Home » About Hepatic Encephalopathy » Other HE Treatment Options

• HE-Related Hospitalizations
• Other HE Treatment Options

Other HE treatment options

Nonabsorbable disaccharides

Lactulose has been considered the standard of treatment for HE, with clinical studies showing about 50% of patients experiencing improvement.1,2

• Lactulose has a very sweet taste and may cause gas, bloating, and diarrhea, making it difficult for some patients to tolerate.1,2
• Lactulose also may lead to dehydration in some patients, which may be a trigger for HE.1

Antibiotics

Several antibiotics, including neomycin and metronidazole, which have activity in the small bowel, although not approved for HE, have been shown to reduce symptoms of encephalopathy.3

• Despite poor absorption, neomycin is potentially associated with hearing loss and renal failure.3
• Metronidazole has a high rate of adverse events, the most serious being neurotoxicity, which can be severe in cirrhotic patients with impaired intestinal motility.3

Learn more about Xifaxan 550 mg.

See how Xifaxan 550 mg may reduce hospitalizations.

IMPORTANT SAFETY INFORMATION

XIFAXAN 550 mg is indicated for reduction in risk of overt hepatic encephalopathy (HE) recurrence in patients ≥18 years of age. In the trials of XIFAXAN for HE, 91% of the patients were using lactulose concomitantly. XIFAXAN has not been studied in patients with MELD scores >25, and only 8.6% of patients in the controlled trial had MELD scores over 19. There is increased systemic exposure in patients with more severe hepatic dysfunction. Therefore, caution should be exercised when administering XIFAXAN to patients with severe hepatic impairment (Child-Pugh C).

XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, any of the 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. Treatment with antibacterial agents alters the normal flora of the colon which may lead to overgrowth of C. difficile. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.

The most common adverse reactions occurring in >8% of patients in the clinical study were edema peripheral (15%), nausea (14%), dizziness (13%), fatigue (12%), ascites (11%), muscle spasms (9%), pruritus (9%), and abdominal pain (9%).

Complete Prescribing Information.

For product information, adverse event reports, and product complaint reports, please contact:
Salix Product Information Call Center
Phone: 1-800-508-0024
Fax: 1-510-595-8183
Email: Salix@medcomsol.com

References: 1. Muñoz SJ. Hepatic encephalopathy. Med Clin North Am. 2008;92(4):795-812. 2. Als-Nielsen B, Gluud LL, Gluud C. Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials. Br Med J. 2004;328(7447):1046. 3. Blei AT, Cordoba J, Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines: hepatic encephalopathy. Am J Gastroenterol. 2001;96(7):1968-1976.