![]() Caution should be exercised when administering XIFAXAN to these patients. ![]() There is an increased systemic exposure in patients with severe (Child-Pugh Class C) hepatic impairment.If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. 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.Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis. XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN.As a reminder, it is the responsibility of the HCP and/or their office staff, as appropriate, to determine the correct diagnosis, treatment protocol, and content of all such forms for each individual patient. ¶NOTE: These sample forms are provided for informational purposes only. ‡Based on aggregated total of all prescribers as of October 2022. Visit or call 1-866-XIFAXAN for full eligibility criteria, terms, and conditions. Maximum benefits and other restrictions apply. Offer excludes full-cash-paying patients. Patient must be enrolled in, and must seek reimbursement from or submit a claim for reimbursement to, a commercial insurance plan. †Patient is not eligible if he/she participates in, seeks reimbursement or submits a claim for reimbursement to any federal or state healthcare program with prescription drug coverage, such as Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state healthcare program (each a Government Program), or where prohibited by law. *Salix Pharmaceuticals does not guarantee coverage or reimbursement for the product. You can ask insurance plan to reevaluate XIFAXAN is covered for 97% of commercially insured patients and 100% of Medicare Part D patients 1,*,§ Include information on why XIFAXAN is necessary and how you expect it to help the patientĭouble-check coverage Medicare excludes certain kinds of drugs, but XIFAXAN is not in those categories Indicate lactulose history if applicable 1 K58.0 Irritable bowel syndrome with diarrhea 1.For OHE: XIFAXAN 550 mg, twice daily, 60 tablets 2 if coverage allows refills, write for at least 3.2 Patients who experience a recurrence of symptoms can be retreated up to 2 times For IBS-D: XIFAXAN 550 mg, three times a day/14 days, 42 tablets.You may also visit our Resource List to view other copayment organizations that may provide assistance.Double-check PA, fill in missing information, and resubmit Source: Organic Acidemia Association Additional Resources Early detection and treatment can greatly mitigate the effects of the disorder. Characteristics of the conditions include general malaise, reluctance to feed, breathing problems, vomiting, hypotonia (floppiness) and/or spasticity (stiffness). ![]() Children with less severe forms of the conditions develop symptoms later. The effect of the disorder will depend upon the age at which symptoms occur. This causes an overdosage of one chemical (often toxic) and the shortage of another which is essential to normal body functioning. This defect results in a buildup of chemicals, in this case usually acids, on one side of the metabolic blockage and a deficiency of vital chemicals on the other. Organic acidemias are a group of inheritable genetic metabolic disorders in which there is a defect in protein metabolism where an essential enzyme is absent or malfunctioning. Acquired forms of elevated homocysteine are usually due to lack of vitamins B6 (pyridoxine), B9 (folate), or B12 in one’s diet or the inability of the stomach to absorb the vitamins. Homocystinuria is elevation of the amino acid, homocysteine (a protein building block), in the urine or blood.
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