Side Effects of rifaximin: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Rifaximin is a non-absorbable antibiotic used to treat digestive disorders such as hepatic encephalopathy, inflammatory bowel disease, and irritable bowel syndrome. Many studies have shown that rifaximin improves symptoms of these diseases. 13 6 11

Rifaximin is thought to work by altering the composition of the gut microbiota. 26 8 9 Rifaximin stays in the gut and is not absorbed into the bloodstream. Therefore, it is considered to have fewer side effects than other antibiotics. 23 24 19

Reasons for side effects

Rifaximin works by altering the composition of the gut microbiota. Therefore, some patients may experience side effects related to changes in the gut microbiota. 26

Common side effects

Diarrhea

Diarrhea is a common side effect of rifaximin. 8 17

Abdominal pain

Rifaximin can cause abdominal pain. 17

Nausea

Rifaximin can cause nausea. 17

Vomiting

Rifaximin can cause vomiting. 17

Constipation

Rifaximin can cause constipation. 17

Maldigestion

Rifaximin can cause maldigestion. 17

Superinfection

Rifaximin can cause superinfection. 23 12

Clostridium difficile infection

Rifaximin can cause Clostridium difficile infection. 23 12

Side effects management

Diarrhea

If you experience diarrhea, drink plenty of fluids. If it is mild, you may be able to improve by using an antidiarrheal. 8 If your symptoms do not improve, consult your doctor. 17

Abdominal pain

If you experience abdominal pain, consult your doctor. 17

Nausea

If you feel nauseous, avoid food and drink plenty of fluids. 17 If your symptoms do not improve, consult your doctor.

Vomiting

If you experience vomiting, drink plenty of fluids and avoid food. 17 If your symptoms do not improve, consult your doctor.

Constipation

If you experience constipation, eat a diet high in fiber and drink plenty of fluids. 17 If your symptoms do not improve, consult your doctor.

Maldigestion

If you experience maldigestion, consult your doctor. 17

Superinfection

If you experience superinfection, consult your doctor. 23 12

Clostridium difficile infection

If you experience Clostridium difficile infection, consult your doctor. 23 12

Comparison between studies

Common points

Many studies have shown that rifaximin improves symptoms of digestive disorders. 13 6 11 Also, rifaximin is thought to work by altering the composition of the gut microbiota. 26 8 9 Many studies have shown that rifaximin has fewer side effects than other antibiotics. 23 24 19

Differences

There may be differences in the results depending on the study of rifaximin side effects. 23 12 For example, some studies have shown that rifaximin increases the risk of Clostridium difficile infection, while others have not shown such a risk. 23 12

Precautions for real-life application

Rifaximin is expected to improve symptoms of digestive disorders, but it is important to remember that there is a risk of side effects. 23 12 It is important to consult with your doctor before taking rifaximin and to get instructions on how to take it correctly. 17 12

Current limitations of research

Rifaximin should be used with caution for long-term use due to the risk of side effects. 23 Also, some aspects of the mechanism of action of rifaximin are still unclear. 26

Future research directions

Studies on the safety and efficacy of long-term use of rifaximin are needed. 23 Also, further research is needed to clarify the mechanism of action of rifaximin. 26

Conclusion

Rifaximin is a non-absorbable antibiotic used to treat digestive disorders. 13 6 11 Many studies have shown that rifaximin improves symptoms of these diseases. 13 6 11 However, it is important to remember that rifaximin has a risk of side effects. 23 12 It is important to consult with your doctor before taking rifaximin and to get instructions on how to take it correctly. 17 12

Literature analysis of 26 papers
Positive Content
23
Neutral Content
1
Negative Content
2
Article Type
4
2
2
14
25
1.

Synthetic Imidazopyridine-Based Derivatives as Potential Inhibitors against Multi-Drug Resistant Bacterial Infections: A Review.

Author: SanapalliBharat Kumar Reddy, AshamesAkram, SigalapalliDilep Kumar, ShaikAfzal B, BhandareRichie R, YeleVidyasrilekha

Antibacterial activity
Side effects

Imidazopyridines (IZPs) are fused heterocyclic compounds with diverse pharmacological properties, including antibacterial activity. This review highlights the synthetic strategies for preparing IZPs, focusing on their antibacterial profiles and structure-activity relationships (SAR). The research aims to guide the development of novel, potent antibacterial agents with fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Nitazoxanide versus rifaximin in preventing the recurrence of hepatic encephalopathy: A randomized double-blind controlled trial.

Author: GlalKhadija A M, Abd-ElsalamSherief M, MostafaTarek M

HE prevention
Improved QOL

This study is looking at the safety and effectiveness of nitazoxanide, a drug used to treat intestinal infections, in preventing the return of hepatic encephalopathy, a brain disorder that can occur in people with liver cirrhosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Appropriate and Potentially Inappropriate Medication Use in Decompensated Cirrhosis.

Author: ThomsonMary J, LokAnna S F, TapperElliot B

Medication use

The study examined a large national claims database (2010-2015) to characterize the medication profiles of 12,621 patients with decompensated cirrhosis and the factors associated with appropriate and potentially inappropriate medication use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Anti-Diarrheal Drug Repositioning in Tumour Cell Cytotoxicity.

Author: Elloumi-MseddiJihene, MsalbiDhouha, FakhfakhRaouia, AifaSami

cancer treatment
chemotherapy side effect treatment
none

Nifuroxazide and rifaximin, anti-diarrheal drugs commonly used to manage chemotherapy side effects, showed anti-tumor activity against breast cancer cells.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Long-term efficacy of rifaximin to manage the symptomatic uncomplicated diverticular disease of the colon.

Author: Di MarioFrancesco, MiragliaChiara, CambièGinevra, VioliAlessandra, NouvenneAntonio, FranceschiMarilisa, BrandimarteGiovanni, EliseiWalter, PicchioMarcello, TursiAntonio

Complication reduction
SUDD treatment
Symptom relief

This retrospective study assessed the long-term outcome of rifaximin treatment in patients with symptomatic uncomplicated diverticular disease (SUDD). The study found that rifaximin was effective in relieving symptoms and reducing the risk of disease-related complications over an 8-year follow-up period, with no reported side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Pharmacokinetic drug evaluation of rifaximin for treatment of diarrhea-predominant irritable bowel syndrome.

Author: BruzzeseEugenia, PesceMarcella, SarnelliGiovanni, GuarinoAlfredo

Rifaximin efficacy
Rifaximin safety
Bacterial resistance

Rifaximin, a poorly absorbable antibiotic, is a suitable treatment for IBS-D, in both adults and children.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

The Effects of Probiotics and Symbiotics on Risk Factors for Hepatic Encephalopathy: A Systematic Review.

Author: Viramontes HörnerDaniela, AveryAmanda, StowRuth

HE treatment
Microflora modulation

This systematic review evaluated the efficacy of probiotics and symbiotics for treating hepatic encephalopathy (HE) in patients with cirrhosis. Probiotics and symbiotics showed promising results in modulating gut microflora, reducing endotoxemia, and improving HE outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

The Possible Innovative Use of Bifidobacterium longum W11 in Association With Rifaximin: A New Horizon for Combined Approach?

Author: GrazianoTeresa, AmorusoAngela, NicolaStefania, DeiddaFrancesca, AllesinaSerena, PaneMarco, PiffanelliPietro, StrozziFrancesco, MognaLuca, Del PianoMario

Combined therapy with rifaximin

Bifidobacterium longum W11, which exhibits resistance to rifaximin, is not capable of transferring this resistance to other bacteria. This suggests that the strain could be used safely in combination with rifaximin for treatment of antibiotic-associated diarrhea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Randomized-controlled trial of rifaximin versus norfloxacin for secondary prophylaxis of spontaneous bacterial peritonitis.

Author: ElfertAsem, Abo AliLobna, SolimanSamah, IbrahimShimaa, Abd-ElsalamSherief

SBP prevention
Gram-positive SBP
Quinolone resistance

This study compares the safety and efficacy of rifaximin versus norfloxacin for the secondary prevention of spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis and ascites.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Rifaximin for the treatment of irritable bowel syndrome - a drug safety evaluation.

Author: PonzianiFrancesca Romana, PecereSilvia, LopetusoLoris, ScaldaferriFranco, CammarotaGiovanni, GasbarriniAntonio

Gut microbiota modulation

Gut microbiota modulation by non-absorbable antibiotics is a potential therapeutic option for patients with Irritable Bowel Syndrome (IBS). This approach targets the multifactorial etiology of IBS, which includes alterations of intestinal motility and immunity, gut-brain interactions, and gut microbiota dysbiosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Role of antibiotics for treatment of inflammatory bowel disease.

Author: NitzanOrna, EliasMazen, PeretzAvi, SalibaWalid

IBD treatment
Antibiotic resistance
C. difficile infection
Side effects

Antibiotics have a modest effect in treating active luminal Crohn's disease, particularly in patients with colonic involvement. Rifamixin has shown promising results for active luminal CD. Antibiotics are also used for treating suppurative complications of CD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Profile of rifaximin and its potential in the treatment of irritable bowel syndrome.

Author: IorioNatalya, MalikZubair, ScheyRon

IBS treatment
Side effects

Rifaximin is a non-absorbable antibiotic that targets the gastrointestinal tract and has been shown to improve symptoms of irritable bowel syndrome, such as bloating, flatulence, stool consistency, and abdominal pain. It has a side-effect profile similar to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Management of overt hepatic encephalopathy.

Author: SharmaPraveen, SharmaBarjesh C

HE treatment

Lactulose and lactitol are considered first-line therapies for hepatic encephalopathy (HE), with lactitol having fewer side effects. Rifaximin is effective in treating and preventing HE. Combination therapy of disaccharides with rifaximin, l-ornithine l-aspartate, or probiotics needs further evaluation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Evaluation of rifaximin in management of hepatic encephalopathy.

Author: WahibAli A, El-Deen SalemM Negm, AhmedMostafa A, El-DessoukyYasser M M, El-TibyDiaa M, El-MolaKhaled, El-SayedAbeer M

Ammonia reduction
HE treatment
Hospitalization reduction

This study compared the efficacy of rifaximin and lactulose in treating hepatic encephalopathy, finding rifaximin to be a potentially better alternative.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

17.

The safety of novel drugs used to treat irritable bowel syndrome.

Author: MozaffariShilan, NikfarShekoufeh, AbdollahiMohammad

Constipation
Diarrhea

Most reported adverse events for novel gastrointestinal drugs were related to the GI tract with mild-to-moderate severity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Evaluating the functional net value of pharmacologic agents in treating irritable bowel syndrome.

Author: ShahE, PimentelM

IBS treatment
Motility spectrum variation

The FDA provisional endpoint for irritable bowel syndrome (IBS) is based on a unidirectional measure of motility improvement. However, patients may experience diarrhea during constipation-predominant IBS treatment or constipation during diarrhea-predominant IBS treatment, but still meet the endpoint.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Rifaximin is safe and well tolerated for long-term maintenance of remission from overt hepatic encephalopathy.

Author: MullenKevin D, SanyalArun J, BassNathan M, PoordadFred F, SheikhMuhammad Y, FrederickR Todd, BorteyEnoch, ForbesWilliam P

HE recurrence reduction

This phase 3, open-label maintenance study assessed the safety and rate of hospitalization with long-term rifaximin use in patients with hepatic encephalopathy (HE). Rifaximin, a gut-selective oral antimicrobial agent, had previously shown efficacy in reducing HE recurrence and hospitalizations.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Disaccharides in the treatment of hepatic encephalopathy.

Author: SharmaPraveen, SharmaBarjesh Chander

Improved cognitive function
Improved quality of life
Side effects

Lactulose and lactitol, nonabsorbable disaccharides, are considered first-line therapy for the treatment of hepatic encephalopathy (HE) and minimal hepatic encephalopathy (MHE). Combination therapy of disaccharides with rifaximin, L-ornithine L-aspartate, or probiotics needs further validation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Use of antibiotics in the treatment of Crohn's disease.

Author: ScribanoMaria Lia, PranteraCosimo

Crohn's disease remission
Systemic side effects

The intestinal microbiota is increasingly recognized as a key factor in the pathogenesis of Crohn's disease (CD). While antibiotics have been explored, their efficacy is limited in active uncomplicated CD. Rifaximin, with its excellent safety profile, shows promise in inducing remission of CD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

End-stage liver disease complications.

Author: RahimiRobert S, RockeyDon C

Ascites treatment
EVH treatment
HRS treatment
MHE treatment
Hemorrhagic ascites
Paracentesis-induced circulatory dysfunction

Several new treatment strategies have been developed for complications of chronic liver disease, including hepatic encephalopathy, ascites, hepatorenal syndrome, and esophageal variceal hemorrhage. These strategies have improved patient outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

[Proton-pump inhibitor therapy and small bowel bacterial contamination].

Author: HamvasJózsef

Fewer side effects
High efficacy
Symptom-free condition

This study investigates the prevalence of small intestinal bacterial overgrowth (SIBO) in patients using long-term proton pump inhibitors (PPIs). Results showed a high prevalence of SIBO in PPI users, suggesting a potential association between PPI use and SIBO.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Hungarian

25.

Evaluation of harm in the pharmacotherapy of irritable bowel syndrome.

Author: ShahEric, KimSharon, ChongKelly, LemboAnthony, PimentelMark

Treatment of irritable bowel syndrome

This study examines the side effects of medications used to treat irritable bowel syndrome (IBS) with diarrhea and constipation. It looks at treatments recommended by the American College of Gastroenterology and uses a systematic review to assess the number of patients who experience harm from each medication.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

26.

Rifaximin in the treatment of inflammatory bowel disease.

Author: GuslandiMario

IBD treatment

Rifaximin α polymer, an unabsorbed antibacterial agent, has shown promising results in inducing remission of Crohn's disease and ulcerative colitis. Further studies are needed to confirm its efficacy and determine the optimal dosage.

EditorialAn article in which the editor or publisher expresses their opinion or perspective on a particular topic or issue. Its purpose is to convey a specific message or idea to the reader.

Language : English

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