Rifaximin

Gefahreninformationscode (GHS)

• Bildanzeige (GHS)

  

• Alarmwort

  Warnung

• Gefahrenhinweise

  H312：Gesundheitsschädlich bei Hautkontakt.

  H332：Gesundheitsschädlich bei Einatmen.

  H335：Kann die Atemwege reizen.

  H361：Kann vermutlich die Fruchtbarkeit beeinträchtigen oder das Kind im Mutterleib schädigen.

• Sicherheit

  P201：Vor Gebrauch besondere Anweisungen einholen.

  P202：Vor Gebrauch alle Sicherheitshinweise lesen und verstehen.

  P261：Einatmen von Staub vermeiden.

  P271：Nur im Freien oder in gut belüfteten Räumen verwenden.

  P280：Schutzhandschuhe/Schutzkleidung/Augenschutz tragen.

  P281：Vorgeschriebene persönliche Schutzausrüstung verwenden.

  P302+P352：BEI BERÜHRUNG MIT DER HAUT: Mit viel Wasser/... (Hersteller kann, falls zweckmäßig, ein Reinigungsmittel angeben oder, wenn Wasser eindeutig ungeeignet ist, ein alternatives Mittel empfehlen) waschen.

  P304+P340：BEI EINATMEN: Die Person an die frische Luft bringen und für ungehinderte Atmung sorgen.

  P308+P313：BEI Exposition oder falls betroffen: Ärztlichen Rat einholen/ärztliche Hilfe hinzuziehen.

  P312：Bei Unwohlsein GIFTINFORMATIONSZENTRUM/Arzt/... (geeignete Stelle für medizinische Notfallversorgung vom Hersteller/Lieferanten anzugeben) anrufen.

  P322：Gezielte Maßnahmen

  P363：Kontaminierte Kleidung vor erneutem Tragen waschen.

  P405：Unter Verschluss aufbewahren.

  P501：Inhalt/Behälter ... (Entsorgungsvorschriften vom Hersteller anzugeben) zuführen.

Rifaximin Chemische Eigenschaften,Einsatz,Produktion Methoden

• Beschreibung

  Rifaximin is an antibiotic structurally related to rifamycin. It is reported to be efficacious in the treatment of gastrointestinal infections and hepatic encephalopathy, being highly active against Gram-positive and -negative aerobic and anaerobic bacteria. Due to poor systemic absorption, rifaximin is effective in presurgical sterilization of the GI tract.It displays good activity against a wide spectrum of bacteria, including Salmonella spp., S. aureus, and E. coli.

• Chemische Eigenschaften

  Red-Orange Crystalline Powder

• Originator

  Alfa (Italy)

• Verwenden

  Muscle Relaxant

• Verwenden

  antibacterial, RNA synthesis inhibitor

• Verwenden

  Rifaximin is a non-absorbable semisynthetic Rifamycin antibiotic.

• Definition

  ChEBI: A semisynthetic member of the class of rifamycins and non-systemic gastrointestinal site-specific broad spectrum antibiotic. Used in the treatment of traveller's diarrhoea, hepatic encephalopathy and irritable bowel syndrome.

• Trademarks

  Xifaxan (Salix);Normix.

• Antimicrobial activity

  The in-vitro activity is slightly inferior to that of rifampicin. The MIC90 for Gram-positive cocci is well below 1 mg/L, with the exception of enterococci (MIC 2–8 mg/L). Among intestinal pathogens C. difficile is sensitive (MIC90 0.8 mg/L), Esch. coli, Salmonella spp. and Shigella spp. are inhibited by 4–8 mg/L. Campylobacter jejuni is mostly insensitive.

• Pharmazeutische Anwendungen

  A semisynthetic derivative of rifamycin S formulated for oral administration. It is poorly absorbed from the gastrointestinal tract, where its high concentrations are effective against a variety of gastrointestinal pathogens.

• Mechanism of action

  The mechanism of action of pyrazinamide is unknown, but recent findings suggest that pyrazinamide may be active either totally or in part as a pro-drug. Susceptible organisms produce pyrazinamidase, which is responsible for conversion of pyrazinamide to pyrazinoic acid intracellularly. Mutation in the pyrazinamidase gene (pncA) results in resistant strains of M . tuberculosis. Pyrazinoic acid has been shown to possess biological activity at a pH 5.4 or lower, in contract in vitro tests that show pyrazinoic acid is 8- to 16-fold less active than pyrazinamide . Pyrazinoic acid may lower the pH in the immediate surroundings of the M . tuberculosis to such an extent that the organism is unable to grow, but this physicochemical property appears to account for only some of the activity. The protonated pyrazinoic acid also can permeate the mycobacterial membrane to lower the pH of the cytoplasm. Recent evidence suggests that pyrazinoic acid decreases membrane potential in older, nonreplicating bacilli, thus decreasing membrane transport, and interferes with the energetics of the membrane.

• Pharmakokinetik

  Oral absorption is very low. However, a fraction of the dose may be absorbed and rapidly eliminated through the bile. A 400 mg oral dose produces a maximum plasma concentration of 3.8 mg/L after 1.2 h. The plasma half-life is 5.8 h. Up to 90% of the administered dose is concentrated in the gut, less than 0.2% in the liver and kidney, and less than 0.01% in other tissues.

• Clinical Use

  It is used for a variety of gastrointestinal diseases, including the treatment of traveler’s diarrhea. Preliminary results suggest clinical efficacy in the therapy of hepatic encephalopathy and of C. difficile infections.

• Nebenwirkungen

  Oral doses up to 100 mg/kg for 6 months produced no significant signs of toxicity to rats. Teratogenic effects in rats and rabbits have been reported (pregnancy category C).
  Very few adverse effects were reported during human treatment, mostly gastrointestinal discomfort. Prolonged therapy was associated with infrequent urticarial skin reactions.

• in vitro

  rifaximin, a gut-specific ligand for the human nuclear receptor pregnane-x receptor (pxr), contributes to the maintenance of the intestinal immune homeostasis. rifaximin abrogates the binding of nf-κb caused by lps. in human colon biopsies from inflammatory bowel diseases patients, exposure of rifaximin (100 μm) reduced mrna levels of il-8, rantes, mip-3α and tnfα induced by lps stimulation [1]. rifaximin acted on the β subunit of the deoxyribonucleic acid (dna)-dependent ribonucleic acid (rna) polymerase enzyme of bacteria to inhibit bacterial rna synthesis. the susceptibility of gram-positive organisms to rifaximin was greater than that of gram-negative organisms [2]. in the dpx2 cell line transfected with stable recombinant human pxr expression, hpxr was significantly activated at rifax concentrations over 1 μm and the ec50 was about 20 μm[3].

• in vivo

  in the small intestine of hpxr mice treated with rifaximin, several pxr target genes such as cyp3a11, gsta1, mrp2, and oatp2 were up-regulated. rifaximin treatment demonstrated no significant effect on hepatic pxr target genes in wild-type, pxr-null, and hpxr mice [3]. in pxr-humanized mice, long-term administration of rifaximin for 6 months on the liver up-regulated the expression of hepatic genes related to triglyceride synthesis and lipid accumulation [4].

• Arzneimittelwechselwirkung

  Potentially hazardous interactions with other drugs
  Ciclosporin: concentration increased by ciclosporin.

• Stoffwechsel

  Pyrazinamide is readily absorbed after oral administration, but little of the intact molecule is excreted unchanged. The major metabolic route consists of hydrolysis by hepatic microsomal pyrazinamidase to pyrazinoic acid, which may then be oxidized by xanthine oxidase to 5-hydroxypyrazinoic acid. The latter compound may appear in the urine either free or as a conjugate with glycine.

• Lager

  -20°C

• Einzelnachweise

  [1]. mencarelli a, renga b, palladino g, et al. inhibition of nf-κb by a pxr-dependent pathway mediates counter-regulatory activities of rifaximin on innate immunity in intestinal epithelial cells[j]. european journal of pharmacology, 2011, 668(1): 317-324.
  [2]. gillis j c, brogden r n. rifaximin[j]. drugs, 1995, 49(3): 467-484.
  [3]. ma x, shah y m, guo g l, et al. rifaximin is a gut-specific human pregnane x receptor activator[j]. journal of pharmacology and experimental therapeutics, 2007, 322(1): 391-398.
  [4]. cheng j, krausz k, tanaka n, et al. chronic exposure to rifaximin causes hepatic steatosis in pregnane x receptor-humanized mice[j]. toxicological sciences, 2012: kfs211.
  [5]. bass n m, mullen k d, sanyal a, et al. rifaximin treatment in hepatic encephalopathy[j]. new england journal of medicine, 2010, 362(12): 1071-1081.
  [6]. pimentel m, lembo a, chey w d, et al. rifaximin therapy for patients with irritable bowel syndrome without constipation[j]. new england journal of medicine, 2011, 364(1): 22-32.
  [7]. sharara a i, aoun e, abdul-baki h, et al. a randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence[j]. the american journal of gastroenterology, 2006, 101(2): 326-333.

Rifaximin Anbieter Lieferant Produzent Hersteller Vertrieb Händler.

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