Metronidazole + Rifaximin is a combination medicine used to treat various bacterial and parasitic infections of the gastrointestinal tract. It contains metronidazole, a nitroimidazole antimicrobial, and rifaximin, a rifamycin-based non-systemic antibiotic. This medicine works by destroying anaerobic bacteria and parasites in the gut while stopping the growth of aerobic bacteria directly within the intestines to relieve infection, diarrhoea, and abdominal distress.

Metronidazole + Rifaximin is a combination medicine used to treat gastrointestinal infections caused by bacteria and certain parasites. It contains metronidazole, a systemic antimicrobial that targets anaerobic bacteria and protozoan parasites, and rifaximin, a non-systemic antibiotic that works directly in the intestines to stop the growth of harmful aerobic bacteria.

This dual action helps relieve symptoms such as diarrhoea, abdominal pain, bloating, and discomfort associated with bacterial overgrowth or parasitic infections. Metronidazole + Rifaximin is often prescribed for traveller’s diarrhoea, small intestinal bacterial overgrowth (SIBO), and other gastrointestinal infections where multiple types of microbes may be involved.

The combination of metronidazole and rifaximin allows for more comprehensive treatment of gastrointestinal infections than either medicine alone. Take this medicine exactly as prescribed, and complete the full course even if your symptoms improve early, to prevent recurrence and resistance.

This combination medicine is used to treat:

Bacterial diarrhoea

Helps treat diarrhoea caused by bacteria, reducing the frequency and severity of loose stools.

Traveller’s diarrhoea

Effective against E. coli infections acquired during travel.

Small intestinal bacterial overgrowth (SIBO)

Reduces excess bacteria in the small intestine to relieve bloating, gas, and discomfort.

Gastrointestinal infections

Treats other bacterial or parasitic infections of the gut, helping relieve abdominal pain, cramps, and diarrhoea.

Mixed infections

Provides coverage against both anaerobic and aerobic bacteria for more comprehensive symptom relief.

• Targets multiple types of pathogens: Metronidazole works systemically against anaerobic bacteria and parasites, while rifaximin acts locally in the intestines against aerobic bacteria.

• Relieves diarrhoea and abdominal discomfort: Helps restore normal bowel function and reduce cramping and bloating.

• Supports faster recovery: Treats infections effectively when taken as prescribed, shortening the duration of symptoms.

• Reduces risk of recurring infection: Completing the full course helps prevent bacteria from returning or developing resistance.

• Convenient combination therapy: Provides broad coverage in a single medicine, reducing the need for multiple antibiotics.

Metronidazole + Rifaximin may cause side effects in some people. Most are mild and temporary, but contact your doctor if they persist or worsen.

Common side effects:

• Nausea or mild stomach upset

• Diarrhoea or soft stools

• Headache

• Mild dizziness

Less common side effects:

• Loss of appetite

• Fatigue or tiredness

• Mild skin rash or itching

Serious side effects (seek medical help immediately):

• Severe allergic reactions, such as swelling of the face, lips, tongue, or throat, hives, or difficulty breathing

• Severe diarrhoea, possibly with blood or mucus (could indicate serious intestinal infection)

• Persistent or severe abdominal pain

• Jaundice (yellowing of the skin or eyes)

• Neurological symptoms: numbness, tingling, or a burning pain in your hands or feet; or sudden confusion.

• This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects.

Take Metronidazole + Rifaximin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger amounts or for longer than recommended. Complete the full course of therapy, even if your symptoms improve quickly.

• Take this medicine with a full glass of water.

• This medication can be taken with or without food.

• Swallow the tablet whole. Do not crush, chew, or break it.

Metronidazole + Rifaximin combines two antibiotics to target bacterial and parasitic infections in the gastrointestinal tract.

• Metronidazole: Enters anaerobic bacteria and certain parasites, where it interferes with DNA synthesis. This prevents the microbes from multiplying and ultimately kills them. It is absorbed into the bloodstream, so it works systemically.

• Rifaximin: Acts locally in the intestines by inhibiting bacterial RNA synthesis. Because it is minimally absorbed, it mainly targets bacteria in the gut with fewer systemic effects.

By combining these two mechanisms, Metronidazole + Rifaximin reduces harmful bacteria and parasites in the gut, relieving symptoms such as diarrhoea, abdominal pain, bloating, and cramping.

• Do not consume any alcohol during treatment and for at least 72 hours after your final dose to avoid severe, violent abdominal cramping and vomiting.

• Metronidazole may cause a harmless darkening or reddish-brown discolouration of the urine.

• Finish the entire course of this antibiotic exactly as your doctor instructed, even if your digestive symptoms clear up after a few days. Stopping early can allow the infection to return.

• Store in their original packaging.

• Store at room temperature, ideally between 20 °C and 25 °C (68 °F and 77 °F).

• Protect from excessive moisture, heat, and direct light.

• Keep the medication out of the reach of children and pets.

• Alcohol: Severe interaction causing extreme nausea, vomiting, headache, and chest pain.

• Food: Food does not significantly affect the absorption of these drugs.

Tell your doctor about all your current medicines and any you start or stop using, especially:

• Blood thinners (such as warfarin)

• Disulfiram (do not take metronidazole if you have taken disulfiram in the last 2 weeks)

• Lithium

• Phenytoin or phenobarbital

• Cyclosporine

This medicine should be used with caution, or avoided, if you have:

• Active neurological disease or history of seizures

• Severe liver disease or cirrhosis

• Blood dyscrasias (history of blood cell disorders)

• Known hypersensitivity to nitroimidazoles or rifamycin derivatives

The usual adult dose depends on the condition being treated. Take exactly as prescribed. Do not take more than the recommended dose. Follow your doctor’s instructions regarding the number of doses per day and the duration of treatment.

Seek immediate medical attention if an overdose is suspected. Symptoms of a metronidazole overdose may include nausea, vomiting, and ataxia (loss of balance).

If you miss a dose, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose. Do not take extra medicine to make up for the missed dose.