Well hello there! I just wrote an article about treatment of Clostridium difficile diarrhea with oral vancomycin -aptly named Oral Vancomycin 🙂 Well, right about when I posted the article another drug hit the market to treat C.diff.
Dificid (fidaxomicin) is approved to treat C.diff only. Typically, it is taken twice daily for 10 days. It works as well as oral vancomycin. There was one study that showed that patients treated with Dificid had a slightly lower risk of recurrent infection then those treated with oral vancomycin.
Here is the kicker…
option 1: oral metronidazole 500mg three times a day for 10-14 days -COST: ~$4 to $8
option 2: oral vancomycin capsules four times a day for 14 days -COST: $1,800
option 3: using the injectable vancomycin but taking it orally four times a day for 14 days-COST: $40
and the new one –option 4: Dificid 200mg twice daily for 10 days -COST: ~$2,800 – ouch!
Which one looks best to you?!
Just a note here, if you are having trouble with recurrent C.diff that has already been treated with metronidazole and vancomycin then Dificid is definitely an option. However, a large part of recurrent C.diff infections are caused by a specific strain -BI/NAP1/027 . For this strain, Dificid has NOT been proven to work better then oral vancomycin and recurrent rates are the same.
Keep these points in mind when you discuss your options with your physician. If you need some hints on the best way for your physician to write a script for injectable vanco taken orally -please see the article Oral Vancomycin.
I had been taking flagyl and was near the end of the pulse, and had 2 beers on a hot afternoon. I “forgot” I was not supposed to drink alcohol. I know there have been studies done that suggest the interaction is rare, but I projectile vomited and was very weak and fatigued for the next 24 hours. Don’t wonder and don’t believe the studies! Just don’t drink if you are taking this medication 🙂
My husband has a G-tube. Can Dificid be crushed and administered (mixed with water) into the tube or does it lose its effectiveness?
Hi Valerie,
There was a study conducted 11/2014, they crushed and mixed Dificid with 20ml of water, applesauce or Ensure and administered through NG tube. The study found that if the tablet was crushed, mixed and given within 2 hours, it did not lose effectiveness. So, yes -ok to crush and mix with water.
Thanks!
Nova
Will drinking alcohol while taking Dificid affect it’s effectiveness? I have had c.diff for almost a year and don’t want to do anything that might interfere with it. Thank you. Regards, Jane Kreitler
Hi Jane,
Thanks for dropping by! There are no studies showing that Dificid interacts with alcohol. However, C.Diff can be difficult to treat (sounds like you know that already!) I think it would be best to avoid alcohol at least during treatment with Dificid.
I hope you are much better very soon!