent dosing around meals helps adherence.

Alcohol has no direct pharmacokinetic interaction, but patients with severe liver disease should avoid excess alcohol intake.

Clinicians are advised to check concomitant therapies, especially other antibiotics or drugs that affect gut motility.

Comparable medicines and prescribing preferences

Clinicians choose alternatives based on the indication, patient factors and local formulary rules.

Pros and cons to discuss include efficacy, safety, likelihood of resistance and NHS formulary status.

Frequently asked questions

1. Can I get rifaximin on the NHS? — Yes where clinically indicated; local formulary decisions vary by region.
2. Is rifaximin safe long‑term? — For hepatic encephalopathy maintenance, long‑term 550 mg twice daily has safety data from trials; monitor liver function and infection risk.
3. Can I take rifaximin while pregnant? — Human data are limited; weigh risk versus benefit and avoid routine use for non‑serious conditions.
4. Will rifaximin cause resistance? — Gut‑targeted action lowers systemic selection pressure, but resistance in gut flora is possible and antibiotic stewardship remains important.

Guidelines for proper use

Pharmacist counselling should begin by clarifying the indication and expected timeline for benefit.

Give the exact dosing regimen: travellers’ diarrhoea 200 mg TID for 3 days; IBS‑D 550 mg TID for 14 days; HE 550 mg BID maintenance.

Explain common side effects such as nausea, constipation and headache, and less common reactions like rash or peripheral oedema.

Advise patients to seek urgent review for red‑flag symptoms including fever, bloody diarrhoea or severe abdominal pain.

Provide missed‑dose and storage instructions and discourage doubling doses.

Encourage reporting adverse events via the MHRA Yellow Card scheme and offer assistance with reporting where appropriate.

For repeat IBS‑D courses, document objective response and discuss non‑antibiotic measures including dietary and psychological therapies.

Delivery across the United Kingdom

Final notes for patients and clinicians

When prescribing rifaximin, always check the current Summary of Product Characteristics and local formulary guidance.

Document the indication and response for repeat IBS‑D courses and discuss non‑antibiotic strategies as part of a long‑term plan.

Report any suspected adverse reactions via the MHRA Yellow Card service and keep a record of counselling for patient safety.

For straightforward supply, ensure prescriptions are from an authorised prescriber and that dispensing follows national regulations.

Pharmacists offering online services should confirm MHRA registration and validate e‑prescriptions for safe, discreet delivery.