Fidaxomicin: Antibiotic for C. difficile and Intestinal Infections

Summary of Key Points

Fidaxomicin is an antibiotic used to treat specific bacterial infections in the intestines, particularly Clostridium difficile (C. diff) infections. It works by preventing the growth of bacteria that cause severe diarrhea. While Fidaxomicin is generally well-tolerated, like all medications, it may cause side effects. Always consult your healthcare provider before starting or adjusting your dose. You can schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Dificid

Generic Name: Fidaxomicin

The generic name refers to the active ingredient in the medication, while the brand name is the name given by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category

Macrolide Antibiotic

Fidaxomicin Dosage

Fidaxomicin is primarily used to treat bacterial infections in the intestines. Below are the recommended doses for adults. Always consult your doctor before adjusting your dose or starting a new medication. Our telemedicine providers are available to assist you with any questions or concerns.

1. Clostridium difficile infection (C. diff): 200 mg taken orally twice daily for 10 days.
2. Antibiotic-associated diarrhea: 200 mg taken orally twice daily for 10 days.
3. Gastroenteritis: 200 mg taken orally twice daily for 10 days.
4. Colitis: 200 mg taken orally twice daily for 10 days.
5. Pseudomembranous colitis: 200 mg taken orally twice daily for 10 days.
6. Infectious diarrhea: 200 mg taken orally twice daily for 10 days.
7. Bacterial enteritis: 200 mg taken orally twice daily for 10 days.
8. Intestinal infection: 200 mg taken orally twice daily for 10 days.
9. Diarrhea caused by antibiotics: 200 mg taken orally twice daily for 10 days.

Dosage Forms and Strengths

Tablet: 200 mg

Administration Instructions for Fidaxomicin

Fidaxomicin should be taken exactly as prescribed by your healthcare provider. It is typically taken by mouth, with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew the tablet. If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at once. Always follow your doctor’s instructions carefully.

Fidaxomicin Side Effects and Adverse Reactions

Like all medications, Fidaxomicin may cause side effects. Most side effects are mild, but some can be more serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine visit with one of our providers for further guidance.

1. Common side effects (1-10%): Nausea, vomiting, stomach pain, and constipation. These are usually mild and tend to resolve on their own.
2. Less common side effects (<1%): Allergic reactions, including rash, itching, and swelling. Seek immediate medical attention if you experience these symptoms.
3. Serious side effects (rare): Severe allergic reactions (anaphylaxis), difficulty breathing, or swelling of the face, lips, tongue, or throat. These require emergency medical attention.

Contraindications for Fidaxomicin

A contraindication is a specific situation or condition where a particular treatment or medication should not be used because it may be harmful to the patient. It’s important to understand if you have any contraindications before starting a new medication like Fidaxomicin.

Here are the main contraindications for Fidaxomicin:

1. Allergy to Fidaxomicin: If you have a known allergy to Fidaxomicin or any of its ingredients, you should not take this medication. Allergic reactions can range from mild (such as a rash) to severe (such as anaphylaxis, which is life-threatening).
2. Allergy to Macrolide Antibiotics: Fidaxomicin is similar to macrolide antibiotics, so if you have a history of allergic reactions to macrolides (such as erythromycin or azithromycin), you may also be allergic to Fidaxomicin. This could lead to serious allergic reactions.

If you believe you have any of these contraindications, it’s important to talk to your healthcare provider before starting Fidaxomicin. Our telemedicine practice can help you assess your risks and determine the best course of action.

Drug Interactions with Fidaxomicin

Fidaxomicin has a low potential for drug interactions because it is minimally absorbed into the bloodstream. However, it’s still important to inform your healthcare provider of all the medications you are taking, including prescription drugs, over-the-counter medications, and supplements.

Here are some medications that may interact with Fidaxomicin:

1. Cyclosporine (Gengraf, Neoral, Sandimmune): This immunosuppressant may increase the levels of Fidaxomicin in the intestines, potentially leading to side effects.
2. Rifampin (Rifadin, Rimactane): This antibiotic may reduce the effectiveness of Fidaxomicin by decreasing its concentration in the intestines.
3. Anticoagulants (Warfarin, Coumadin): Although rare, there is a potential for Fidaxomicin to affect blood clotting when taken with anticoagulants. Regular monitoring may be required.

Always discuss your medication list with your healthcare provider to ensure there are no harmful interactions. Our telemedicine providers are available to review your medications and offer guidance.

Fidaxomicin in Pregnancy

Is it safe to take Fidaxomicin during pregnancy?

There is limited information on the use of Fidaxomicin in pregnant women. While animal studies have not shown harm to the fetus, no well-controlled studies have been conducted in humans. Since Fidaxomicin is minimally absorbed into the bloodstream, it is thought to pose a low risk to the developing baby. However, it should only be used during pregnancy if absolutely necessary, and only after a thorough discussion with your healthcare provider about the potential risks and benefits.

If you are pregnant or planning to become pregnant, it is important to consult your healthcare provider before starting Fidaxomicin. Our telemedicine team is available to help you evaluate the risks and benefits based on your individual circumstances.

Fidaxomicin while Breastfeeding

Is it safe to take Fidaxomicin while breastfeeding?

It is not known whether Fidaxomicin passes into breast milk. However, because the drug is minimally absorbed into the bloodstream, it is unlikely to be present in significant amounts in breast milk. The risk to a breastfeeding infant is considered low, but caution is still recommended.

If you are breastfeeding, it is essential to discuss the potential risks and benefits of taking Fidaxomicin with your healthcare provider. Our telemedicine team can provide guidance on whether this medication is appropriate for you while breastfeeding.

Estimated Cost of Fidaxomicin

The estimated cost of a 30-day supply of Fidaxomicin (typically 20 tablets) without insurance ranges from $4,000 to $5,000. However, using a GoodRx coupon, the price may be reduced to around $3,800. Prices can vary depending on the pharmacy and location, so it’s a good idea to check for available discounts or coupons.

If the cost of Fidaxomicin is a concern, our telemedicine providers can discuss alternative treatment options with you.

Possible Alternatives to Fidaxomicin

Fidaxomicin is primarily used to treat infections caused by Clostridium difficile (C. diff), but other treatment options and lifestyle changes may be considered for similar conditions. Always consult your healthcare provider before making any changes to your treatment plan.

1. Clostridium difficile infection: Alternatives include vancomycin (Vancocin) or metronidazole (Flagyl). In cases of recurrent infection, probiotics and fecal microbiota transplantation (FMT) may also be considered.
2. Antibiotic-associated diarrhea: Probiotics, such as Saccharomyces boulardii, may help restore the balance of gut flora. Discontinuing the antibiotic that caused the diarrhea may also resolve symptoms.
3. Gastroenteritis: Supportive care, including hydration and electrolyte replacement, is essential. In bacterial cases, antibiotics like ciprofloxacin (Cipro) or azithromycin (Zithromax) may be prescribed.
4. Colitis: Treatment depends on the underlying cause and may include anti-inflammatory medications, immunosuppressants, or antibiotics. Dietary changes may also help manage symptoms.
5. Pseudomembranous colitis: Vancomycin or metronidazole are commonly used alternatives. In severe or recurrent cases, probiotics and FMT may be considered.
6. Infectious diarrhea: Depending on the cause, antibiotics such as ciprofloxacin or azithromycin may be used. Hydration and electrolyte replacement are crucial.
7. Bacterial enteritis: Antibiotics like ciprofloxacin or azithromycin may be prescribed. Supportive care, including hydration, is also important.
8. Intestinal infection: Treatment depends on the specific pathogen involved and may include antibiotics, probiotics, and supportive care.
9. Diarrhea caused by antibiotics: Probiotics may help restore the balance of gut bacteria. Stopping the antibiotic may also resolve the diarrhea.

Our telemedicine providers can help you explore these alternatives and determine the best treatment plan for your condition.

Recent Updates on Fidaxomicin Research

Recent research on Fidaxomicin has focused on its effectiveness in treating recurrent Clostridium difficile infections. Studies suggest that Fidaxomicin may be more effective than vancomycin in preventing the recurrence of C. diff infections, particularly in patients who have experienced multiple recurrences.

Ongoing studies are also exploring the use of Fidaxomicin in combination with other therapies, such as probiotics or fecal microbiota transplantation, to further reduce recurrence rates. Additionally, researchers are investigating whether Fidaxomicin could be effective in treating other bacterial infections in the gastrointestinal tract.

If you are interested in learning more about the latest research on Fidaxomicin or have questions about your treatment options, our telemedicine providers are available to discuss the most up-to-date information with you.

James Kingsley

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