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# Diloxanide furoate
## Overview
Diloxanide furoate is a luminal amebicide used primarily to eradicate *Entamoeba histolytica* cysts in asymptomatic carriers. It has minimal systemic absorption and acts directly within the intestinal lumen. It is not effective for invasive (extraintestinal) amebiasis.
## Primary Indications
* Treatment of asymptomatic *Entamoeba histolytica* (luminal cyst passers).
* Follow-up treatment for symptomatic amebiasis (after an invasive tissue-active agent like metronidazole or tinidazole has been administered).
## Adult Dosing
* **Routine dose:** 500 mg orally three times daily for 10 days.
## Pediatric Dosing
* **Routine dose:** 20 mg/kg/day divided into three doses (given every 8 hours) for 10 days.
* *Note:* Maximum dose is 500 mg per dose (1,500 mg/day).
## Dose Adjustments
* **Renal/Hepatic Impairment:** No specific guidelines exist; however, use caution in severe hepatic impairment due to potential biliary clearance issues.
* **Local Protocol:** Always verify with local infectious disease guidelines as regional resistance or treatment protocols may vary.
## Contraindications
* Hypersensitivity to diloxanide furoate.
* Severe hepatic disease (relative contraindication).
## Adverse Effects
* **Common:** Flatulence, abdominal cramps, nausea, and vomiting.
* **Rare:** Urticaria, pruritus, and rarely tachycardia or diplopia.
## Key Drug Interactions
* Minimal clinical interactions due to low systemic absorption. However, consult current databases if the patient is on multiple medications, as individual pharmacokinetic variations may occur in the presence of altered gut flora.
## Monitoring
* Monitor for resolution of gastrointestinal symptoms.
* Stool microscopy should be repeated 2–4 weeks after completion of therapy to confirm the clearance of cysts.
## Clinical Pearls
* **Not for invasive disease:** This drug does not achieve adequate blood levels to treat amebic liver abscesses or acute invasive dysentery; it must be used as an adjunct to tissue-active agents (e.g., metronidazole, tinidazole) in these cases.
* **Administration:** Typically taken with meals to reduce gastrointestinal irritation.
* **Availability:** Availability is geographically limited; it is often obtained via specialized pharmacy services or travel clinics.
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*Disclaimer: This information is for educational purposes only. Clinical guidelines and prescribing practices can change. Always verify dosage, contraindications, and drug interactions with the most current institutional protocols and the manufacturer's official package insert before prescribing or administering medication.*
