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# Diloxanide furoate
## Overview
Diloxanide furoate is a luminal amebicide used primarily to eradicate *Entamoeba histolytica* cysts from the intestinal lumen. It is not effective against extra-intestinal (tissue) amebiasis. It is hydrolyzed in the gut to release diloxanide, which acts directly on the trophozoites.
## Primary Indications
* Asymptomatic intestinal amoebiasis (cyst passers).
* Follow-up treatment for symptomatic intestinal or extra-intestinal amoebiasis after therapy with a tissue amebicide (e.g., metronidazole, tinidazole).
## Adult Dosing
* 500 mg orally three times daily for 10 days.
## Pediatric Dosing
* 20 mg/kg/day orally, divided into three doses, for 10 days.
* Maximum dose: 1500 mg/day total.
## Dose Adjustments
* **Renal/Hepatic Impairment:** No specific guidelines available; use with caution in severe hepatic impairment due to possible accumulation.
## Contraindications
* Hypersensitivity to diloxanide furoate.
* Not indicated for the treatment of invasive amebiasis (liver abscesses or acute dysentery) as monotherapy.
## Adverse Effects
* **Common:** Flatulence, abdominal cramps, nausea, vomiting, and diarrhea.
* **Rare:** Urticaria, pruritus, and elevated hepatic enzymes.
## Key Drug Interactions
* Minimal systemic absorption limits significant drug-drug interactions, but systemic amebicides (like metronidazole) are required for concomitant tissue infection.
## Monitoring
* Monitor for resolution of gastrointestinal symptoms.
* Perform follow-up stool examination for *E. histolytica* cysts after completion of therapy to confirm eradication.
## Clinical Pearls
* **Luminal Clearance:** It does not reach therapeutic concentrations in the blood or tissues; therefore, it is never used alone for invasive disease.
* **Safety:** Generally well-tolerated. If gastrointestinal side effects are bothersome, split doses at mealtimes.
* **Availability:** Availability varies significantly by region (often obtained through specialized travel clinics or international pharmacies); consult local formulary or infectious disease specialists for distribution protocols.
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*Disclaimer: This information is for educational purposes only. Always verify current prescribing information, local clinical guidelines, and contraindications before prescribing or administering medication.*
