Fecal Microbiota Spores, Live-brpk (Monograph)
Brand name: Vowst
Drug class: GI Drugs, Miscellaneous
Introduction
Fecal microbiota spores, live-brpk is a bacterial spore suspension in capsules prepared from human fecal matter sourced from qualified donors.
Uses for Fecal Microbiota Spores, Live-brpk
Fecal microbiota spores, live-brpk has the following uses:
Fecal microbiota spores, live-brpk is indicated to prevent the recurrence of Clostridioides difficile infection (CDI) in individuals 18 years of age and older following antibacterial treatment for recurrent CDI.
The Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) has published guidelines on the management of CDI. The guidelines state that fecal microbiota transplantation (FMT) is recommended only for patients with multiple recurrences of CDI who have failed appropriate antibiotic treatments and where appropriate screening of donor and donor fecal specimens has been performed.
Fecal microbiota spores, live-brpk is not indicated for treatment of CDI.
Fecal Microbiota Spores, Live-brpk Dosage and Administration
General
Fecal microbiota spores, live-brpk is available in the following dosage form(s) and strength(s):
Bacterial spore suspension in capsules; each capsule contains between 1×106 and 3×107 Firmicutes spore colony forming units (CFU) in 92 ± 4% (w/w) glycerol in saline.
Dosage
It is essential that the manufacturer's labeling be consulted for more detailed information on dosage and administration of this drug. Dosage summary:
Adults
Dosage and Administration
For oral administration only.
Prior to taking the first dose, complete antibacterial treatment for recurrent CDI 2 to 4 days before initiating treatment with fecal microbiota spores, live-brpk.
Drink 296 mL (10 oz) of magnesium citrate on the day before and at least 8 hours prior to taking the first dose of fecal microbiota spores, live-brpk. In clinical studies, participants with impaired kidney function received polyethylene glycol electrolyte solution (250 mL GoLYTELY, not approved for this use).
Do not eat or drink, except for small amount of water, for at least 8 hours prior to taking the first dose.
The dosage of fecal microbiota spores, live-brpk is 4 capsules taken orally once daily for 3 consecutive days.
Take each dose (4 capsules) on an empty stomach prior to the first meal of the day.
Cautions for Fecal Microbiota Spores, Live-brpk
Contraindications
-
None.
Warnings/Precautions
Transmissible Infectious Agents
Because fecal microbiota spores, live-brpk is manufactured from human fecal matter, it may carry a risk of transmitting infectious agents. Any infection suspected by a healthcare provider possibly to have been transmitted by this product should be reported by the healthcare provider to Aimmune Therapeutics, Inc. at 1-833-246-2566.
Potential Presence of Food Allergens
Fecal microbiota spores, live-brpk is manufactured from human fecal matter and may contain food allergens. The potential for fecal microbiota spores, live-brpk to cause adverse reactions due to food allergens is unknown.
Specific Populations
Pregnancy
All pregnancies have a background risk of major birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriages in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
There are no data on use of fecal microbiota spores, live-brpk in pregnant individuals. Developmental toxicity studies in animals have not been conducted with fecal microbiota spores, live-brpk.
Lactation
It is not known whether fecal microbiota spores, live-brpk is excreted in human milk. Data are not available to assess the effects of fecal microbiota spores, live-brpk on the breastfed infant or on milk production/excretion. The developmental and health benefits of breastfeeding should be considered, along with the mother's clinical need for fecal microbiota spores, live-brpk and any other potential adverse effects on the breastfed child from fecal microbiota spores, live-brpk or from the underlying maternal condition.
Pediatric Use
The safety and effectiveness of fecal microbiota spores, live-brpk in individuals younger than 18 years of age have not been established.
Geriatric Use
Of the 349 adults who received fecal microbiota spores, live-brpk, 52.4% were ≥65 years of age (n=183), and 28.1% were ≥75 years of age (n=98). Data from clinical studies of fecal microbiota spores, live-brpk are not sufficient to determine if adults ≥65 years of age respond differently than younger adults.
Common Adverse Effects
Most common adverse reactions (reported in ≥5% of participants) were abdominal distension (31.1%), fatigue (22.2%), constipation (14.4%), chills (11.1%) and diarrhea (10.0%).
Drug Interactions
Specific Drugs
It is essential that the manufacturer's labeling be consulted for more detailed information on interactions with this drug, including possible dosage adjustments. Interaction highlights:
Antibacterials should not be administered concurrently with fecal microbiota spores, live-brpk.
Actions
Mechanism of Action
The mechanism of action of fecal microbiota spores, live-brpk has not been established.
Advice to Patients
-
Advise the patient to read the FDA-approved patient labeling (Patient Information).
-
Inform patients not to take fecal microbiota spores, live-brpk concurrently with antibacterials.
Additional Information
AHFSfirstRelease™. For additional information until a more detailed monograph is developed and published, the manufacturer's labeling should be consulted. It is essential that the manufacturer's labeling be consulted for more detailed information on usual uses, dosage and administration, cautions, precautions, contraindications, potential drug interactions, laboratory test interferences, and acute toxicity.
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Capsules |
Each capsule contains between 1×106 and 3×107 Firmicutes spore colony forming units (CFU) |
Vowst |
Aimmune Therapeutics |
AHFS DI Essentials™. © Copyright 2025, Selected Revisions May 10, 2024. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
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