Status of Rifaximin: A Review of Characteristics, Uses and Analytical Methods

Abstract

Rifaximin, an oral antimicrobial, has many advantages because it is selective intestine, has minimal adverse effects and is used for the treatment of some diseases such as hepatic encephalopathy, irritable bowel syndrome, travelers' diarrhea, ulcerative colitis, Clostridium difficile and acute diarrhea. Rifaximin in the form of 200 mg tablets is commercially available. The crystalline α form is therapeutically safe and effective. In most of the official compendia, rifaximin has no monograph and in none of them is there a monograph for rifaximin tablets. The literature, however, contemplates this gap with varied methods. The literature presents some methods for evaluation of rifaximin in both biological fluid and pharmaceutical product. High performance liquid chromatography stands out for the evaluation of rifaximin. Most of the methods reported in the literature are for pharmaceuticals products. They use (1) toxic organic solvents, harmful to the operator and the environment, and/or (2) buffer solution, which has a shorter service life and requires time-consuming washes of the chromatographic system generating more waste. So, this work aims to discuss (i) properties; (ii) applications; (iii) polymorphism and (iv) analytical methods of rifaximin by the look of green chemistry. This review shows an extremely current topic of great importance to the chemical-pharmaceutical area and everything it involves, since the analytical process until the impact on the environment in which it is embedded.

Travelers’ Diarrhea: A Clinical Review

“…The medication is safe to use in pregnant women and children. Rifaximin (Xifaxan, Xifaxante, Normix) is a nonabsorbable (< 0.4% absorbed), locally active antimicrobial that can achieve high concentrations in the intestines [62, 63]. The medication binds to the beta subunit of the bacterial RNA polymerase and inhibits bacterial RNA synthesis.…”

“…The medication is poorly absorbed from the gastrointestinal tract, thereby achieving high concentration in the intestines [48]. The medication has minimal side effects [63]. Rifaximin is less effective for the treatment of invasive pathogens and should not be used for the treatment of dysentery [6].…”

Rifaximin Modulates the Gut Microbiota to Prevent Hepatic Encephalopathy in Liver Cirrhosis Without Impacting the Resistome

“…The main drugs currently used for prevention and treatment of HE are L-ornithine-L-aspartate, lactulose, lactitol, and rifaximin. Rifaximin(as the only available crystalline α form rifaximin in clinical, rifaximin refers to rifaximin-α in this article) is a rifamycin derivative with low absorption that may exert pharmacological actions through its effect on the gut microbiota ( Kogawa and Salgado, 2018 ). In 2010, the US FDA approved rifaximin for prevention and treatment of HE; indeed, EASL-AASLD guidelines (2014 version) for the treatment of HE recommends this drug as an effective add-on treatment for patients with overt HE (i.e., those who develop the disease while taking lactulose) and for preventing recurrence of HE.…”

Monoclonal antibody production and the development of a quantitative time-resolved fluoroimmunoassay for rifaximin in milk

“…There are a number of review articles concerning instrumental methods for the analysis of RIF in milk, blood, faeces, and other fluids, but no immunoassay method was observed (Kogawa & Salgado, 2018). These instrument-based methods are mostly sensitive and accurate, but they usually require expensive equipment, large volumes of organic solvents and time-consuming sample clean-up procedures.…”