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# Diloxanide furoate
## Overview
Diloxanide furoate is a luminal amebicide that acts by killing *Entamoeba histolytica* trophozoites in the lumen of the gastrointestinal tract. It is poorly absorbed systemically and is ineffective against extraintestinal (e.g., hepatic) amebiasis.
## Primary Indications
Treatment of asymptomatic intestinal amebiasis (cyst passers). It is often used as a follow-up agent after treatment with a systemic tissue amebicide (such as metronidazole or tinidazole) for symptomatic intestinal or extraintestinal amebiasis.
## 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.
## Dose Adjustments
* **Renal Impairment:** No specific data available; use with caution.
* **Hepatic Impairment:** Use with caution, although the drug acts primarily in the gut lumen.
* **Geriatric:** No specific adjustments, but monitor for dehydration if side effects occur.
## Contraindications
Hypersensitivity to diloxanide furoate. Not indicated as a monotherapy for invasive or extraintestinal amebiasis.
## Adverse Effects
* **Common:** Flatulence (frequent), nausea, vomiting, abdominal cramps, and pruritus/urticaria.
* **Rare:** Diplopia, dizziness, and mild elevations in liver enzymes.
## Key Drug Interactions
There are no major clinically significant drug-drug interactions documented. However, as it is a luminal agent, its efficacy depends on exposure within the gut; concurrent use of drugs that drastically alter gut motility or transit time may theoretically influence efficacy.
## Monitoring
* Monitor for resolution of gastrointestinal symptoms.
* Stool microscopy should be repeated 2–4 weeks after completion of therapy to confirm parasite clearance.
## Clinical Pearls
* **Role in Therapy:** Diloxanide is not a treatment for dysentery or liver abscesses. It must be paired with metronidazole or tinidazole if invasive disease is present.
* **Administration:** Take with food to minimize gastrointestinal upset.
* **Availability:** In many regions, this drug may be listed as an "essential medicine," but it is often unavailable commercially in the United States; procurement may require an application for an Investigational New Drug (IND) or consultation with the CDC Parasitic Diseases Branch.
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**Educational Disclaimer:** This information is for educational purposes only. Prescribing information, including availability and indications, varies by region and clinical context. Always verify dosages and guidelines with the most current institutional protocols or official drug monographs (e.g., CDC guidelines/FDA labels) before prescribing or administering.
