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rINN: Rifaximin
Other Names
Rifaximine, DB01220, rifaxidin, 2S, 16Z, 18E, 20S, 21S, 22R, 23R, 24R, 25S, 26S, 27S, 28E)-5, 6, 21, 23, 25-pentahydroxy-27-methoxy-2, 4, 11, 16, 20, 22, 24, 26-octamethyl-2, 7- (epoxypentadeca-[1, 11, 13]trienimino) benzofuro[4, 5-e]pyrido[1, 2-a]-benzimida-zole-1, 15(2H)- dione, 25-acetate, Fatroximin®, Normix®, Ritacol®, Xifaxan®
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Wikipedia on Rifaximin (Less technical, ? quality control)

Rifaximin is a non-absorbed antibiotic fairly widely used to treat travellers diarrhoea[1] and in further development for treating hepatic encephalopathy[2] and Crohn's disease[3]. It seems to have minimal impact on the normal intestinal microflora, so is being studied in a wide range of infective bowel disease such as clostridium difficile infection and diverticulitis. However it has been associated with cases of clostridium difficile in patients with risk of hepatic encephalopathy[4]. There are preliminary reports of its use in restless legs syndrome[5] and irritable bowel syndrome[6].


Rifaximin is a semisynthetic rifamycin derived from Amycolatopsis mediterranei. With diarrhoea caused by Escherichia coli and Shigella sonnei it alters bacterial virulence[1].


  1. a b Jiang ZD, Ke S, Dupont HL. Rifaximin-induced alteration of virulence of diarrhoea-producing Escherichia coli and Shigella sonnei. International journal of antimicrobial agents. 2010 Mar; 35(3):278-81.(Link to article – subscription may be required.)
  2. Jiang Q, Jiang XH, Zheng MH, Jiang LM, Chen YP, Wang L. Rifaximin versus nonabsorbable disaccharides in the management of hepatic encephalopathy: a meta-analysis. European journal of gastroenterology & hepatology. 2008 Nov; 20(11):1064-70.(Link to article – subscription may be required.)
  3. Shafran I, Burgunder P. Adjunctive Antibiotic Therapy with Rifaximin May Help Reduce Crohn's Disease Activity. Digestive diseases and sciences. 2010 Jan 29.(Epub ahead of print) (Link to article – subscription may be required.)
  4. Bass NM, Mullen KD, Sanyal A, Poordad F, Neff G, Leevy CB, Sigal S, Sheikh MY, Beavers K, Frederick T, Teperman L, Hillebrand D, Huang S, Merchant K, Shaw A, Bortey E, Forbes WP. Rifaximin treatment in hepatic encephalopathy. The New England journal of medicine. 2010 Mar 25; 362(12):1071-81.(Link to article – subscription may be required.)
  5. Weinstock LB. Antibiotic therapy may improve idiopathic restless legs syndrome: Prospective, open-label pilot study of rifaximin, a nonsystemic antibiotic. Sleep medicine. 2009 Dec 28.(Epub ahead of print) (Link to article – subscription may be required.)
  6. Pimentel M, Lembo A, Chey WD, Zakko S, Ringel Y, Yu J, Mareya SM, Shaw AL, Bortey E, Forbes WP. Rifaximin therapy for patients with irritable bowel syndrome without constipation. The New England journal of medicine. 2011 Jan 6; 364(1):22-32.(Link to article – subscription may be required.)
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