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# Diloxanide Furoate
## Overview
Diloxanide furoate is a luminal amebicide used to eliminate *Entamoeba histolytica* cysts from the gastrointestinal tract. It is typically considered an oral, non-absorbed agent used as a follow-up to systemic tissue amebicide therapy (e.g., metronidazole).
## Primary Indications
* Treatment of asymptomatic cyst passers of *Entamoeba histolytica*.
* Follow-up treatment for acute intestinal or extraintestinal amebiasis after initial therapy with a systemic amebicide.
## Adult Dosing
* 500 mg orally three times daily for 10 days.
## Pediatric Dosing
* 20 mg/kg/day orally in three divided doses for 10 days.
* Maximum dose: 500 mg per dose (1,500 mg/day).
## Dose Adjustments
* **Renal/Hepatic Impairment:** No formal dosage adjustments are established; use with caution in patients with severe hepatic impairment due to limited pharmacokinetic data.
## Contraindications
* Hypersensitivity to diloxanide furoate or any component of the formulation.
## Adverse Effects
* **Common:** Flatulence, abdominal cramps, nausea, vomiting, and diarrhea.
* **Rare:** Urticaria, pruritus, and elevation of liver enzymes.
## Key Drug Interactions
* No significant drug-drug interactions are well-documented. However, as it is a luminal agent, efficacy may be affected by drugs that significantly alter intestinal transit time.
## Monitoring
* Monitor stool specimens for the presence of *E. histolytica* (cysts or trophozoites) post-treatment to ensure clearance.
* Monitor for resolution of gastrointestinal symptoms.
## Clinical Pearls
* **Not for invasive disease:** Diloxanide furoate is ineffective against systemic or hepatic *E. histolytica*. It must be used in conjunction with a systemic agent (e.g., metronidazole or tinidazole) for symptomatic disease.
* **Local Availability:** In many regions (including the United States), diloxanide furoate is not commercially available and must be sourced through specialized pharmacies or the CDC Drug Service as an orphan drug. Always verify local availability and institutional protocols before prescribing.
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**Educational Disclaimer:** This information is for educational purposes only. Drug information, availability, and clinical protocols are subject to change. Always verify current prescribing information, institutional guidelines, and local regulations before ordering or administering any medication.
