Xifaxan Side Effects
Generic name: rifaximin
Medically reviewed by drugclasses.com. Last updated on Sep 27, 2023.
Note: This document contains side effect information about rifaximin. Some dosage forms listed on this page may not apply to the brand name Xifaxan.
Applies to rifaximin: oral tablet.
Serious side effects of Xifaxan
Along with its needed effects, rifaximin (the active ingredient contained in Xifaxan) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking rifaximin:
More common
- Anxiety
- black, tarry stools
- bladder pain
- bloody or cloudy urine
- difficult, burning, or painful urination
- dizziness or lightheadedness
- frequent urge to urinate
- lower back or side pain
- muscle spasm
- rapid breathing
- trouble sleeping
Less common
- Blood in the urine
- bloody nose
- chest pain
- continuing ringing or buzzing or other unexplained noise in the ears
- fainting
- feeling of constant movement of self or surroundings
- increased heart rate
- sensation of spinning
- sunken eyes
- ulcers, sores, or white spots in the mouth
- unusual bleeding or bruising
- unusual tiredness or weakness
Incidence not known
- Cracks in the skin
- hives or welts, itching skin, or rash
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- loss of heat from the body
- red, swollen skin
- redness of the skin
- scaly skin
Other side effects of Xifaxan
Some side effects of rifaximin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Bloated
- constipation
- difficulty with moving
- excess air or gas in the stomach or intestines
- fever
- frequent urge to defecate
- full feeling
- headache
- muscle pain or stiffness
- pain in the joints
- passing gas
- stomach pain or bloating
- straining while passing stool
- swelling of the hands, ankles, feet, or lower legs
Less common
- Abnormal dreams
- blurred vision
- chills
- confusion
- cough
- decreased urination
- difficulty having a bowel movement (stool)
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- dry lips
- dry mouth
- ear pain
- feeling of warmth
- hearing loss
- loss of appetite
- loss of taste
- nausea
- painful or difficult urination
- pale skin
- redness of the face, neck, arms, and occasionally, upper chest
- sore throat
- sweating
- swollen glands
- thirst
- vomiting
- wrinkled skin
For Healthcare Professionals
Applies to rifaximin: oral tablet.
General
When used for the treatment of travelers' diarrhea, the most common side effect was headache. This drug was discontinued due to side effects in 0.4% of patients; such side effects were taste loss, dysentery, decreased weight, anorexia, nausea, and nasal passage irritation.
When used for reduction in risk of overt hepatic encephalopathy recurrence, the most common side effects were peripheral edema, nausea, dizziness, fatigue, and ascites.
When used for the treatment of irritable bowel syndrome with diarrhea, the most common side effects were nausea and increased ALT.[Ref]
Gastrointestinal
Very common (10% or more): Nausea (up to 14.3%), ascites (11.4%), flatulence (up to 11%)
Common (1% to 10%): Abdominal pain, abdominal distension, rectal tenesmus, upper abdominal pain, defecation urgency, constipation, stomach discomfort, vomiting, lower abdominal pain, abdominal tenderness, dry mouth, esophageal variceal bleed, diarrhea, bloating and distension, nausea and vomiting symptoms
Uncommon (0.1% to 1%): Dry lips, dyspepsia, gastrointestinal motility disorder, hard feces, hematochezia, mucous stools, taste disorders
Frequency not reported: Blood in stool, dysentery, fecal abnormality, gingival disorder, inguinal hernia, straining, bad taste in mouth, Clostridium colitis
Postmarketing reports: Clostridioides difficile-associated colitis[Ref]
Other
Very common (10% or more): Peripheral edema (15%), fatigue (up to 12.1%)
Common (1% to 10%): Pyrexia, chest pain, pain, generalized edema, influenza-like illness, contusion, fall, procedural pain
Uncommon (0.1% to 1%): Ear pain, candidiasis, hot flush, edema, herpes simplex, asthenic conditions, pain and discomfort, chills
Rare (less than 0.1%): Asthenia
Frequency not reported: Motion sickness, malaise, hot flashes
Postmarketing reports: Clostridial infections (C difficile)[Ref]
Nervous system
Very common (10% or more): Dizziness (up to 13%), headache (10%)
Common (1% to 10%): Vertigo, amnesia, disturbance in attention, hypoesthesia, memory impairment, tremor
Uncommon (0.1% to 1%): Balance disorders, convulsion, attention disorders, migraine, paresthesia, sinus headache, somnolence
Frequency not reported: Syncope, tinnitus, loss of taste
Postmarketing reports: Presyncope, syncope[Ref]
Hypersensitivity
Frequency not reported: Anaphylactic reactions
Postmarketing reports: Hypersensitivity reactions (including exfoliative dermatitis, rash, angioneurotic edema [swelling of face and tongue and difficulty swallowing], urticaria, pruritus, flushing, anaphylaxis), anaphylactic responses, angioedemas, hypersensitivity[Ref]
Hypersensitivity reactions have occurred as early as within 15 minutes of drug administration.[Ref]
Dermatologic
Common (1% to 10%): Pruritus, rash, cellulitis
Uncommon (0.1% to 1%): Eruptions and exanthemas, sunburn, hyperhidrosis/increased sweating, cold sweat
Frequency not reported: Clamminess
Postmarketing reports: Angioedema, dermatitis, exfoliative dermatitis, eczema, erythemas, pruritus, purpura, urticarias[Ref]
Musculoskeletal
Rhabdomyolysis has been reported in patients with cirrhosis (with and without concurrent statin use).[Ref]
Common (1% to 10%): Muscle spasms, arthralgia, back pain, myalgia, pain in extremity
Uncommon (0.1% to 1%): Neck pain, muscular weakness
Frequency not reported: Increased blood creatine phosphokinase
Postmarketing reports: Rhabdomyolysis[Ref]
Hematologic
Common (1% to 10%): Anemia
Uncommon (0.1% to 1%): Lymphocytosis, monocytosis, neutropenia
Postmarketing reports: Thrombocytopenia, INR abnormalities[Ref]
Respiratory
Common (1% to 10%): Cough, nasopharyngitis, dyspnea, upper respiratory tract infection, rhinitis, pneumonia, epistaxis
Uncommon (0.1% to 1%): Pleural effusion, pharyngitis, oropharyngeal pain, rhinorrhea, dry throat, nasal congestion
Rare (less than 0.1%): Chronic obstructive pulmonary disease
Frequency not reported: Respiratory tract infection, nasal passage irritation, pharyngolaryngeal pain[Ref]
Psychiatric
Common (1% to 10%): Depression, insomnia, confusional state
Uncommon (0.1% to 1%): Anxiety, hypersomnia, abnormal dreams, depressed mood, nervousness[Ref]
Metabolic
Common (1% to 10%): Increased weight, anorexia, dehydration, hyperglycemia, hyperkalemia, hypoglycemia, hyponatremia
Uncommon (0.1% to 1%): Decreased appetite
Frequency not reported: Decreased weight[Ref]
Cardiovascular
Common (1% to 10%): Hypotension
Uncommon (0.1% to 1%): Palpitations, increased blood pressure
Rare (less than 0.1%): Hypertension[Ref]
Genitourinary
Uncommon (0.1% to 1%): Urinary tract infection, dysuria, polyuria, proteinuria, pollakiuria, blood in urine present, glycosuria, polymenorrhea
Frequency not reported: Choluria, hematuria, urinary frequency[Ref]
Hepatic
Common (1% to 10%): Increased ALT
Uncommon (0.1% to 1%): Increased AST
Postmarketing reports: Liver function test abnormalities[Ref]
Ocular
Uncommon (0.1% to 1%): Diplopia[Ref]
More about Xifaxan (rifaximin)
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References
1. (2004) "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals
2. Cerner Multum, Inc. "Australian Product Information."
3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
4. Pimentel M, Park S, Mirocha J, Kane SV, Kong Y (2006) "The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial." Ann Intern Med, 145, p. 557-63
5. Trapnell CB, Connolly M, Pentikis H, Forbes B, Bettenhausen DK (2007) "Absence of effect of oral rifaximin on the pharmacokinetics of ethinyl estradiol/norgestimate in healthy females." Ann Pharmacother, 41, p. 222-8
6. Juillerat P, Pittet V, Felley C, et al. (2007) "Drug safety in Crohn's disease therapy." Digestion, 76, p. 161-8
7. Garey KW, Salazar M, Shah D, Rodrigue R, Dupont HL (2008) "Rifamycin antibiotics for treatment of Clostridium difficile-associated diarrhea." Ann Pharmacother, 42, p. 827-35
8. (2010) "Rifaximin (Xifaxan 550) for hepatic encephalopathy." Med Lett Drugs Ther, 52, p. 87
9. Hynicka LM, Silva KN (2012) "Probable rifaximin-induced neutropenia." Am J Health Syst Pharm, 69, p. 583-6
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.