Comparative Pharmacology
Head-to-head clinical analysis: RIFAXIMIN versus ZOSYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: RIFAXIMIN versus ZOSYN.
RIFAXIMIN vs ZOSYN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Rifaximin is a non-aminoglycoside, semi-synthetic antibiotic derived from rifamycin that inhibits bacterial RNA synthesis by binding to the beta-subunit of bacterial DNA-dependent RNA polymerase, thereby blocking transcription.
Piperacillin, a semisynthetic penicillin, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). Tazobactam, a beta-lactamase inhibitor, inactivates beta-lactamases, preventing piperacillin degradation.
550 mg orally three times daily for 14 days for travelers' diarrhea; 200 mg orally three times daily for 3 days for irritable bowel syndrome with diarrhea; 400 mg orally three times daily for 7 days for hepatic encephalopathy.
3.375 g (piperacillin 3 g / tazobactam 0.375 g) intravenously every 6 hours over 30 minutes; for nosocomial pneumonia, 4.5 g intravenously every 6 hours.
None Documented
None Documented
Clinical Note
moderateRifaximin + Digoxin
"The serum concentration of Digoxin can be increased when it is combined with Rifaximin."
Clinical Note
moderateRifaximin + Levofloxacin
"The serum concentration of Levofloxacin can be increased when it is combined with Rifaximin."
Clinical Note
moderateRifaximin + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Rifaximin."
Clinical Note
moderateRifaximin + Tranilast
The terminal elimination half-life is approximately 1.8 to 2.5 hours in patients with normal hepatic function. Due to negligible systemic absorption, the half-life has limited clinical relevance; drug action is largely confined to the gastrointestinal tract.
Piperacillin ~0.7-1.2 h; tazobactam ~0.7-1.0 h; extended in renal impairment (piperacillin up to 3.3 h, tazobactam up to 4.7 h in CrCl <20 mL/min)
Rifaximin is primarily eliminated in feces as unchanged drug (>96% of an oral dose). Renal excretion is negligible (<0.4%). Biliary excretion is minimal due to poor systemic absorption.
Primarily renal; piperacillin 68% unchanged, tazobactam 80% unchanged; biliary/fecal excretion <10%
Category A/B
Category C
Antibiotic
Antibiotic
"The serum concentration of Tranilast can be decreased when it is combined with Rifaximin."