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# Diloxanide furoate
## Overview
Diloxanide furoate is a luminal amebicide used primarily to treat asymptomatic intestinal colonization by *Entamoeba histolytica*. It acts by killing trophozoites in the lumen of the gastrointestinal tract but is ineffective against invasive (extraintestinal/tissue) disease.
## Primary Indications
* Treatment of asymptomatic *E. histolytica* cyst passers.
* Follow-up therapy after treatment of invasive amebiasis (e.g., amebic liver abscess or intestinal dysentery) to eradicate remaining luminal cysts.
## Adult Dosing
* **Standard Regimen:** 500 mg orally three times daily for 10 days.
## Pediatric Dosing
* **Standard Regimen:** 20 mg/kg/day orally, divided into three doses, for 10 days.
* *Note: Consult local infectious disease protocols for precise pediatric weight-based adjustments.*
## Dose Adjustments
* **Renal Impairment:** No specific data available; clinical caution is advised.
* **Hepatic Impairment:** Use with caution; monitor for potential drug accumulation, though the drug is poorly absorbed systemically.
## Contraindications
* Known hypersensitivity to diloxanide furoate.
## Adverse Effects
* **Common:** Flatulence, abdominal bloating, metallic taste, nausea, and vomiting.
* **Rare:** Urticaria, pruritus, and mild diarrhea.
## Key Drug Interactions
* Drug-drug interactions are generally minimal due to low systemic absorption. However, caution is advised when co-administering with other medications that affect gastrointestinal motility.
## 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
* **Not for Invasive Disease:** Diloxanide must not be used as monotherapy for invasive amebiasis; it must be preceded by a tissue-active agent (e.g., metronidazole or tinidazole).
* **Compliance:** Complete the full 10-day course even if gastrointestinal symptoms resolve earlier.
* **Availability:** Diloxanide furoate is not widely available in the United States commercially; it may require procurement via the CDC Drug Service for specialized cases.
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**Disclaimer:** This information is for educational purposes and does not substitute for clinical judgment. Always verify current prescribing information, institutional protocols, and CDC guidelines before administering medications.
