Blujepa
Blujepa (gepotidacin) is an antibiotic pill used to treat uncomplicated urinary tract infections (UTIs) in women and girls 12 years and older who weigh at least 40 kg (88 lbs). The medication was approved by the FDA in March 2025, making it the first antibiotic in its class. And studies show it works well against certain types of drug-resistant bacteria. The usual dose is taken by mouth twice a day for 5 days. Common side effects include diarrhea, nausea, and stomach pain.
What is Blujepa (gepotidacin)?
What is Blujepa (gepotidacin) used for?
Uncomplicated urinary tract infections (UTIs) in women and girls 12 years and older who weigh at least 40 kg (88 lbs)
How Blujepa (gepotidacin) works
Blujepa (gepotidacin) is a triazaacenaphthylene antibiotic. It works by blocking two important enzymes (proteins) that certain bacteria need to grow and survive.
Drug Facts
More on Blujepa (gepotidacin) essentials
What are the side effects of Blujepa (gepotidacin)?
Common Side Effects
- Diarrhea (16%)
- Nausea (9%)
- Stomach pain (4%)
Other Side Effects
- Excessive gas
- Headache
- Soft stool
- Dizziness
- Vomiting
- Vaginal yeast infection
Serious Side Effects
- Abnormal heart rhythm (QT prolongation): fast, pounding, or uneven heartbeat, feeling dizzy or lightheaded, feeling faint, passing out
- Infectious (C. difficile-related) diarrhea: diarrhea that doesn't go away, watery diarrhea, bloody stools, fever, stomach cramps
- Acetylcholine build up: slurred speech, muscle spasms, feeling faint, diarrhea, nausea, vomiting, stomach pain, more saliva in the mouth, more sweating
- Serious allergic reaction: hives, rash, swelling in the face or throat, feeling faint or dizzy
Source: DailyMed
Pros and cons of Blujepa (gepotidacin)
Pros
Only need to take for 5 days
Might work better for some people when other treatments haven’t helped
Can be used by women and girls as young as 12 years old
Cons
Commonly causes diarrhea, nausea, and stomach pain
Interacts with many medications
Not recommended for people with serious kidney or liver problems
Pharmacist tips for Blujepa (gepotidacin)
Take your doses of Blujepa (gepotidacin) about 12 hours apart. It's a good idea to take it after a meal to help lower the chance of stomach-related side effects like diarrhea and stomach pain.
If you miss a dose of Blujepa (gepotidacin), take it as soon as you remember. Then take your next dose at the usual time. Don't take two doses at once since this can lead to more side effects.
Don't stop taking Blujepa (gepotidacin) without talking to your prescriber, even if you start to feel better. Stopping too soon could cause the infection to come back or become harder to treat.
Get medical help right away if you develop watery or bloody diarrhea, fever, tiredness, or stomach cramps anytime during treatment or after stopping Blujepa (gepotidacin). These could be signs of C. difficile-related diarrhea, which needs treatment right away.
Blujepa (gepotidacin) can affect your heart rhythm. Get medical help and call your prescriber if you feel faint, have fast or skipped heartbeats, or lose consciousness.
Side effects from Blujepa (gepotidacin) can include slurred speech, dizziness, muscle spasms, nausea, and sweating. Let your prescriber know if you have these symptoms or if you have conditions or take medications that affect your nervous system.
Share a list of all medications and supplements with your prescriber because Blujepa (gepotidacin) can interact with many common medications.
Frequently asked questions about Blujepa (gepotidacin)
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What are the risks and warnings for Blujepa (gepotidacin)?
Blujepa (gepotidacin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart rhythm problems (QT prolongation)
Risk factors: Heart problems | Taking other medications that can cause QT prolongation | Taking medications that raise levels of Blujepa (gepotidacin) | Kidney problems | Liver problems | Electrolyte imbalance
Blujepa (gepotidacin) can affect your heart rhythm by causing a condition called QT prolongation, which can be serious or even life-threatening. Your risk is higher if you have heart problems or take other medications that can cause heart rhythm problems. Some medications also interact with Blujepa (gepotidacin) to cause it to build up in your body, increasing this risk. Be sure to tell your prescriber about your full medical history and all medications you take, including prescriptions, over-the-counter drugs, and supplements. If you feel a fast, pounding, or uneven heartbeat, feeling dizzy or lightheaded, or feeling faint while taking Blujepa (gepotidacin), call 911 right away.
Build-up of acetylcholine
Risk factors: Taking medications that affect acetylcholine | Certain medical conditions
Blujepa (gepotidacin) can cause a chemical in your nervous system called acetylcholine to build up. This can lead to side effects like diarrhea, more sweating, more saliva in your mouth, slurred speech, and muscle spasms. In rare cases, it can cause slow heart rate, seizures, breathing problems, or fainting. Tell your prescriber if you experience any of these symptoms.
Because Blujepa (gepotidacin) raises acetylcholine levels, it can interfere with other medications that also affect this chemical. For example, it can exaggerate effects of acetylcholinesterase inhibitors (medications used for Alzheimer's disease, myasthenia gravis, and more). It can also cause anticholinergic medications to not work as well. Some examples of anticholinergic medications include ipratropium, benztropine, and dicyclomine. Make sure to tell your care team about all medications and supplements you take, so they can check for possible interactions.
Severe allergic reactions
Blujepa (gepotidacin) can cause serious allergic reactions, including anaphylaxis, which can be life-threatening. Get medical attention right away if you experience symptoms of an allergic reaction such as a rash, swelling in your face or throat, or trouble breathing.
Diarrhea from Clostridioides difficile infection
Although rare, Blujepa (gepotidacin) can raise your risk of getting infected with a bacteria called Clostridioides difficile (C. diff), which can lead to severe diarrhea. Antibiotics like Blujepa (gepotidacin) can change the normal bacteria in your gut, allowing C. diff to overgrow and cause infection. This type of infection can happen during treatment or even up to 2 months after stopping the antibiotic.
If you develop diarrhea while taking Blujepa (gepotidacin), especially if it's severe or doesn't go away, tell your healthcare team right away. It's important to know the difference between mild diarrhea (a common side effect) and this type of infectious diarrhea. C. diff-related diarrhea can cause watery diarrhea, bloody stools, fever, stomach cramps. If you have these symptoms, get medical help right away to be tested and treated.
Blujepa (gepotidacin) dosage forms
Typical dosing for Blujepa (gepotidacin)
The typical dose is 1,500 mg (two 750 mg tablets) by mouth twice a day for 5 days.
What are alternatives to Blujepa (gepotidacin)?
Uncomplicated urinary tract infections (UTIs) in women and girls 12 years and older who weigh at least 40 kg (88 lbs)
Treatment or prevention of urinary tract infections
Lower respiratory tract infection (e.g., Pneumocystis pneumonia, infections related to bronchitis)
Travelers' diarrhea - tablet or liquid only
Ear infections - tablet or liquid only
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References
Best studies we foundAdeyinka, A., et al. (2023). Cholinergic crisis. StatPearls.
Al-Akchar, M., et al. (2022). Long QT syndrome. StatPearls.
GlaxoSmithKline LLC. (2025). Bluejepa- gepotidacin tablet, film coated [package insert]. DailyMed.
Hooton, T. M., et al. (2023). 2831. Efficacy and safety of gepotidacin for uncomplicated urinary tract infection: Pooled subgroup analyses of the EAGLE-2 and EAGLE-3 randomized phase 3 trials. Open Forum Infectious Diseases.
Purves, D., et al. (2001). Acetylcholine. Neuroscience.
Wagenlehner, F., et al. (2024). Oral gepotidacin versus nitrofurantoin in patients with uncomplicated urinary tract infection (EAGLE-2 and EAGLE-3): Two randomised, controlled, double-blind, double-dummy, phase 3, non-inferiority trials. The Lancet.
Watkins, R. R., et al. (2023). Gepotidacin: A novel, oral, ‘first-in-class’ triazaacenaphthylene antibiotic for the treatment of uncomplicated urinary tract infections and urogenital gonorrhoea. Journal of Antimicrobial Chemotherapy.
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