Rifacol
Generic Name
Rifaximin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rifacol 550 mg tablet | ৳ 45.13 | ৳ 451.31 |
Description
Overview of the medicine
Rifaximin is a non-systemic antibiotic that acts locally in the gut. It is used to treat Irritable Bowel Syndrome with Diarrhea (IBS-D) and to reduce the risk of overt hepatic encephalopathy (HE) recurrence.
Uses & Indications
Dosage
Adults
For IBS-D: 550 mg orally three times a day for 14 days. For HE: 550 mg orally twice a day.
Elderly
No dosage adjustment is required based on age.
Renal_impairment
No dosage adjustment is required due to minimal systemic absorption.
Hepatic_impairment
No dosage adjustment is required in patients with hepatic impairment.
How to Take
Take orally, with or without food. Complete the full course of treatment as prescribed by your doctor.
Mechanism of Action
Rifaximin inhibits bacterial RNA synthesis by binding to the beta-subunit of bacterial DNA-dependent RNA polymerase. Due to its minimal systemic absorption, it primarily exerts its antibacterial effect within the gastrointestinal lumen, reducing bacterial load.
Pharmacokinetics
Onset
Symptom improvement for IBS-D can be observed within days. For HE, reduction in ammonia levels and clinical improvement may take longer.
Excretion
Over 96% of the administered dose is excreted unchanged in the feces. Less than 0.4% is excreted in urine.
Half life
The systemic half-life of the minimally absorbed rifaximin is approximately 5-6 hours.
Absorption
Minimally absorbed systemically (<0.4%) after oral administration. Peak plasma concentration occurs at approximately 1 hour.
Metabolism
Undergoes limited hepatic metabolism by CYP3A4. The primary metabolite is 2'-desoxy-rifaximin.
Pharmacodynamics details
Local antibacterial action within the gut lumen, reducing bacterial overgrowth and ammonia production.
Side Effects
Contraindications
- Hypersensitivity to rifaximin, rifamycin antibiotics, or any component of the formulation.
- Patients with severe diarrhea complicated by fever or blood in the stool.
Drug Interactions
Cyclosporine
Coadministration with cyclosporine significantly increases systemic exposure to rifaximin, but clinical significance is uncertain due to minimal absorption.
P-glycoprotein (P-gp) inhibitors/inducers
Drugs that inhibit or induce P-gp (e.g., verapamil, quinidine, ritonavir, rifampicin) may alter the systemic exposure of rifaximin, though this is generally not clinically significant.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, discontinue the drug and institute symptomatic and supportive therapy. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if rifaximin is excreted in human milk. Exercise caution when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to rifaximin, rifamycin antibiotics, or any component of the formulation.
- Patients with severe diarrhea complicated by fever or blood in the stool.
Drug Interactions
Cyclosporine
Coadministration with cyclosporine significantly increases systemic exposure to rifaximin, but clinical significance is uncertain due to minimal absorption.
P-glycoprotein (P-gp) inhibitors/inducers
Drugs that inhibit or induce P-gp (e.g., verapamil, quinidine, ritonavir, rifampicin) may alter the systemic exposure of rifaximin, though this is generally not clinically significant.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, discontinue the drug and institute symptomatic and supportive therapy. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if rifaximin is excreted in human milk. Exercise caution when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
FDA Approved
Patent Status
Patent for specific formulations/indications may exist, generic versions available
Clinical Trials
Rifaximin has been extensively studied in various clinical trials demonstrating efficacy and safety for IBS-D and HE recurrence prevention.
Lab Monitoring
- Routine laboratory monitoring is generally not required due to minimal systemic absorption.
Doctor Notes
- Emphasize rifaximin's local gut-specific action and minimal systemic absorption, making it suitable for GI conditions with reduced systemic side effects.
- Counsel patients on completing the full course to prevent recurrence, particularly in HE.
- Differentiate its use from systemic antibiotics; it's not indicated for systemic infections.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Complete the entire course of treatment, even if you start to feel better.
- Inform your doctor if your symptoms worsen or do not improve after treatment.
- Seek medical advice if you experience severe diarrhea, fever, or bloody stools while taking this medicine.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Rifaximin is not expected to impair the ability to drive or operate machinery. However, if you experience dizziness or fatigue, avoid such activities.
Lifestyle Advice
- Maintain adequate hydration.
- For IBS-D, follow dietary recommendations from your doctor or dietitian.
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