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# Diloxanide furoate
## Overview
Diloxanide furoate is a luminal amebicide that acts directly on *Entamoeba histolytica* in the intestinal lumen. It is poorly absorbed systemically and is ineffective against extraintestinal (e.g., hepatic) amebiasis.
## Primary Indications
* Treatment of asymptomatic intestinal colonization (cysts) by *E. histolytica* (luminal agent).
* Follow-up therapy for symptomatic amebiasis (after treatment with a tissue amebicide like metronidazole).
## Adult Dosing
* 500 mg orally 3 times daily for 10 days.
## Pediatric Dosing
* 20 mg/kg/day orally, divided into 3 doses, for 10 days.
* Maximum dose: 500 mg per dose (1500 mg/day).
## Dose Adjustments
* Renal/Hepatic impairment: No specific dosage adjustments are established, though clinical caution is advised in severe hepatic disease due to metabolic pathways, despite minimal systemic absorption.
## Contraindications
* Hypersensitivity to diloxanide or its components.
## Adverse Effects
* Common: Flatulence (high incidence), abdominal pain, nausea, and vomiting.
* Rare/Serious: Pruritus, urticaria, and albuminuria.
## Key Drug Interactions
* Minimal systemic absorption limits significant drug-drug interactions.
* Monitor concurrently administered medications that may cause similar GI side effects, as these may exacerbate the patient's discomfort.
## Monitoring
* Monitor for resolution of GI symptoms.
* Perform follow-up stool examination for ova and parasites (usually 2–4 weeks after completion of therapy) to ensure clearance of the organism.
## Clinical Pearls
* It is strictly a luminal agent; it will not treat liver abscesses or systemic invasive disease.
* Always pair with a tissue-active agent (e.g., metronidazole or tinidazole) if active invasive amoebic dysentery or tissue disease is present.
* Safety in pregnancy is not fully established; use only if clearly indicated and risks/benefits are weighed.
* Availability is often limited; it may require procurement through specialized tropical medicine pharmacies or national health authorities.
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**Educational Disclaimer:** This information is for educational purposes only. Always consult current institutional protocols, prescribing leaflets, or clinical guidelines (e.g., CDC/WHO) before prescribing or administering medication, as clinical practice may vary based on geography and local resistance patterns.
