Names and pronunciation
(fye-dax′oh-mye′sin) Dificid
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Drug reference
(fye-dax′oh-mye′sin) Dificid
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Func. class.: Antiinfective-macrolide
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ACTION: Bactericidal against Clostrid ium difficile; inhibits RNA synthesis by inhibiting transcription of bacterial RNA polymerases; may act at the early stages of transcription
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USES: Clostridium difficile–associated diarrhea
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CONTRAINDICATIONS: Hyper- sensitivity Precautions: Pregnancy, breastfeeding, children
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SIDE EFFECTS GI: Nausea, vomiting, abdominal pain, GI bleeding, intestinal obstruction HEMA: Anemia, neutropenia INTEG: Rash, pruritus
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INTERACTIONS Drug/Lab Test Increase: glucose, LFTs, alk phos Decrease: fexofenadine sodium bicar- bonate, platelets
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DOSAGE AND ROUTES • Adult: PO 200 mg bid × 10 days
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Available forms: Tab 200 mg
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Administer: • Without regard to food • Store at room temperature
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Assess: • CDAD: for diarrhea, abdominal pain, fever, fatigue, anorexia, anemia, elevated WBC and low serum albumin; product may be used in place of vancomycin (PO); monitor CBC with differential and stool culture (Clostridium difficile), not to be used for systemic infection; obtain C&S before use; monitor glucose (dia- betic patients); monitor fluid, electrolyte depletion • Hypersensitivity: rash, pruritus; angio- edema (rare) • Pregnancy/breastfeeding: no well- controlled studies; use only if clearly needed; cautious use in breastfeeding, excretion unknown
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Evaluate: • Positive therapeutic response: resolu- tion of Clostridium difficile, decreased diarrhea
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report GI bleeding, severe abdomi- nal pain • To notify if pregnancy is planned or suspected or if breastfeeding • To take as directed; must take all of medication • May take without regard to food HIGH ALERT
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PHARMACOKINETICS Half-life 12 hr, onset <1 hr, peak 1-5 hr, excreted in feces 92%, minimal absorption, substrate of PGP efflux transporter
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• Adult: PO 200 mg bid × 10 days
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