MedPath
EMA Approval

Dificlir

A07AA12

fidaxomicin

Antidiarrheals, intestinal antiinflammatory / antiinfective agents

fidaxomicin

Clostridium Infections

Basic Information

EMA regulatory identification and product classification information

EMA Identifiers

ATC CodeA07AA12
EMA European Classification

Overview Summary

Comprehensive product overview and regulatory summary

Dificlir is a medicine used to treat children and adults with infections of the gut caused by bacteria called Clostridioides difficile.

Dificlir contains the active substance fidaxomicin.

Authorisations (1)

EMEA/H/C/002087

Tillotts Pharma GmbH,Warmbacher Strasse 80,79618 Rheinfelden,Germany

Authorised

December 5, 2011

Active Substances (1)

fidaxomicin

Documents (13)

CHMP summary of positive opinion for Dificlir

September 22, 2011

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Dificlir : EPAR - Risk-management-plan summary

January 21, 2019

RISK_MANAGEMENT_PLAN_SUMMARY

CHMP summary of positive opinion for Dificlir

September 22, 2011

CHANGES_SINCE_INITIAL_AUTHORISATION

Dificlir : EPAR - Public assessment report

December 18, 2011

CHANGES_SINCE_INITIAL_AUTHORISATION

Dificlir-H-C-002087-X-0034-G : EPAR - Assessment Report - Extension

March 11, 2020

CHANGES_SINCE_INITIAL_AUTHORISATION

Dificlir : EPAR - Medicine overview

December 18, 2011

OVERVIEW_DOCUMENT

Dificlir : EPAR - All Authorised presentations

December 18, 2011

AUTHORISED_PRESENTATIONS

Dificlir : EPAR - Public assessment report

December 18, 2011

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Dificlir : EPAR - Product Information

December 18, 2011

DRUG_PRODUCT_INFORMATION

CHMP post-authorisation summary of positive opinion for Dificlir (X-34)

December 13, 2019

CHANGES_SINCE_INITIAL_AUTHORISATION

Dificlir-H-C-2087-P46-0022 : EPAR - Assessment Report

February 16, 2015

CHANGES_SINCE_INITIAL_AUTHORISATION

Dificlir-EMEA-H-C-2087-PSUV-0015: EPAR - Scientific conclusions and grounds recommending the variation to the terms of the marketing authorisation

April 24, 2014

CHANGES_SINCE_INITIAL_AUTHORISATION

Dificlir : EPAR - Procedural steps taken and scientific information after authorisation

March 22, 2012

CHANGES_SINCE_INITIAL_AUTHORISATION

Overview Q&A (6)

Question

How is Dificlir used?

Answer

Dificlir is available as tablets (200 mg) or granules for oral suspension (40 mg/ml) and can only be obtained with a prescription.

In adults and children weighing at least 12.5 kg, the recommended dose is 200 mg twice a day (every 12 hours) for 10 days. For children weighing less than 12.5 kg, the dose depends on the bodyweight. For more information about using Dificlir, see the package leaflet or contact your doctor or pharmacist.

Question

How does Dificlir work?

Answer

C. difficile are bacteria that are present naturally in the gut and do not cause any problems in healthy people. This is because they are kept under control by other ‘good’ bacteria which are beneficial to the body and enhance health. However, some antibiotics that are used to treat infections can interfere with the balance and kill the 'good' bacteria in the gut. When this happens, C. difficile bacteria can multiply and produce toxins (poisons) which cause illness such as diarrhoea and fever. At this point, a person is said to be infected with C. difficile.

The active substance in Dificlir, fidaxomicin, is an antibiotic that belongs to the class of macrocylic antibiotics. When it is swallowed most of the active substance does not get absorbed into the blood stream but acts locally on C. difficile bacteria in the gut. It works by blocking the bacterial enzyme RNA polymerase, which is used to produce the genetic material that the bacteria need to make proteins.

This stops the C. difficile bacteria from growing and multiplying, thereby reducing the symptoms of the disease.

Question

What benefits of Dificlir have been shown in studies?

Answer

Dificlir was at least as effective as vancomycin (another antibiotic for C. difficile infections) in three main studies in patients with mild to moderately severe C. difficile infection. The results of two studies involving a total of 1,147 adults showed that 92% of patients taking Dificlir were cured after 10 days compared with 90% of patients taking vancomycin.

In the third study, which involved 148 patients aged from birth to 18 years, 78% of patients taking Dificlir were cured 2 days after the end of treatment, compared with 71% of patients taking vancomycin.

Question

What are the risks associated with Dificlir?

Answer

The most common side effects with Dificlir (which may affect up to 1 in 10 people) are nausea (feeling sick), vomiting and constipation. For the full list of side effects and restrictions with Dificlir, see the package leaflet.

Question

What measures are being taken to ensure the safe and effective use of Dificlir?

Answer

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Dificlir have been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Dificlir are continuously monitored. Side effects reported with Dificlir are carefully evaluated and any necessary action taken to protect patients.

Question

Other information about Dificlir

Answer

Dificlir received a marketing authorisation valid throughout the EU on 5 December 2011.

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