Drug interactions
Microbiota + Rifaximin
Severity: Major
Microbiota and Rifaximin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Oral fecal microbiota contains live bacterial spores intended to restore the gut flora. Rifaximin acts in the gut lumen and can reduce the engrafting organisms, lowering efficacy. Antibiotic courses should end before the microbiota product is given.
What this interaction means in plain words
Microbiota and Rifaximin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Luminal antibacterial activity of rifaximin suppresses the administered live bacterial spores and impairs engraftment.
What to do
Finish the antibiotic course and allow the interval in the product labeling before giving microbiota. Avoid concurrent rifaximin unless essential.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Rifaximin
- Cholera vaccine + Rifaximin Major
- Amiodarone + Rifaximin Moderate
- Bcg intravesical live + Rifaximin Moderate
- Cyclosporine + Rifaximin Moderate
- Cyclosporin + Rifaximin Moderate
- Dronedarone + Rifaximin Moderate
Frequently asked questions
Can I take Microbiota with Rifaximin?
MediHelp rates the interaction as major. Microbiota and Rifaximin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Oral fecal microbiota contains live bacterial spores intended to restore the gut flora. Rifaximin acts in the gut lumen and can reduce the engrafting organisms, lowering efficacy. Antibiotic courses should end before the microbiota product is given.
How serious is the interaction between Microbiota and Rifaximin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Finish the antibiotic course and allow the interval in the product labeling before giving microbiota. Avoid concurrent rifaximin unless essential.
What other medicines interact with Rifaximin?
MediHelp also lists interactions of Rifaximin with, for example, Cholera vaccine, Amiodarone, Bcg intravesical live. The full list is on the Rifaximin page.
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