If you want to try Xifaxan but the expense is prohibitive, read on.

I've had a pouch since 2005 and I've had  antibiotic responsive pouchitis for about 5 years.  Cipro worked well for me but I wasn't able to wean myself off it and I was  concerned about side effects - neuropathy, palpitations, tendonitis.  I tried alternative therapies - VSL3, tinidazole, tinidazole and Cipro in combo -  but they didn't work. I wanted to try Xifaxan which imo has a better safety profile than Cipro.  Problem is Xifaxan is patent protected in the USA which means it's hellishly expensive.  I was able to source generic Xifaxan - Rifagut - from a pharmacy in Canada.  The out-of-pocket cost is about $4.00 per day. That's about the price of a Cafe Americano at your local Starbucks.  Rifagut is working well for me and I'm not worried about blowing out a tendon.  If you've never ordered from a Canadian pharmacy before,  you'll need a doctor's prescription which can be a tricky because the old prescription pad is a thing of the past. You'll also have to complete a questionnaire on-line or over the phone and pay as the time of order placement. My first order took about four weeks from order placement until receipt and my first refill took about three weeks.  Good luck!