FI8

Fidaxomicin


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Chemical Component Summary

NameFidaxomicin
Identifiers[(2~{R},3~{S},4~{S},5~{S},6~{R})-6-[[(3~{E},5~{E},8~{S},9~{E},11~{S},12~{R},13~{E},15~{E},18~{S})-12-[(2~{R},3~{S},4~{R},5~{S})-6,6-dimethyl-5-(2-methylpropanoyloxy)-3,4-bis(oxidanyl)oxan-2-yl]oxy-11-ethyl-9,13,15-trimethyl-8-oxidanyl-18-[(1~{R})-1-oxidanylethyl]-2-oxidanylidene-1-oxacyclooctadeca-3,5,9,13,15-pentaen-3-yl]methoxy]-5-methoxy-2-methyl-4-oxidanyl-oxan-3-yl] 3,5-bis(chloranyl)-2-ethyl-4,6-bis(oxidanyl)benzoate
FormulaC52 H74 Cl2 O18
Molecular Weight1,058.039
TypeNON-POLYMER
Isomeric SMILESCCc1c(c(c(c(c1Cl)O)Cl)O)C(=O)O[C@@H]2[C@H](O[C@H]([C@H]([C@H]2O)OC)OC/C/3=C\C=C\C[C@@H](/C(=C/[C@@H]([C@H](/C(=C/C(=C/C[C@H](OC3=O)[C@@H](C)O)/C)/C)O[C@H]4[C@H]([C@H]([C@@H](C(O4)(C)C)OC(=O)C(C)C)O)O)CC)/C)O)C
InChIInChI=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
InChIKeyZVGNESXIJDCBKN-UUEYKCAUSA-N

Chemical Details

Formal Charge0
Atom Count146
Chiral Atom Count14
Bond Count149
Aromatic Bond Count6

Drug Info: DrugBank

DrugBank IDDB08874 
NameFidaxomicin
Groups approved
DescriptionFidaxomicin is a novel macrolide antibiotic used in the treatment of diarrhea caused by _Clostridioides_ (formerly _Clostridium_) _difficile_ in adult and pediatric patients over the age of 6 months.[L11575] Fidaxomicin is a naturally-occurring 18-member macrocycle derived from fermentation.[A190501] Because fidaxomicin contains an 18-membered lactone ring in its structure, it is referred to as a macrocyclic lactone antibiotic drug.[A190492] The antibacterial activity of fidaxomicin is distinct from macrolides and rifamycins, as the bactericidal activity is time-dependent, and not concentration-dependent.[A190492] Fidaxomicin was the first macrocyclic lactone antibiotic with activity against _C. difficile_,[A190486] and it displays a narrow spectrum of activity against gram-positive anaerobes.[A7445] It mediates its potent bactericidal action on the bacteria by inhibiting the bacterial RNA synthase, thereby disrupting bacterial transcription.[A190486] The minimum inhibitory concentration (MIC<sub>90</sub>) for fidaxomicin is four times less than that of [vancomycin], which was the primary drug of choice for _C. difficile_ infection before the approval of fidaxomicin.[A190492] Unlike vancomycin, however, fidaxomicin has a negligible effect on normal colonic microflora.[A190516] The FDA initially approved fidaxomicin in May 2011 for the treatment of _C. difficile_-associated diarrhea in adult patients over the age of 18.[A190492] Later that year in December, the drug was also approved by the European Medicine Agency.[A190492] In June 2012, fidaxomicin was also granted approval by Health Canada.[A190486] The approved indication of fidaxomicin was expanded by the FDA in January 2020 to include pediatric patients over the age of 6 months in the treatment population.[L11575]
Synonyms
  • Lipiarmycin
  • Fidaxomicina
  • Lipiarmicin
  • Lipiarrmycin
  • Fidaxomicin
Brand Names
  • Dificid
  • Dificlir
IndicationFidaxomicin is indicated for the treatment of _Clostridioides_ (formerly _Clostridium_) _difficile_-associated diarrhea in adult and pediatric patients 6 months of age and older.[L11575] Fidaxomicin should only be used in patients with proven or strongly suspected _C. difficile_ infection to reduce the risk of development of drug-resistant bacteria and maximize the therapeutic effectiveness of fidaxomicin and other antimicrobial agents.[L11575]
Categories
  • Alimentary Tract and Metabolism
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Antidiarrheals, Intestinal Antiinflammatory/antiinfective Agents
  • Carbohydrates
ATC-CodeA07AA12
CAS number873857-62-6

Drug Targets

NameTarget SequencePharmacological ActionActions
RNA polymerase sigma factorMSVENKSNKKELKKVTAKTLIEKGKKQGSLTLAEIMEAFSETELDKDQVE...unknowninhibitor
Cytochrome P450 3A4MALIPDLAMETWLLLAVSLVLLYLYGTHSHGLFKKLGIPGPTPLPFLGNI...unknowninhibitor
P-glycoprotein 1MDLEGDRNGGAKKKNFFKLNNKSEKDKKEKKPTVSVFSMFRYSNWLDKLY...unknownsubstrate
Drug Info/Drug Targets: DrugBank 3.0: a comprehensive resource for 'omics' research on drugs. Knox C, Law V, Jewison T, Liu P, Ly S, Frolkis A, Pon A, Banco K, Mak C, Neveu V, Djoumbou Y, Eisner R, Guo AC, Wishart DS. Nucleic Acids Res. 2011 Jan; 39 (Database issue):D1035-41. | PMID:21059682

Related Resource References

Resource NameReference
PubChem 10034073
ChEMBL CHEMBL1255800