Buying Rifaximin?

[BangkokTraveller]

Hello,

Has anyone been able to find Rifaximin in Thailand? For those that don't know, it's an antibiotic commonly used for intestinal infections, and can be helpful with IBS and SIBO (Small Intestine Bacterial Overgrowth). I've checked a few local pharmacies, and I've only gotten blank stares. Any help would be greatly appreciated.

Thanks!

[Sceptict11]

Not I believe , available in Thailand.

US and Canadian warnings exist about this drug .

[Sheryl]

Not approved for use in Thailand.

Highly inadvisable to treat with this or any other antibiotic for gut problems unless specific bacteria have been identified on culture. You will massively disrupt normal gut flora which may well make matters much worse.

Would suggest probiotics instead and if that fails consult a good GI specialist.

[BangkokTraveller]

Thanks very much for the info

[mstevens]

On 9/9/2013 at 1:05 PM, Sheryl said:

Not approved for use in Thailand.

Highly inadvisable to treat with this or any other antibiotic for gut problems unless specific bacteria have been identified on culture. You will massively disrupt normal gut flora which may well make matters much worse.

Would suggest probiotics instead and if that fails consult a good GI specialist.

I know this thread is very old but my question is the same as the OP. In the subsequent years that have passed, has Rifaxamin been approved for use in Thailand? As the OP said, it's the best antibiotic for SIBO (and various other intestinal infections).

[Sheryl]

18 minutes ago, mstevens said:

I know this thread is very old but my question is the same as the OP. In the subsequent years that have passed, has Rifaxamin been approved for use in Thailand? As the OP said, it's the best antibiotic for SIBO (and various other intestinal infections).

It is approved for use but there is no brand registered here, which means you will not be able to get it at a pharmacy and probably also nto at a hospital though slight possibility some may have imported it themselves. I haven't heard if anyone being prescribed it, though. They still tend to use quinolones.

 

 

[Nayet]

Any updates from anyone? I'm currently trying to find a vendor but having little luck. I know you can order online, but I don't like the payment options.

[Sheryl]

Still no brand of this registered in Thailand. 

[mstevens]

On 2/19/2025 at 11:08 PM, Nayet said:

Any updates from anyone? I'm currently trying to find a vendor but having little luck. I know you can order online, but I don't like the payment options.

 

I know it's not ideal and doesn't answer your question about availability, but Rifaxmin is available over the counter at the bigger pharmacies in Phnom Penh, Cambodia.

Any reason you specifically want to use this particular antibiotic? SIBO, perhaps? If that's the case, you might want to look at Metronidazole AKA Flagyll. Augmentin may also work. Or consider herbal anti-microbials like Oregano oil / Neem / Allicin. (Oregano oil is far and away the strongest of these, assuming you get one of the better brands like Gaia Herbs or my favourite, North American Herb & Spice.)

[Nayet]

On 2/21/2025 at 2:53 AM, mstevens said:

 

I know it's not ideal and doesn't answer your question about availability, but Rifaxmin is available over the counter at the bigger pharmacies in Phnom Penh, Cambodia.

Any reason you specifically want to use this particular antibiotic? SIBO, perhaps? If that's the case, you might want to look at Metronidazole AKA Flagyll. Augmentin may also work. Or consider herbal anti-microbials like Oregano oil / Neem / Allicin. (Oregano oil is far and away the strongest of these, assuming you get one of the better brands like Gaia Herbs or my favourite, North American Herb & Spice.)

 

Thanks, it's for suspected SIBO, and I actually managed to get some rifaximin at Samitivej hospital after talking to one of their gastroenterologists.

[mstevens]

9 hours ago, Nayet said:

 

Thanks, it's for suspected SIBO, and I actually managed to get some rifaximin at Samitivej hospital after talking to one of their gastroenterologists.

 

If you have not yet started the course, remember that Rifaximin for SIBO works best when taken with Nystatin or Metronidazole at the same time. Also, do everything you can to identify the root cause. SIBO doesn't just "happen". It takes a failure of some sort for it to occur, such as low stomach acid, poor gallbladder function, low motility etc.

[Nayet]

On 2/25/2025 at 5:14 AM, mstevens said:

 

If you have not yet started the course, remember that Rifaximin for SIBO works best when taken with Nystatin or Metronidazole at the same time. Also, do everything you can to identify the root cause. SIBO doesn't just "happen". It takes a failure of some sort for it to occur, such as low stomach acid, poor gallbladder function, low motility etc.

 

Thanks, I appreciate the advice. I actually started having second thoughts about the whole thing the same day I went to the hospital. I no longer think it's SIBO, and I haven't touched the rifaximin yet.

[mstevens]

12 hours ago, Nayet said:

 

Thanks, I appreciate the advice. I actually started having second thoughts about the whole thing the same day I went to the hospital. I no longer think it's SIBO, and I haven't touched the rifaximin yet.

 

There are so many ailments which mimic the symptoms of SIBO. The best thing to do is to find a practitioner who can conduct a SIBO breath test, an OAT test and maybe even a comprehensive stool test. Yes, it's a lot of testing but the only way to really know what is going on is to test, otherwise you end up going around in circles and feel like you're throwing darts at a darts board!

[ExpatInCM]

I lived with undiagnosed and untreated SIBO for over 2 years.  I really had to push my gastroenterologist specialist in the US to diagnose my very upsetting and distressing problem.

 

But finally he had me perform a SIBO breath test at home using a test kit he had in stock at his office and I mailed the test samples produced to the kit's manufacture to determine the results. 

 

Wow! The results were almost 100% indicative to having SIBO, which was something I knew nothing about.  The Xifaxan antibiotic he then prescribed eliminated the problem.

 

SIBO can be difficult to cure permanently for most people I am told and have been observing. I just finished my 4 regimen of Xifaxan during the last 2.5 years.  Each time , the Xifaxan has eliminated it for me anywhere from 3 to 9 months before I needed another Xifaxan Rx from my doctor.  

[mstevens]

14 hours ago, ExpatInCM said:

SIBO can be difficult to cure permanently for most people I am told and have been observing. I just finished my 4 regimen of Xifaxan during the last 2.5 years.  Each time , the Xifaxan has eliminated it for me anywhere from 3 to 9 months before I needed another Xifaxan Rx from my doctor.  

 

If your SIBO keeps coming back, it means that the root cause has not been addressed. Common root causes are low stomach acid or issues with bile flow which can be anything from cholestasis to biliary dyskinesia (poor function gallbladder) to gallstones to liver issues or even something as obscure as vegus nerve problems. Taking Rifaxmin periodically is not an ideal situation and if at all possible, try to identify and then address the root cause.