fidaxomicin (Dificid)

Indications

• recurrent Clostridium difficile colitis after prior treatment with vancomycin (FDA approved for adults & children >= 6 months)
• may be used 1st line for treatment of Clostridium difficile colitis

Contraindications

• fidaxomixin may exhibit cross-reactivity in pattients with macrolide allergies

Pregnancy category: B

Safety in lactation: ?

Dosage

• 200 PO BID with or without food for 10 days

Tablets: 200 mg

Oral Suspension

Pharmacokinetics

• fidaxomicin is a substrate of P-glycoprotein

Adverse effects

• nausea (11%)/vomiting
• headache
• abdominal pain (6%)
• diarrhea

• drug adverse effects of macrolide(s)

Drug interactions

• inhibitors of P-glycoprotein (cyclosporine) may increase plasma levels of fidaxomicin

• drug interaction(s) anticonvulsants with anti-bacterial agents
• drug interaction(s) of digoxin in combination with macrolides
• drug interaction(s) of statins with macrolide
• drug interaction(s) of antibiotics with warfarin
• drug interaction(s) of theophylline with macrolide
• drug interaction(s) of macrolides with sulfonylureas

Mechanism of action

• inhibits RNA synthesis by inhibiting RNA polymerases

More general terms

• macrolide (macrolide antibiotic)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=46174142
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=11528171