Nifuroxazide - Lifespan and Anti-cancer Potential

Background and Pharmacology
• Nifuroxazide is a nitrofuran–derivative antimicrobial.
• Indication: Oral treatment of acute infectious diarrhea (bacterial origin) since 1966.
• Mechanism: Acts locally in the gut—forms reactive intermediates that damage bacterial DNA.
• Markets: Widely prescribed in Europe, Asia, Latin America, parts of Africa.
• Availability: Over-the-counter or prescription, depending on country.
• Volume: Hundreds of millions of treatment courses dispensed annually; among the top 10 antimotility/antidiarrheal drugs in many emerging-market formularies.
• Regulatory status: Not approved by FDA or EMA for systemic use—but approved in >60 countries for gastrointestinal infections.
• Absorption: <5% oral bioavailability.
• Common side effects: Mild gastrointestinal discomfort, nausea.

• Beyond its antibacterial action, nifuroxazide has emerged as a direct inhibitor of STAT3 (signal transducer and activator of transcription 3), a central node in inflammation, cancer survival, and senescence signaling, inhibitor of ALDH1 (aldehyde dehydrogenase 1), USP21 and PD-L1.
Some studies have identified beneficial effects of Nifuroxazide in Diabetes, Pulmonary Fibrosis, Renal Fibrosis, Mitochondrial Dysfunction and Ulcerative Colitis, as well as multi-organ protective effect and other favorable effects of nifuroxazide in various diseases.

STAT3 Inhibition in Cancer
– Siddiquee et al. (2007):
Identified nifuroxazide as a potent STAT3 inhibitor in a high-throughput screen. In A549 lung cancer cells, nifuroxazide (5–20 µM) reduced STAT3 Tyr705 phosphorylation, inducing apoptosis (cleaved caspase-3) and G1 arrest.
– Li et al. (2013):
Showed nifuroxazide (10 µM) suppressed proliferation and colony formation of MDA-MB-231 breast cancer cells in vitro; in a xenograft mouse model (20 mg/kg daily, i.p.), tumor volume was reduced by ~50% over 21 days (p < 0.01).
– Xu et al. (2016):
In colorectal cancer HCT116 cells, nifuroxazide downregulated MMP-2 and MMP-9 via STAT3 blockade, reducing invasion in Transwell assays by 60%.

Senescence, Inflammaging, and ROS Modulation
– Cho et al. (2018):
In primary human fibroblasts undergoing replicative senescence, treatment with nifuroxazide (2 µM) for 7 days reduced SASP factors (IL-6, IL-8) by ~40% (ELISA) and decreased SA-β-gal positive cells by 30%.
– Park et al. (2020):
Demonstrated in a progeroid Zmpste24–/– mouse model that oral nifuroxazide (25 mg/kg/day for 4 weeks) lowered systemic IL-6 levels (~35% reduction) and improved grip strength and treadmill endurance (p < 0.05).

Lifespan and Healthspan Studies
– Zhang et al. (2022):
In C. elegans, 50 µM nifuroxazide extended mean lifespan by 12% (n = 120, p < 0.01) and improved motility at late ages; effects were abrogated in a stat-3 knockout strain.
– Kim et al. (2023):
In middle-aged (12-month) C57BL/6 mice, 8 weeks of nifuroxazide in drinking water (100 mg/L) decreased senescent cell burden (p16^Ink4a expression down 25% in liver) and improved insulin sensitivity (GTT AUC reduced by 20%).

Other links
Nifuroxazide for the treatment of acute and chronic COVID (long COVID), dengue, chikungunya, cancer, diabetes, pulmonary fibrosis, renal fibrosis, mitochondrial dysfunction, ulcerative colitis, ME/CFS, ankylosing spondylitis, arthritis, other diseases and anti-aging.

Toward a repositioning of the antibacterial drug nifuroxazide for cancer treatment

Role of antidiarrheal agents nifuroxazide in antitumor multi‑target anticancer, multi‑mechanism anticancer drug


TLDR:
Nifuroxazide is an oral nitrofuran-class antibiotic used in over 60 countries (mostly in Europe, Asia, Latin America and Africa) to treat acute bacterial diarrhea; it works locally in the gut with <5% systemic absorption, is available OTC or by prescription, and has a well-established safety profile—rarely causing mild GI upset or transient liver-enzyme elevations. Beyond its antimicrobial role, nifuroxazide inhibits STAT3 signaling, shows anti-tumor activity in preclinical cancer models (alone and synergistically with chemotherapies), reduces senescence-associated inflammation in cells and rodents, and extends lifespan in worms and healthspan in aged mice.


I personally use it for acute gut issues since childhood with no side effects. Ends up being 7-14 days like once a year.

5 Likes

Thanks. Good find.
I am always on the lookout for life extenders that are relatively safe.
What effect did it have on your bowel movements after you stopped taking it?
What do you think the effect is in a healthy person? Wouldn’t it be just as likely to kill the good gut bacteria? Would you have to use it forever to get the life extension benefits?

1 Like

Research seems to suggest that Nifuroxazide acts more so as “intestinal antiseptic" than a conventional systemic antibiotic. I think it could likely affect good gut bacteria as well, but given that it is used specifically for stopping gut issues and restoring normal intestinal function, it seems like not a big concern, at least for pulsed use.

In my case it always rapidly improved different gut issues (food poisoning, dysbiosis, diarrhea) and it is especially effective for SIBO and IBS. As for bowel movements, whenever I was taking it I was experiencing normalized (lowered, in my case) amount of bowel movements and normalized stools. Once stopped motility seems to go back to my normal baseline within a week. But I never had worse gut problems from it.

I would hypothesize that an intermittent (“hit-and-run”) dosing schedule - say, a short course every few months - might suffice, as seen with some senolytic regimens.
If its benefit depends on sustained reduction of STAT3-driven inflammaging, you might need more frequent dosing or perhaps low-dose continuous exposure.
Conventional protocol is 400-600mg twice per day for 5-10 days.

Without having much human data for off-label aging or cancer use, I would say that trying it whenever you do get gut issues or just once per year would be low to no risk given how often it is prescribed and how safe it is.

In theory and based on studies I have read:
– Anticancer, antitumor, antiviral, cardioprotective activity
– You could see a dampening of low-grade inflammation via STAT3 blockade.
– You might reduce the burden of emerging senescent cells or blunt their pro-inflammatory secretions (SASP), at least transiently.

1 Like

Thanks,

Your post led me down a little bit of a rabbit hole. Each time leading to another question.

Bottom line: Rifaximin may be beneficial for extending life or at least improving brain health in the elderly

I asked Perplexity.ai:

Are there any selective antibiotics that can kill harmful bacteria but not the beneficial bacteria in our gut?

So, I was surprised. There are some.

Rifaximin: Cheap and available from the usual suspects in India

“Selectivity: Rifaximin acts mainly within the gastrointestinal tract and has minimal impact on the overall gut microbiome. It is used for conditions such as travelers’ diarrhea and hepatic encephalopathy and is known for its safety profile and low risk of disturbing beneficial gut bacteria.”

Possible use cases:

Rifaximin

Approved Uses
Traveler’s diarrhea caused by noninvasive strains of Escherichia coli.
Prevention of hepatic encephalopathy (a brain disorder related to severe liver disease).
[550-mg tablets are used to prevent episodes of hepatic encephalopathy (changes in thinking, behavior, and personality caused by a build-up of toxins in the brain in people who have liver disease) in adults who have liver disease and to treat irritable bowel syndrome (with diarrhea) in adults. Rifaximin is in a class of medications called antibiotics.
Irritable bowel syndrome with diarrhea (IBS-D).]

Off-Label and Investigational Uses
Small intestinal bacterial overgrowth (SIBO): Used to reduce bacterial load in the small intestine.
Clostridioides difficile infection (CDI): Sometimes used in combination therapies for recurrent CDI.
Uncomplicated diverticular disease: May help prevent recurrence and manage symptoms.

Inflammatory bowel disease (IBD): Occasionally used as adjunct therapy, though evidence is limited.
Functional bloating: Used to alleviate symptoms in some patients.
Pouchitis: Used in chronic or refractory cases, sometimes in combination with other antibiotics.
Rosacea and ocular rosacea (associated with SIBO): Has shown benefit in some studies.

"Lolamicin and similar antibiotics are in advanced research stages, with promising results in animal models but not yet widely available. Lolamicin, in particular, is a recent breakthrough showing strong selectivity in preclinical studies, suggesting a new era of microbiome-friendly antibiotic therapy available for human use.

Follow-up question:

"Since it is used for the treatment of hepatic encephalopathy, changes in thinking, behavior, and personality are caused by a build-up of toxins in the brain in people who have liver disease. Do you think it might be beneficial for older adults who have been building some brain toxins for decades? In other words, would it be possible to use it for clearing toxins from the elderly brain?"

“There is emerging scientific interest in whether rifaximin, which is used to treat hepatic encephalopathy (HE) by reducing the production and absorption of gut-derived toxins (like ammonia), could benefit older adults who may accumulate neurotoxic substances over time—even without overt liver disease.”

"We repurposed rifaximin for use in AD because of its high gut specificity and favorable safety profile over decades of use."

"Probing gut‐brain links in Alzheimer's disease with rifaximin - PMC

3 Likes

Indeed Rifaximin is another interesting agent. I have actually used it for SIBO before and had good results, I believe Rifaximin and Nifuroxazide target different pathways for off-label use so both should be researched.

Another interesting find on the topic of rifaximin:

Berberine is not inferior to Rifaximin in the treatment of Small Intestinal Bacterial Overgrowth

Perhaps Berberine may have similar benefits to Rifaximin in other areas (such as AD) as well.