Rifaximin
Description
Rifaximin is an antibiotic used to treat conditions in the gut caused by an ove
rgrowth of bacteria. It is used for Irritable Bowel Syndrome with Diarrhea (IBS-D), Traveler's Diarrhea (caused by non-invasive E. coli), and for reducing the risk of a serious complication of liver disease called Hepatic Encephalopathy (HE). Rifaximin is concentrated within your gastrointestinal tract, making it a targeted treatment. Take it at the prescribed dose and duration. You should complete the entire course of treatment with Rifaximin and not stop it mid-way on your own without the knowledge of your doctor. It may result in treatment failure and increase the risk of re-infection. Your urine may become reddish in colour while taking Rifaximin, this is expected and normal so do not panic.
Uses
- Traveler’s diarrhea
- Irritable bowel syndrome (IBS)
- Hepatic encephalopathy
- Contraindications/ Do not use if
- diarrhea that is not because of bacteria (such as viral diarrhea)
- Diarrhea with fever
- Bloody diarrhea
- Liver disease
- If you are allergic to Rifaximin, Rifampin, Rifapentine or Rifabutin
- If you are suffering from abdominal pain, constipation or blockage in the bowel
Contraindications
When should one not use Rifaximin
- Diarrhea that is not because of bacteria (such as viral diarrhea)
- Diarrhea with fever
- Bloody diarrhea
- Liver disease
- If you are allergic to Rifaximin, Rifampin, Rifapentine or Rifabutin
- If you are suffering from abdominal pain, constipation or blockage in the bowel
Side effects
Common side effects of this drug are:
- Stomach pain
- Headache
- Difficulty in breathing
- Fatigue
- Vomiting
- Nausea
- Urgency to empty your bowels
- Abnormal test results in white blood cells
- Loss of appetite, loss of body fluid (dehydration)
Precautions and Warnings
Pregnancy
Q:
Can I take Rifaximin during pregnancy?
A:
Rifaximin is not recommended in pregnancy.
Breast Feeding
Q:
Can I take Rifaximin while breastfeeding?
A:
It is unknown if Rifaximin passes in breast milk. Rifaximin is, therefore, not to be used if you are breastfeeding.
Driving
Q:
Can I drive if I have consumed Rifaximin?
A:
Safe to drive as Rifaximin is unlikely to impair driving ability. If you feel dizzy, do not drive.
Alcohol
Q:
Can I consume alcohol with Rifaximin?
A:
No known interaction of alcohol and Rifaximin.
Other General Warnings
Talk to your doctor if
- If you develop severe diarrhea during or after using Rifaximin, you should immediately stop the medication
- Your urine may become reddish in colour while taking Rifaximin, this is expected and normal
Mode of Action
How Does It Work?
Rifaximin works by interfering with bacterial cell growth mechanics; thus, bacterial growth is stalled, and the existing ones are killed by immunity or when their lifecycle ends. Rifaximin is used to treat bacterial infections in the intestine. It passes through the stomach and intestines without being absorbed into the bloodstream....
Interactions
Interactions with other medicines
Inform your doctor if you are taking any other medicines as Rifaximin may interact with other medications such as Azithromycin, Diltiazem, Warfarin, Erythromycin, anti-fungal medications. It may also interact with BCG and cholera vaccines, Ciclosporin....
Interactions with food items
Rifaximin may interact with grapefruit or its juice.
Dietary Restrictions
Avoid grapefruit.
Dosage
Overdose
No specific information is available on the symptoms and treatment of overdose with Rifaximin. However, in acute or long term accidental or intentional overdose, discontinue Rifaximin and seek emergency medical attention immediately....
Missed a Dose
If you missed any dose, take it as soon as you remember. Do not take extra medicine to compensate for the missed dose. It is recommended not to miss a dose of antibiotics as it can lead to antibiotic resistance....
Content Details
WRITTEN BY
Dr. Abhishek B L
MBBS, MD (Pharmacology)
REVIEWED BY
Dr. Ritu Budania
MBBS, MD (Pharmacology)
Frequently Asked Questions (FAQs)
Q: What should I discuss with my healthcare expert before starting on this medication?
A: Some medical conditions and this medicine may interact with Rifaximin. Tell your healthcare provider about your complete medical history, especially of liver diseases, if any. You must give details about the nature of diarrhea, whether it is with or without fever, whether you are taking any antibiotics for some other condition (because some antibiotics cause diarrhea), presence or absence of blood in stools, etc. Tell your doctor about ongoing medications, herbal preparations or dietary supplements. The doctor needs to know if you are allergic to Rifampin (medicine given in tuberculosis and leprosy), Rifapentine, Rifabutin or Rifaximin itself. Share this information if you have any history.
Q: Will Rifaximin change the color of my urine?
- Yes, it is common and completely normal for your urine to turn a reddish or reddish-orange color while you are taking Rifaximin. This harmless change is due to the way a small amount of the medication is naturally processed by your body. It is not a sign that anything is wrong and does not mean the medication is ineffective....
Q: Is Rifaximin a normal antibiotic that will affect my whole body?
- No, Rifaximin is a "non-systemic" antibiotic. This means it acts within your gut (intestines) and is minimally absorbed into your bloodstream. This local action is a major advantage, as it allows Rifaximin to target and kill the problem-causing bacteria right where they live, while minimizing the risks of side effects often associated with traditional antibiotics that circulate throughout your whole body....
Q: How quickly will Rifaximin start working for my diarrhea/IBS symptoms?
- The time to relief depends on the condition being treated.
- For Traveler's Diarrhea, many patients notice improvement in symptoms within 24 to 48 hours.
- For IBS-D (Irritable Bowel Syndrome with Diarrhea), it often takes longer, with patients typically starting to see symptomatic relief and less bloating in the weeks following the complete 14-day course of treatment. Always complete the entire prescribed course even if you feel better quickly....
Q: Can I take Rifaximin with food, or does it need to be taken on an empty stomach?
- You can take Rifaximin with or without food. This makes it easy to fit into your daily routine. Taking it consistently, around the same time each day, as prescribed by your doctor, is more important than whether you take it before or after a meal....
References
View All
- Ema.rifaximin. [Accessed 27 Oct 2025] (online)
- Lactmed.rifaximin. [Accessed 25.Jun.2019] (online) Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Rifaximin. [Updated 2025 Oct 27].
- Mayoclinic.rifaximin. [Accessed 27 Oct 2025] (online)
- Dailymed.rifaximin. [Accessed 27 Oct 2025] (online)
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