Comparative Pharmacology
Head-to-head clinical analysis: DIFICID versus TRIMETHOPRIM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIFICID versus TRIMETHOPRIM.
DIFICID vs TRIMETHOPRIM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fidaxomicin is a macrocyclic antibiotic that inhibits bacterial RNA polymerase, leading to RNA synthesis inhibition and cell death. It is bactericidal against Clostridioides difficile and has minimal systemic absorption.
Trimethoprim inhibits bacterial dihydrofolate reductase (DHFR), preventing the reduction of dihydrofolate to tetrahydrofolate, thereby inhibiting thymidine synthesis and bacterial DNA replication. It has bacteriostatic activity against susceptible organisms.
200 mg (tablet) orally twice daily for 10 days.
Adult: 100 mg orally twice daily or 200 mg once daily for uncomplicated UTI; for severe infections, up to 20 mg/kg/day in divided doses. IV: 10-20 mg/kg/day divided every 6-12 hours.
None Documented
None Documented
Clinical Note
moderateTrimethoprim + Teriflunomide
"The metabolism of Teriflunomide can be decreased when combined with Trimethoprim."
Clinical Note
moderateTrimethoprim + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Trimethoprim."
Clinical Note
moderateTrimethoprim + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Trimethoprim."
Clinical Note
moderateTrimethoprim + Fluconazole
11.7 hours (terminal half-life in healthy subjects); supports twice-daily dosing.
Terminal elimination half-life is 8-12 hours in adults with normal renal function; prolonged to 20-40 hours in severe renal impairment (CrCl <15 mL/min).
Fecal (primarily as unchanged drug, ~44% of dose); renal (~1.6% unchanged, <1% as metabolites); biliary (minor).
Renal excretion: approximately 50-60% of the dose is excreted unchanged in urine via glomerular filtration and tubular secretion; about 10-20% as metabolites (conjugated and oxidized forms); biliary/fecal excretion accounts for less than 10%.
Category C
Category D/X
Antibiotic
Antibiotic
"The metabolism of Fluconazole can be decreased when combined with Trimethoprim."