Rifaximin Semi - synthetic Intestinal Antibiotic for Diarrhea and Hepatic Encephalopathy

Rifaximin Semi-synthetic Intestinal Antibiotic for Diarrhea  and Hepatic Encephalopathy

Generic Name:Rifaximin

Brand Name:Xifaxan

Drug Class and Mechanism:

Rifaximin is a semi-synthetic intestinal antibiotic used for treating traveler's diarrhea and hepatic encephalopathy. It is derived from rifamycin, a naturally occurring chemical produced by a bacterium called Streptomyces mediterranei.

Rifaximin is active against Escherichia colibacterial strains that cause traveler's diarrhea, preventing growth of the bacteria by preventing them from manufacturing proteins needed for their replication and survival. By suppressing growth of the bacteria, rifaximin reduces symptoms of traveler's diarrhea.

Prescribed for :

Rifaximin is approved for treating patients 12 years or older with traveler's diarrhea caused by Escherichia coli. It also is effective at preventing traveler's diarrhea. It is approved for preventing the recurrence of hepatic encephalopathy in individuals 18 years of age or older. Rifaximin also has been shown to effectively treat non-constipating irritable bowel syndrome.

SIDE EFFECTS: Common side effects associated with rifaximin include:

• nausea,

• vomiting,

• constipation,

• urge to defecate,

• dizziness,

• fatigue,

• headache,

• abdominal pain,

• fever,

• flatulence, and

• fluid retention (edema)

Mechanism of action

Rifaximin interferes with transcription by binding to the β-subunit of bacterial RNA polymerase. This results in the blockage of the translocation step that normally follows the formation of the first phosphodiester bond, which occurs in the transcription process.

Efficacy

​A 2011 study in patients with IBS (without constipation) indicated 11% showed benefits over a placebo.The study was supported by Salix Pharmaceuticals, the patent holder. A 2010 study in patients treated for Hepatic Cirrhosis with hospitalization involving Hepatic encephalopathy resulted in 22% of the rifaxmin treated group experiencing a breakthrough episode of Hepatic encephalopathy as compared to 46% of the placebo group.

The majority patients were also receiving Lactulose therapy for prevention of hepatic encephalopathy in addition to Rifaximin.Rifaximin shows promising results, causing remission in up to 59% of people with Crohn’s disease and up to 76% of people with Ulcerative Colitis.

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