Xifaxan Too Expensive? Your Options in 2026
Xifaxan (rifaximin 550 mg) is used for hepatic encephalopathy and IBS with diarrhea. It’s also one of the most expensive gut medicines in the US: about $3,949 for 60 tablets at cash prices. If that price has you stuck, here are your options.
Why is Xifaxan so expensive?
Xifaxan is still a brand-only drug in the US. The FDA has approved a generic, but it isn’t on sale there yet. Without competition, the price stays high, and insurance plans often need prior authorization or charge high copays.
Option 1: Insurance and copay programs
If you have commercial insurance, ask your doctor’s office about prior authorization and the manufacturer’s copay card. Some patients also qualify for patient assistance programs. These can bring the cost down a lot, but not everyone qualifies.
Option 2: Order Zaxine, the Canadian brand, from Canada
In Canada, rifaximin 550 mg is sold under the brand name Zaxine. It has the same active ingredient and strength as Xifaxan.
| Option | 60 tablets |
|---|---|
| Xifaxan 550 mg, US cash price | About $3,949 |
| Zaxine 550 mg from Northside Meds | $764.01 |
For someone taking rifaximin twice a day for hepatic encephalopathy, 60 tablets last about a month. That’s a difference of over $3,000 a month, or more than $30,000 a year. Prices are in US dollars.
What is rifaximin used for?
Rifaximin is an antibiotic that works mostly inside the gut, with very little absorbed into the bloodstream. In Canada, Zaxine is approved for adults to:
- Lower the risk of repeat hepatic encephalopathy (confusion caused by liver disease). The usual dose is 550 mg twice a day.
- Treat IBS with diarrhea (IBS-D). The usual dose is 550 mg three times a day for 14 days, so one 60-tablet box covers a full course.
Your prescriber sets your dose.
How to order Xifaxan (Zaxine) from Canada
- Create a free account and add Zaxine to your cart.
- Upload your prescription, or have your doctor fax it to 1-833-220-2470.
- Once your prescription is verified, your order ships to your door in the US.
If your prescription says Xifaxan, call us at 1-888-234-8578 to confirm it can be filled with Zaxine.
Safety information
Don’t take rifaximin if you’re allergic to it or to other rifamycin antibiotics. Tell your doctor right away about severe, watery or bloody diarrhea, during treatment or weeks after, since it can be a sign of C. difficile infection. Tell your doctor if you have severe liver disease or take cyclosporine or warfarin. Common side effects include bloating, nausea, headache and dizziness. This isn’t a complete list; talk to your doctor or pharmacist.
This article is for information only and is not medical advice. A valid prescription is required.