Don’t wait until a patient is hospitalized:
screen for HE today

Because cirrhosis is such a strong risk factor for overt HE, screening for HE is critical in patients with CLD/cirrhosis.1 Diagnosis requires the detection of signs suggestive of HE in a patient with severe liver insufficiency who does not have obvious alternative causes of brain dysfunction.2

You can help patients at risk of overt HE recurrence by screening today

  • As burden of CLD/cirrhosis increases, frequency of HE increases2-5
  • Disrupt the pattern: screen with West Haven Criteria (Conn score)2

Align with the Guidelines for patients at risk

XIFAXAN earned AASLD/EASL’s highest possible recommendation (GRADE I, A, 1) as an add-on therapy to lactulose to reduce the risk of overt HE recurrence after a patient has a recurrence while on lactulose alone2*

  • Overt HE may recur despite treatment with lactulose2
  • Lactulose alone may not be sufficient for secondary prophylaxis2,5

Preview AASLD Guidelines 2014

Connect to AASLD

Managing overt HE

  • A main goal in managing overt HE: reduce or eliminate toxins produced in the gut3
  • After an overt HE episode, ongoing management is recommended to reduce the risk of recurrence2

Standard of care

Continue lactulose
  • Lactulose is generally used as initial treatment for OHE2
  • Nonabsorbable disaccharide that eliminates fecal waste, including gut toxins3,6
Add XIFAXAN
  • 40% cumulative risk of an overt HE recurrence at 1 year and a 40% cumulative risk of another overt HE recurrence within 6 months of that episode, despite lactulose treatment2
  • AASLD/EASL 2014 Guideline recommends adding XIFAXAN to lactulose for ongoing management after an overt HE recurrence on lactulose alone to reduce the risk of another recurrence2*
  • Adding XIFAXAN to lactulose therapy has been proven to lower the risk of overt HE recurrence and HE-related hospitalizations2
INDICATIONS

XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults and for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

IMPORTANT SAFETY INFORMATION
  • XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.
  • Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including XIFAXAN, and may range in severity from mild diarrhea to fatal colitis. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.
  • There is an increased systemic exposure in patients with severe (Child-Pugh Class C) hepatic impairment. Caution should be exercised when administering XIFAXAN to these patients.
  • Caution should be exercised when concomitant use of XIFAXAN and P-glycoprotein (P-gp) and/or OATPs inhibitors is needed. Concomitant administration of cyclosporine, an inhibitor of P-gp and OATPs, significantly increased the systemic exposure of rifaximin. In patients with hepatic impairment, a potential additive effect of reduced metabolism and concomitant P-gp inhibitors may further increase the systemic exposure to rifaximin.
  • In clinical studies, the most common adverse reactions for XIFAXAN were:
    • HE (≥10%): Peripheral edema (15%), nausea (14%), dizziness (13%), fatigue (12%), and ascites (11%)
    • IBS-D (≥2%): Nausea (3%), ALT increased (2%)
  • INR changes have been reported in patients receiving rifaximin and warfarin concomitantly. Monitor INR and prothrombin time. Dose adjustment of warfarin may be required.
  • XIFAXAN may cause fetal harm. Advise pregnant women of the potential risk to a fetus.

To report SUSPECTED ADVERSE REACTIONS, contact Salix Pharmaceuticals at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please click here for full Prescribing Information.

INDICATIONS

XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults and for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

IMPORTANT SAFETY INFORMATION
  • XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.