DIFICID®

(fidaxomicin) tablets, for oral use

Safety 

Adverse reactions

Adverse reaction rates for DIFICID were similar to vancomycin in two Phase 3, randomized, double-blind, noninferiority trials

The most common adverse reactions reported in clinical trials are nausea (11%), vomiting (7%), abdominal pain (6%), gastrointestinal hemorrhage (4%), anemia (2%), and neutropenia (2%).

Adverse reactions with an incidence ≥2% in the DIFICID pivotal trials


DIFICID
(n=564) 
n (%)

Vancomycin
(n=583) 
n (%) 

Blood and lymphatic system disorders
Anemia 14 (2%) 12 (2%)
Neutropenia 14 (2%) 6 (1%)
Gastrointestinal disorders
Nausea 62 (11%) 66 (11%)
Vomiting 41 (7%) 37 (6%)
Abdominal pain 33 (6%) 23 (4%)
Gastrointestinal hemorrhage 20 (4%) 12 (2%)

Discontinuation rates

Among patients receiving DIFICID, 33 (5.9%) withdrew from trials as a result of adverse reactions. Vomiting was the primary adverse reaction leading to discontinuation of dosing (incidence of 0.5% for DIFICID and vancomycin patients).

Indication

DIFICID is a macrolide antibacterial drug indicated in adults (≥18 years of age) for treatment of Clostridium difficile–associated diarrhea (CDAD). 

To reduce the development of drug-resistant bacteria and maintain the effectiveness of DIFICID and other antibacterial drugs, DIFICID should be used only to treat infections that are proven or strongly suspected to be caused by C difficile.

Selected Safety Information

  • DIFICID is contraindicated in patients with hypersensitivity to fidaxomicin.
  • DIFICID should not be used for systemic infections.
  • Acute hypersensitivity reactions, including dyspnea, rash pruritus, and angioedema of the mouth, throat, and face have been reported with fidaxomicin. If a severe hypersensitivity reaction occurs, DIFICID should be discontinued and appropriate therapy should be instituted.
  • Only use DIFICID for infection proven or strongly suspected to be caused by C difficile. Prescribing DIFICID in the absence of a proven or strongly suspected C difficile infection is unlikely to provide benefit to the patient and increases the risk of development of drug-resistant bacteria.
  • The most common adverse reactions reported in clinical trials are nausea (11%), vomiting (7%), abdominal pain (6%), gastrointestinal hemorrhage (4%), anemia (2%), and neutropenia (2%).
  • Among patients receiving DIFICID, 33 (5.9%) withdrew from trials as a result of adverse reactions. Vomiting was the primary adverse reaction leading to discontinuation of dosing (incidence of 0.5% for both DIFICID and vancomycin patients).
  • The safety and effectiveness of DIFICID in patients <18 years of age have not been established.
  • The recommended dose of DIFICID is one 200 mg tablet orally twice daily for 10 days, with or without food.
  • No dose adjustment is recommended for patients ≥65 years of age.
  • No dose adjustment is recommended for patients with renal impairment.
  • No dosage adjustments are recommended when co-administering fidaxomicin with substrates of P-gp or CYP enzymes.
  • The impact of hepatic impairment on the pharmacokinetics of fidaxomicin has not been evaluated; however, because fidaxomicin and its active metabolite (OP-1118) do not appear to undergo significant hepatic metabolism, elimination of fidaxomicin and OP-1118 is not expected to be significantly affected by hepatic impairment.
Before prescribing DIFICID® (fidaxomicin), please read the Prescribing Information.
AINF-1245964-000007/18