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Rifaximin is a medicine used in adults with traveler’s diarrhea. This is a type of medicine called a rifamycin antibiotic. The Food and Drug Administration (FDA) has already approved this prescription. Rifaximin comes as a tablet for oral use with the dosage strengths of 200 mg and 550 mg. 

Traveler’s diarrhea is a digestive tract disorder that causes abdominal cramps and loose stools. When you visit a place where the climate or sanitary practices are different from yours at home, you have an increased risk of developing the condition. This usually begins abruptly during your trip or shortly after you return home. Most cases improve within one to two days without treatment and clear up completely within a week. However, you can have multiple episodes of traveler’s diarrhea during one trip. The most common signs and symptoms of traveler’s diarrhea are:

  • Fever
  • Vomiting
  • Nausea
  • Abrupt onset of the passage of three or more loose stools a day
  • Abdominal cramps
  • An urgent need to defecate 

Sometimes, people experience a high fever, moderate to severe dehydration, bloody stools, persistent vomiting, or severe pain in the abdomen. Traveler’s diarrhea may stem from the stress of traveling or a change in diet. But usually, an infectious agent is to blame. You typically develop traveler’s diarrhea after ingesting food or water that’s contaminated with organisms from feces.

Your chances of getting traveler’s diarrhea are mostly determined by your destination. But, certain groups of people have a greater risk of developing the condition. These include:

People with weakened immune systems. A weakened immune system increases vulnerability to infections.

Young adults. The condition is slightly more common in young adult tourists. Though the reasons why aren’t clear, it’s possible that young adults lack acquired immunity. They may also be more adventurous than older people in their travels and dietary choices or they may be less vigilant in avoiding contaminated foods.

People with inflammatory bowel disease, diabetes, or cirrhosis of the liver. These conditions can leave you more prone to infection or increase your risk of a more severe infection.

People who travel during certain seasons. The risk of traveler’s diarrhea varies by season in certain parts of the world. 

People who take acid blockers or antacids. The acid in the stomach tends to destroy organisms, so a reduction in stomach acid may leave more opportunity for bacterial survival. 

How does Rifaximin work?

Rifaximin works by killing the bacteria that are causing the infection. It targets and inactivates the bacterial enzyme called RNA-polymerase. The bacteria use RNA-polymerase to make essential proteins and to copy their genetic information which is called DNA. Without this enzyme, the bacteria cannot reproduce and they die.

This antibiotic acts locally in the intestine and is not absorbed into the bloodstream in significant amounts.

How to use Rifaximin for traveler’s diarrhea?

Rifaximincan be taken with or without a meal. They should be swallowed with a glass of water. Do not chew or crush the medicine. The usual dose of this is one tablet to be taken every eight hours for three days. You should complete this course even if your symptoms improve. The dosage is based on your medical condition and response to treatment. For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time and in the same way every day. If you missed a dose, call your doctor right away for instructions. Do not double the dose to make up for the missed dose. 

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection. Tell your doctor if you are still having diarrhea after 1 to 2 days, if you have bloody diarrhea or if you have a fever along with diarrhea. Tell your doctor if your condition does not improve or if it worsens. 

The possible side effects of Rifaximin 

Common side effects:

  • Vomiting
  • Nausea
  • Bloating
  • Constipation
  • Stomach pain
  • Gas
  • Feeling your bowel is not empty
  • Feeling like you urgently empty your bowel
  • Dizziness
  • Headache
  • Swelling in your feet, hands, or torso
  • Tired feeling

Tell your doctor if you have developed serious side effects such as:

  • Abdominal or stomach pain or cramps
  • Persistent diarrhea
  • Blood or mucus in your stool 


  • This should only be taken for a maximum of three days. If your symptoms do not improve after three days or come back shortly after you have finished the course, you should see a doctor.
  • Antibiotics can sometimes cause inflammation of the bowel. For this reason, if your diarrhea gets worse or starts to contain blood or mucus, either during or after taking this medicine, you should consult a doctor right away.
  • This medicine should not be used in people with an allergy to any rifamycin antibiotics, people with diarrhea containing blood, or those who have experienced eight or more unformed or liquid stools in the previous 24 hours.
  • Children and adolescents under 18 years old should also not use this prescription. 
  • This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine, and inform your doctor instantly.
  • The safety of this medicine in pregnancy has not been established. The manufacturer states that it is not recommended for women who are pregnant or for fertile women who are not using an effective method of contraception. Seek further medical advice from your doctor.
  • It is not known if this medicine passes into breast milk, although this is unlikely because the medicine is only minimally absorbed into the bloodstream. The manufacturer recommends that mothers who are breastfeeding should either not take this medicine or if they wish to take this medicine should stop breastfeeding temporarily during treatment. Ask your doctor for further information.
  • You must tell your doctor about the medicines you are taking including vitamins or herbal supplements.