Bezlotoxumab (Intravenous)

A monoclonal antibody, bezlotoxumab is used together with antibiotics for the treatment of severe cases of diarrhea, and to prevent infections from occurring.


Since clostridium difficile is the single most prevalent cause of infectious diarrhea in patients who are obliged to undergo a prolonged hospital stay, it is the targeted bacteria of a treatment program using bezlotoxumab. Patients who are required to undergo antibiotic therapy commonly develop Clostridium difficile, which can then lead to a dangerously infectious diarrhea. If this were to go untreated, it could even take on a life-threatening aspect. Fortunately, bezlotoxumab has been shown to be highly effective when used in conjunction with specific antibiotics for the treatment of Clostridium difficile, as well as any recurrence of the infection.

Bezlotoxumab, also known by the brand name Zinplava, is not itself an antibiotic but is rather a monoclonal antibody which works in conjunction with antibiotics, for the treatment of diarrhea which has advanced to a life-threatening stage. Bezlotoxumab functions by binding itself to Clostridium Difficile bacteria, so that it can prevent the toxin from spreading, and can help neutralize any negative effects from it. Bezlotoxumab can also be used after the infection has been cleared up, as a strategy to prevent any recurrence of the infection.

It is a sterile solution which must be diluted before being administered in an intravenous infusion, and in appearance it looks colorless, with a slight yellowish tinge. It is free of preservatives, and can therefore not be stored for long periods of time, but must be prepared for individual administration to patients.

Condition Treated

  • Infections from Clostridium Difficile

Type of Medicine

  • Monoclonal antibody

Side Effects

In addition to its intended medical beneficial effects, bezlotoxumab may also have some unwanted side effects which are manifested in patients using the drug. If you should experience any of the side effects listed below, you should contact your doctor as soon as possible and discuss what you've been experiencing, especially if you have two or more of these:

  • Fevers
  • Headaches
  • Difficulty breathing
  • Chest pain or chest tightness
  • Persistent chills
  • Back pain
  • Unexplained weakness
  • Swelling in the lower legs, feet, fingers, or face
  • Nausea or vomiting
  • Irregular heartbeat
  • Extreme fatigue
  • Decreased urine output

There are also several other side effects of bezlotoxumab which you may experience that do not require any medical attention, and will simply fade away during your program of treatment. If you should experience side effects which you suspect are associated with taking the drug, you should mention these to your physician, although there will probably be no particular urgency.

For any side effects which you do experience, your doctor may be able to recommend a strategy for eliminating them, or at least reducing any discomfort associated with them. Some of these uncomfortable side effects which have been reported by users of bezlotoxumab in the past are as follows:

  • Tingling sensation in the extremities
  • Ulceration or warmth at the site of injection
  • Blistering of the skin
  • Burning sensation
  • Bleeding
  • Skin discoloration
  • A sensation of pressure
  • Rashes or hives
  • Inflammation
  • Infection
  • Numbness
  • Itchiness
  • Redness or scarring
  • Stinging or swelling
  • Skin tenderness


Bezlotoxumab is administered intravenously by injection, and this will always be carried out by a professional healthcare provider. The nature of the drug makes it necessary to deliver this injection slowly, over a period of approximately one hour.

It's very important that the antibiotic medication which is used in conjunction with bezlotoxumab be completely used up over the duration of the prescription. Even if symptoms of your infection clear up well before you have finished using the full amount of your antibiotic, you need to continue taking it until it's all used up.

If you skip any dosages of your antibiotic during treatment, it will increase the likelihood that an infection in your body develops resistance to whatever antibiotics are being used, and that may neutralize their effectiveness.

Dosages of bezlotoxumab itself are always administered in single doses by a professional medical person, so you don't have to worry about missing a dosage. You also don't have to be concerned about overdosing on this drug, because no competent medical person would allow that to happen.


There are no specific interactions with other drugs that are known to the scientific community as a result of using bezlotoxumab. However, the reason that no such studies have been conducted is that there are not really any interactions expected, because the drug is eliminated from the body through the process of catabolism. Catabolism breaks down large molecules such as bezlotoxumab into much smaller ones, which are then metabolized. This being the case, there is really almost no opportunity for the drug to interact with any other drugs.


There are certain precautions and warnings which should be heeded by any patient using bezlotoxumab. One of these is that the patient should prepare a detailed list of all other medications which he/he is using, along with the precise dosages of each, so the doctor can review this. Even though bezlotoxumab does not have any known interactions with other drugs, medical personnel always need to know what kinds of medication a patient is using prior to prescribing a new drug in a program of treatment.

This prepared list will also be very useful if the patient needs to make an unscheduled trip to an emergency room or to a healthcare clinic because doctors there are often reluctant to carry out treatments when they don't know which medications a patient might be using. Your list should include not only all prescription drugs you might be taking currently, but also your over the counter drugs, any vitamins you are taking, and even herbal supplements.

Women who are pregnant or are planning to become pregnant should discuss this with their doctor because it is uncertain if there are any effects on infants which may be passed on by usage of this drug.

No animal studies have been conducted to determine the effects on infants, and there has been no controlled research conducted into human effects either. Since it is not known whether any adverse effects accrue as a result of taking bezlotoxumab, the safest course of action is to avoid a pregnancy while on a program of treatment with this drug.

Similarly, there is no information available on whether any of the ingredients of bezlotoxumab are passed on to an infant through breast milk. However, since it is a somewhat large protein molecule with a very high molecular weight, any amount passed through breast milk is likely to be minimal. It is also unlikely that if any were passed on through the breast milk that it would be absorbed by the infant because it would probably be destroyed in the gastrointestinal tract before any absorption could take place.

There are some other general precautions which should be observed when taking bezlotoxumab. For instance, if you have a known allergy to the drug or any of its components, you should discuss this with your doctor to avoid any unpleasant reactions during treatment. Patients with congestive heart failure are strongly advised to avoid taking this drug, as it may exacerbate the condition. This drug is also not approved for usage by individuals under the age of 18, and generally speaking, doctors will not prescribe this medication for anyone other than adults.


Storage of bezlotoxumab is not an issue that a patient needs to worry about because it will not be given to a patient to take home. The drug will be stored at a medical facility in a refrigerated state before usage, and when it is about to be administered to a patient, it would then be warmed up to achieve room temperature.


One of the most important things to remember about bezlotoxumab is that it does not treat the underlying infection which shows up as chronic diarrhea. The drug instead works in conjunction with an antibiotic medication which does treat the condition. Bezlotoxumab will always be administered by a professional medical person in a medical facility setting, so it is not a medication which is taken home for usage. It must be taken intravenously into the body, and the process takes about an hour from start to finish, so each dosage must be well planned in advance, by both patient and medical personnel.

There are no known interactions with other drugs, but there are some relatively mild side effects which have been reported by patients in the past, many of which relate to manifestations around the site of an injection. Any of these which appear should be reported to a doctor as soon as possible, since they may be a sign of something serious developing.

There are relatively few precautions and warnings associated with bezlotoxumab usage, although patients with heart conditions should discuss them with a doctor before agreeing to take the drug. It is also not recommended for patients under the age of 18, but has very few negative warnings for other age groups, even for geriatric patients.

Last Reviewed:
December 23, 2017
Last Updated:
April 04, 2018
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