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This was accomplished by creating an EMR tool to identify patients who were prescribed rifaximin and then coordinating between the inpatient providers and outpatient hepatology clinic to ensure prior authorization (PA) or a prescription assistance program (PAP) was completed when required and that a follow-up was arranged
The reason is straightforward
The doses involved are usually many times the levels the body can absorb, so most of the B12 is rapidly excreted in urine
Fatigue accompanied by anhedonia, sleep disturbances, or changes in appetite beyond those expected from the medication warrants evaluation for depression, potentially using validated screening tools like the PHQ-9
Calming effects support sleep initiation and maintenance
