From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

Rifaximin is an oral antibiotic that is active in the gastrointestinal tract against both gram-positive and gram-negative bacteria, as well as, both aerobic and anaerobic bacteria.[1] It is used to treat several other gastrointestinal conditions including traveler's diarrhea, irritable bowel syndrome, hepatic encephalopathy, and C. difficile infection.[2] Among ME/CFS patients, it is commonly used as a treatment for Small Intestine Bacterial Overgrowth (SIBO).

Evidence[edit | edit source]

A meta-analysis published in 2017 concluded "Rifaximin treatment seems to be effective and safe for the treatment of SIBO. However, the quality of the available studies is generally poor. Well‐designed RCTs are needed to substantiate these findings and to establish the optimal regimen."[3]

Side effects[edit | edit source]

Cost and Availability[edit | edit source]

United States[edit | edit source]

Rifxamin is marketed with the brand name Xifaxan. As of May 2019, a 42-count bottle of 550mg Xifaxan pills is priced at approximately $1620 according to GoodRx.[4] No generic is authorized in the United States at this time.

Due to the cost, insurance coverage for Rifaximin is limited. Many insurance plans require prior authorization paperwork. Patients who can get coverage are often subject to strict quantity / refill limits.

The combination of cost, lack of an approved generic, and insurance considerations cause many patients to look to foreign pharmacies.

Learn more[edit | edit source]

References[edit | edit source]

  1. Calanni, Fiorella; Renzulli, Cecilia; Barbanti, Miriam; Viscomi, Giuseppe Claudio (September 2014). "Rifaximin: beyond the traditional antibiotic activity". The Journal of Antibiotics. 67 (9): 667–670. doi:10.1038/ja.2014.106. ISSN 0021-8820. PMID 25095806.
  2. Lake, Joanita; Nelson, Scott (May 2013). "Rifaximin (Xifaxan)" (PDF). Utah Department of Health. Retrieved June 1, 2019.
  3. Gatta, L.; Scarpignato, C.; McCallum, R.W.; Lombardo, L.; Pimentel, M.; D'Incà, R.; Gasbarrini, A.; De Stefano, A.; Cerda, E. (March 2017). "Systematic review with meta‐analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth". Alimentary Pharmacology & Therapeutics. 45 (5): 604–616. doi:10.1111/apt.13928. ISSN 0269-2813. PMC 5299503. PMID 28078798.
  4. "Rifaximin Prices, Coupons & Savings Tips". GoodRx. Retrieved May 31, 2019.