Diloxanide Furoate

# Diloxanide furoate ## Overview - **Classification**: Luminal amebicide - **Mechanism**: Acts directly on *Entamoeba histolytica* trophozoites and cysts within the intestinal lumen. Its precise amebicidal mechanism is not fully understood. ## Primary Indications 1. **Asymptomatic Intestinal Amebiasis** - Treatment of asymptomatic cyst passers. 2. **Mild Intestinal Amebiasis** - For non-dysenteric, mild symptomatic infections. ## Adult Dosing ### Standard Dosing **Asymptomatic/Mild Intestinal Amebiasis** - **Dose**: **500 mg** - **Frequency**: **Three times a day (TID)** - **Route**: Oral - **Duration**: **10 days** ### Dose Adjustments - **Renal Impairment**: No specific dose adjustment generally needed due to minimal systemic absorption. - **Hepatic Impairment**: No specific dose adjustment generally needed due to minimal systemic absorption. - **Elderly Patients**: No specific dose adjustment required; follow adult dosing. ## Pediatric Dosing ### Neonates (0-28 days) - **Dose**: Not routinely recommended. - **Special Notes**: Limited data, use with extreme caution and only if alternative safer options are unavailable and benefit outweighs risk. ### Infants (1-12 months) - **Dose**: **20 mg/kg/day** divided into **three doses (TID)** - **Frequency**: Every 8 hours - **Maximum**: **1500 mg/day** (or adult max dose) - **Special Notes**: Consider crushing tablets for easier administration; mix with food or liquid. ### Children (1-12 years) - **Dose**: **20 mg/kg/day** divided into **three doses (TID)** - **Frequency**: Every 8 hours - **Maximum**: **1500 mg/day** (adult maximum dose) - **Special Notes**: Ensure child can swallow tablet or consider crushing if needed. ### Adolescents (13-18 years) - **Dose**: Follow **adult dosing** of **500 mg TID** - **Frequency**: Every 8 hours - **Maximum**: **1500 mg/day** ## Safety Information ### Contraindications - **Absolute**: Hypersensitivity to diloxanide furoate. - **Relative**: Pregnancy (use only if clearly indicated). ### Common Adverse Effects - **Common (1-10%)**: Flatulence, abdominal cramps, nausea, vomiting, diarrhea, pruritus, urticaria. - **Serious but Rare**: No commonly reported serious systemic adverse effects due to low systemic absorption. ### Key Drug Interactions - **Limited Interactions**: Few clinically significant drug interactions due to minimal systemic absorption. - **Monitoring**: No specific routine drug interaction monitoring needed. ## Monitoring & Follow-up - **Before Treatment**: Baseline stool examination for ova and parasites (O&P) to confirm diagnosis. - **After Treatment**: Follow-up stool examinations (O&P) 2-4 weeks post-treatment to confirm eradication. - **Clinical Signs**: Monitor for resolution of symptoms (if present). ## Clinical Pearls - 💡 **Take with food**: Administer with meals to minimize gastrointestinal upset. - 💡 **Luminal action only**: Not effective for extraintestinal amebiasis or severe dysentery. - 💡 **Confirmation**: Eradication is typically confirmed by negative stool O&P exams after treatment. > **⚠️ Important**: This information is for educational purposes only. Always consult current prescribing information, local guidelines, and clinical judgment before prescribing.