Details of the Drug

General Information of Drug (ID: DMFP6MV)

• Drug Name: Fidaxomicin
• Synonyms: Dificid (TN)

Indication

Disease Entry	ICD 11	Status	REF
Clostridioides difficile infection	1A04	Approved	[1]
Clostridium difficile associated diarrhea	1A04	Approved	[2]

• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 5:
  Molecular Weight (mw); 1058
  Logarithm of the Partition Coefficient (xlogp); 6.4
  Rotatable Bond Count (rotbonds); 15
  Hydrogen Bond Donor Count (hbonddonor); 7
  Hydrogen Bond Acceptor Count (hbondacc); 18
• ADMET Property:
  Absorption Cmax: The maximum plasma concentration (Cmax) of drug is 5.20 +/- 2.81 mcg/L [3]
  Absorption Tmax: The time to maximum plasma concentration (Tmax) is 2 h [3]
  Elimination: More than 92% of the dose was recovered in the faces as either the unchanged parent drug or metabolites in one study consisting of healthy adults receiving single doses of 200 mg and 300 mg of fidaxomicin [3]
  Half-life: The concentration or amount of drug in body reduced by one-half in 11.7 +/- 4.80 hours (in healthy adults with a single dose of 200 mg fidaxomicin) [3]
  Metabolism: The drug is metabolized via the hydrolysis at the isobutyryl ester [4]
• Chemical Identifiers:
  Formula: C52H74Cl2O18
  IUPAC Name: [(2R,3S,4S,5S,6R)-6-[[(3E,5E,8S,9E,11S,12R,13E,15E,18S)-12-[(2R,3S,4R,5S)-3,4-dihydroxy-6,6-dimethyl-5-(2-methylpropanoyloxy)oxan-2-yl]oxy-11-ethyl-8-hydroxy-18-[(1R)-1-hydroxyethyl]-9,13,15-trimethyl-2-oxo-1-oxacyclooctadeca-3,5,9,13,15-pentaen-3-yl]methoxy]-4-hydroxy-5-methoxy-2-methyloxan-3-yl] 3,5-dichloro-2-ethyl-4,6-dihydroxybenzoate
  Canonical SMILES: CC[C@H]1/C=C(/[C@H](C/C=C/C=C(/C(=O)O[C@@H](C/C=C(/C=C(/[C@@H]1O[C@H]2[C@H]([C@H]([C@@H](C(O2)(C)C)OC(=O)C(C)C)O)O)\\C)\\C)[C@@H](C)O)\\CO[C@H]3[C@H]([C@H]([C@@H]([C@H](O3)C)OC(=O)C4=C(C(=C(C(=C4O)Cl)O)Cl)CC)O)OC)O)\\C
  InChI: InChI=1S/C52H74Cl2O18/c1-13-30-22-26(6)33(56)18-16-15-17-31(23-66-51-45(65-12)42(61)44(29(9)67-51)69-49(64)35-32(14-2)36(53)39(58)37(54)38(35)57)48(63)68-34(28(8)55)20-19-25(5)21-27(7)43(30)70-50-41(60)40(59)46(52(10,11)72-50)71-47(62)24(3)4/h15-17,19,21-22,24,28-30,33-34,40-46,50-51,55-61H,13-14,18,20,23H2,1-12H3/b16-15+,25-19+,26-22+,27-21+,31-17+/t28-,29-,30+,33+,34+,40-,41+,42+,43+,44-,45+,46+,50-,51-/m1/s1
  InChIKey: ZVGNESXIJDCBKN-UUEYKCAUSA-N
• Cross-matching ID:
  PubChem CID: 10034073
  CAS Number: 873857-62-6
  DrugBank ID: DB08874
  TTD ID: D06LNW
  VARIDT ID: DR00545
  ACDINA ID: D00274

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Bacterial RNA polymerase switch region (Bact RNAP-SR)	TTIJ5EB	NOUNIPROTAC	Modulator	[5]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Fidaxomicin (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Sarecycline	DMLZNIQ	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Sarecycline .	Acne vulgaris [ED80]	[6]
Arn-509	DMT81LZ	Moderate	Increased metabolism of Fidaxomicin caused by Arn-509 mediated induction of CYP450 enzyme.	Acute myeloid leukaemia [2A60]	[7]
Gilteritinib	DMTI0ZO	Moderate	Decreased metabolism of Fidaxomicin caused by Gilteritinib mediated inhibition of CYP450 enzyme.	Acute myeloid leukaemia [2A60]	[7]
Troleandomycin	DMUZNIG	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Troleandomycin.	Bacterial infection [1A00-1C4Z]	[6]
Erdafitinib	DMI782S	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Erdafitinib.	Bladder cancer [2C94]	[8]
Pexidartinib	DMS2J0Z	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Pexidartinib.	Bone/articular cartilage neoplasm [2F7B]	[6]
Talazoparib	DM1KS78	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Talazoparib.	Breast cancer [2C60-2C6Y]	[6]
HKI-272	DM6QOVN	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by HKI-272.	Breast cancer [2C60-2C6Y]	[6]
Tucatinib	DMBESUA	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Tucatinib.	Breast cancer [2C60-2C6Y]	[9]
PF-04449913	DMSB068	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by PF-04449913.	Chronic myelomonocytic leukaemia [2A40]	[9]
Ripretinib	DM958QB	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Ripretinib.	Gastrointestinal stromal tumour [2B5B]	[6]
Daclatasvir	DMSFK9V	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Daclatasvir.	Hepatitis virus infection [1E50-1E51]	[6]
GS-5885	DMSL3DX	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by GS-5885.	Hepatitis virus infection [1E50-1E51]	[6]
Berotralstat	DMWA2DZ	Major	Decreased clearance of Fidaxomicin due to the transporter inhibition by Berotralstat.	Innate/adaptive immunodeficiency [4A00]	[6]
Suvorexant	DM0E6S3	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Suvorexant.	Insomnia [7A00-7A0Z]	[6]
Brigatinib	DM7W94S	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Brigatinib.	Lung cancer [2C25]	[6]
Capmatinib	DMYCXKL	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Capmatinib.	Lung cancer [2C25]	[9]
GDC-0199	DMH0QKA	Major	Decreased clearance of Fidaxomicin due to the transporter inhibition by GDC-0199.	Mature B-cell leukaemia [2A82]	[6]
Ibrutinib	DMHZCPO	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Ibrutinib.	Mature B-cell lymphoma [2A85]	[7]
Ponatinib	DMYGJQO	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Ponatinib.	Mature B-cell lymphoma [2A85]	[6]
Arry-162	DM1P6FR	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Arry-162.	Melanoma [2C30]	[6]
Lasmiditan	DMXLVDT	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Lasmiditan.	Migraine [8A80]	[10]
Rolapitant	DM8XP26	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Rolapitant.	Nausea/vomiting [MD90]	[6]
Istradefylline	DM20VSK	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Istradefylline.	Parkinsonism [8A00]	[6]
Enzalutamide	DMGL19D	Moderate	Accelerated clearance of Fidaxomicin due to the transporter induction by Enzalutamide.	Prostate cancer [2C82]	[11]
Relugolix	DMK7IWL	Major	Decreased clearance of Fidaxomicin due to the transporter inhibition by Relugolix.	Prostate cancer [2C82]	[6]
Larotrectinib	DM26CQR	Moderate	Decreased metabolism of Fidaxomicin caused by Larotrectinib mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[6]
Fostamatinib	DM6AUHV	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Fostamatinib.	Thrombocytopenia [3B64]	[12]
Lusutrombopag	DMH6IKO	Moderate	Decreased clearance of Fidaxomicin due to the transporter inhibition by Lusutrombopag.	Thrombocytopenia [3B64]	[13]
Cabozantinib	DMIYDT4	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Cabozantinib.	Thyroid cancer [2D10]	[6]
Elagolix	DMB2C0E	Minor	Decreased clearance of Fidaxomicin due to the transporter inhibition by Elagolix.	Uterine fibroid [2E86]	[6]

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Butylated hydroxytoluene	E00336	31404	Antioxidant
Magnesium stearate	E00208	11177	lubricant
Polyvinyl alcohol	E00666	Not Available	Coating agent; Emulsion stabilizing agent; Film/Membrane-forming agent
Soybean lecithin	E00637	Not Available	Other agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Fidaxomicin 200 mg tablet	200 mg	Oral Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

• [1] Fidaxomicin FDA Label
• [2] 2011 FDA drug approvals. Nat Rev Drug Discov. 2012 Feb 1;11(2):91-4.
• [3] FDA Approved Drug Products: DIFICID (fidaxomicin) tablets, for oral use
• [4] Russell RG, Watts NB, Ebetino FH, Rogers MJ: Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008 Jun;19(6):733-59. doi: 10.1007/s00198-007-0540-8.
• [5] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
• [6] Cerner Multum, Inc. "Australian Product Information.".
• [7] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [8] Product Information. Balversa (erdafitinib). Janssen Products, LP, Horsham, PA.
• [9] Product Information. Dificid (fidaxomicin). Optimer Pharmaceuticals, San Diego, CA.
• [10] Product Information. Reyvow (lasmiditan). Lilly, Eli and Company, Indianapolis, IN.
• [11] Benoist G, van Oort I, et al "Drug-drug interaction potential in men treated with enzalutamide: Mind the gap." Br J Clin Pharmacol 0 (2017): epub. [PMID: 28881501]
• [12] Product Information. Tavalisse (fostamatinib). Rigel Pharmaceuticals, South San Francisco, CA.
• [13] EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring.".