About HE

What is HE?

HE (hepatic encephalopathy) is a condition that affects the brain in people who have liver disease.

If you have HE, your liver is damaged and cannot filter toxins out of the blood the way that a healthy liver can. These toxins can build up and travel through your body until they reach your brain. It’s the buildup of these toxins in your brain that can lead to the symptoms of HE.

Symptoms of HE

How to recognize the symptoms of HE

If you have liver disease, it is important to know the symptoms of HE. By paying close attention to your mental and physical symptoms, you can alert your doctor before things get worse.

HE can be either “covert” or “overt” depending on the degree of the symptoms:

  • Covert HE symptoms can go unnoticed, even by a doctor
  • Overt HE symptoms are more noticeable to other people
Man in city

Symptoms of overt HE can include:

Mental

Mental
  • Lack of energy or interest
  • Confusion
  • Not knowing where you are or where you’re going
  • Inappropriate behavior
  • Severe personality changes

Physical

Physical
  • Sleepiness or change in sleep patterns
  • Worsening of handwriting
  • Loss of small hand movements
  • Tremors or shaking of hands or arms
  • Breath with a musty or sweet odor

These symptoms can also be found in older people with Alzheimer’s or dementia, but when they occur in people with liver disease, it may be HE.

Physical
Hepatic Encephalopathy
Symptom Checklist

Download this easy-to-use checklist to help identify the signs of an HE episode and talk to your doctor about any mental or physical symptoms you’ve noticed.

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Hear from HE patients and their families

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Causes of overt HE

Overt HE happens when your liver cannot filter toxins in your blood and the toxins build up and reach your brain

The liver is important because

  • It filters your blood, including everything that you eat and drink, such as food, alcohol, and medicines
  • It helps turn food into energy and nutrients that your body can use
  • It also gets rid of toxins in your blood, which otherwise may be harmful to your body

When your liver is damaged, it cannot remove toxins as well as a healthy liver can. When toxins build up in your brain, you may have short-term and long-term effects that can get worse over time.

Risks of overt HE

Symptoms of HE occur during overt HE “episodes”

When HE symptoms become more severe, the condition is called “overt HE.” If you have overt HE, you may have experienced what is called an “episode” of overt HE.

During an episode, your symptoms can become more obvious. There may be a change in your behavior or personality. You may not understand what is happening, and people around you may notice that you are acting strangely.

These episodes can get worse over time and may result in:

Worsening symptoms

Mental

Studies suggest that problems with memory and learning could get worse after repeated episodes of overt HE, and damage may be permanent.

Hospitalization

Physical

According to one source, more than 50% of patients with overt HE were admitted to the hospital for HE episodes. In fact, more than 1 in 3 of these patients were readmitted to the hospital a second time within 30 days for another episode.

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If you have overt HE, learn more about XIFAXAN today and talk to your doctor.

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HE, hepatic encephalopathy; OHE, overt hepatic encephalopathy.

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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.

XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults.

IMPORTANT SAFETY INFORMATION

  • XIFAXAN is not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.
  • If you take antibiotics, like XIFAXAN, there is a chance you could experience diarrhea caused by an overgrowth of bacteria (C. difficile). This can cause symptoms ranging in severity from mild diarrhea to life-threatening colitis. Contact your healthcare provider if your diarrhea does not improve or worsens.
  • XIFAXAN is not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.
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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 not for everyone. Do not take XIFAXAN if you have a known hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN.
  • If you take antibiotics, like XIFAXAN, there is a chance you could experience diarrhea caused by an overgrowth of bacteria (C. difficile). This can cause symptoms ranging in severity from mild diarrhea to life-threatening colitis. Contact your healthcare provider if your diarrhea does not improve or worsens.
  • Talk to your healthcare provider before taking XIFAXAN if you have severe hepatic (liver) impairment, as this may cause increased effects of the medicine.
  • Tell your healthcare provider if you are taking drugs called P-glycoprotein and/or OATPs inhibitors (such as cyclosporine) because using these drugs with XIFAXAN may lead to an increase in the amount of XIFAXAN absorbed by your body.
  • In clinical studies, the most common side effects for XIFAXAN were:
    • - HE: Peripheral edema (swelling, usually in the ankles or lower limbs), constipation, nausea (feeling sick to your stomach), fatigue (feeling tired), insomnia (trouble sleeping), ascites (a buildup of fluid in the abdomen), dizziness, urinary tract infection, anemia (low red blood cell levels), and itching
    • - IBS-D: Nausea (feeling sick to your stomach) and an increase in liver enzymes
  • XIFAXAN may affect warfarin activity when taken together. Tell your healthcare provider if you are taking warfarin because the dose of warfarin may need to be adjusted to maintain proper blood-thinning effect.
  • If you are pregnant, planning to become pregnant, or nursing, talk to your healthcare provider before taking XIFAXAN because XIFAXAN may cause harm to an unborn baby or nursing infant.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch/ or call 1-800-FDA-1088.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch/ or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183
Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183

Please click here for full Prescribing Information.

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