Xifaxan

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What is Xifaxan?

Xifaxan is a rifamycin-class antibiotic that works almost entirely within the gastrointestinal tract—it's minimally absorbed into the bloodstream, so its activity is concentrated where it's needed most. It's used to treat traveler's diarrhea caused by E. coli, to reduce episodes of hepatic encephalopathy (confusion and cognitive decline caused by liver disease), and to treat irritable bowel syndrome with diarrhea (IBS-D). Its gut-limited action allows it to alter the intestinal bacterial environment without the systemic side effects of conventional antibiotics.

Gut-selective antibiotic action

Xifaxan is less than 0.4% absorbed after oral dosing, concentrating its antibacterial effects entirely within the intestinal tract—disrupting bacterial RNA synthesis locally without meaningful systemic antibiotic exposure.

Hepatic encephalopathy prevention

Reduces ammonia-producing bacteria in the gut, lowering the blood ammonia levels that accumulate in liver disease and trigger the confusion, disorientation, and cognitive decline of hepatic encephalopathy.

IBS-D microbiome modulation

Appears to reduce small intestinal bacterial overgrowth and normalize gut microbiome composition, reducing bloating, abdominal pain, and diarrhea in IBS-D patients—effects that can persist for weeks after a short treatment course.

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