Rifaximin is an unusual medication as little to none of the medication is absorbed into the bloodstream. Because of this, there are almost no drug-to-drug interactions. Always tell your child’s doctor’s that they are taking rifaximin and if you are ever in doubt I suggest asking your child’s managing physician if The Nemechek Protocol is safe for your child.
Daily, continuous rifaximin has been safely used for almost thirty years in patients with advanced liver cirrhosis who develop hepatic encephalopathy. Patients with hepatic encephalopathy are placed on twice-daily rifaximin continuously to prevent dangerous ammonia production. Studies indicate the continuous use of rifaximin does not lower the bacterial biodiversity within the gut microbiome.
Over time, from treating neurotypical adult patients, I have learned that their intestinal motility will improve. The relapses of bacterial overgrowth become less and less frequent, as will the need for rifaximin. This seems to hold for children as well.
Only increase to rifaximin if inulin fails to produce any neurological improvement (inulin failure) or when the pace of neurological recovery for all aspects comes to a halt (plateau).
Parents can continue to use inulin for as long as it is effective and produces ongoing neurological recovery. If recovery stalls (see Plateau) and no underlying medical issues are interfering with recovery, I recommend that parents move on to monthly Rifaximin.
Typically I only start rifaximin if either inulin has proven ineffective or the child is in the teens years or older. If inulin never has in a child, going back to inulin or adding to rifaximin can sometimes help. If there is no apparent benefit of adding inulin after rifaximin, I stop the inulin.
Dosing rifaximin 3 times a day is rarely ever used. If there are problems with the rate of recovery, I would recommend adding VNS before considering an unusual dosing regimen of rifaximin.
Yes, just do not mix the rifaximin with anything hot.
Fish oil and olive oil are given every day regardless if your child is on rifaximin at the moment or not.