Diloxanide furoate
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Diloxanide furoate is an anti-protozoal drug used in the treatment of Entamoeba histolytica and some other protozoal infections.
Category
Antiparasitic
US Brand Names
ENTAMIDE, FUMARIDE (not available in the U.S.)
Prescribing Information
Therapeutic indications
For the treatment of acute and chronic intestinal amebiasis.
Administration
Adults: One tablet three times daily for ten days.
Children: 20 mg/kg bodyweight daily in divided doses for ten days. Furamide is not suitable for use in children weighing less than 25 kg.
Elderly: There is no need for dosage reduction in the elderly.
If required, a second course of treatment may be prescribed.
Contraindications
Hypersensitivity to diloxanide furoate.
Precautions
Keep all medicines out of the reach of children.
Drug Interactions
No clinically-significant drug interactions known.
Pregnancy and Lactation
The safety of Furamide during pregnancy and lactation has not been established and use during these periods should therefore be avoided.
Adverse Effects
No serious side effects have been reported and the bacterial flora of the gut is not upset. Flatulence sometimes occurs but may usually be disregarded. Occasionally, vomiting, pruritus and urticaria may occur.
Overdosage
Furamide tablets are unlikely to constitute a hazard in overdosage. In severe overdosage, early gastric lavage is recommended. There is no specific antidote. Treatment should be symptomatic and supportive.
Clinical Pharmacology
In the gut, diloxanide furoate is largely, if not wholly, hydrolysed into diloxanide and furoic acid under the combined action of bacterial and gut esterases. After absorption, diloxanide is very rapidly conjugated to form a glucuronide. In circulating blood, it is present to about 99% as a glucuronide and 1% as free diloxanide. Diloxanide is predominantly excreted in the urine. It is believed that the unabsorbed diloxanide is the active anti-amoebic substance, up to 10% remaining in the gut which is subsequently excreted as diloxanide in the faeces.
Mode of Action
Diloxanide furoate is a luminal amoebicide acting principally in the bowel lumen, although its mode of action is not known.[1]
Safety and Effectiveness
A 13-year study conducted by the United States Center for Disease Control between 1977 and 1990 found that this drug had a low incidence of side effects and was successful in treatment of 86% of asymptomatic carriers of Entamoeba histolytica. [2]
Availability
A CDC study authorized the use of this drug in the treatment of 4,371 cases of Entamoeba histolytica from 1977 to 1990. [2]
References
- ↑ "http://www.medicines.org.uk/emc/medicine/10787/SPC". External link in
|title=(help) - ↑ 2.0 2.1 McAuley JB, Herwaldt BL, Stokes SL; et al. (1992). "Diloxanide furoate for treating asymptomatic Entamoeba histolytica cyst passers: 14 years' experience in the United States". Clin. Infect. Dis. 15 (3): 464–8. PMID 1520794.