Please check your internet connection and try again.
# Diloxanide furoate
## Overview
Diloxanide furoate is a luminal amebicide used to treat intestinal colonization by *Entamoeba histolytica*. It is poorly absorbed from the gastrointestinal tract and acts primarily by leaving the lumen free of cysts. It is ineffective against extra-intestinal (tissue) amebiasis.
## Primary Indications
Asymptomatic intestinal colonization (*E. histolytica* cyst passers). It is often used in combination with or following treatment with a tissue amebicide (e.g., metronidazole, tinidazole) for invasive disease to ensure elimination of intraluminal cysts.
## Adult Dosing
Standard regimen: 500 mg orally three times daily for 10 days.
## Pediatric Dosing
Standard regimen: 20 mg/kg/day divided into three doses for 10 days.
*(Maximum dose: 500 mg per dose).*
## Dose Adjustments
* **Renal Impairment:** No formal dosage adjustments are typically defined due to minimal systemic absorption; use with caution in severe impairment.
* **Hepatic Impairment:** Use with caution; monitor for potential accumulation if significant hepatic clearance is required for the limited absorbed fraction.
## Contraindications
Hypersensitivity to diloxanide or any component of the formulation.
## Adverse Effects
* **Common:** Flatulence (frequent), nausea, vomiting, abdominal cramps, and pruritus/urticaria.
* **Rare/Serious:** Significant systemic toxicity is rare due to poor absorption.
## Key Drug Interactions
There are no major clinically significant drug-drug interactions, as systemic absorption is negligible. However, use caution when co-administering with other medications that affect gastrointestinal motility.
## Monitoring
* **Clinical:** Monitor for resolution of gastrointestinal symptoms.
* **Microbiological:** Perform follow-up stool microscopy (at least 3 samples) 2–4 weeks after completion of therapy to confirm clearance of cysts.
## Clinical Pearls
* **Not for Invasive Disease:** Diloxanide furoate will not treat liver abscesses or invasive colitis. If invasive disease is suspected, a tissue amebicide (e.g., Metronidazole 500–750 mg TID for 5–10 days) must be administered concurrently or first.
* **Pregnancy:** Data are limited; benefits should outweigh risks. Avoid during the first trimester if possible.
* **Compliance:** The 10-day course is essential to prevent relapse of cyst excretion.
* **Availability:** Availability varies by region; in many countries, it is not commercially available by traditional pharmacy chains and may require importation or sourcing through specialized tropical medicine centers.
***
**Disclaimer:** This information is for educational purposes only. Clinical guidelines and local prescribing protocols vary; always verify drug dosing, contraindications, and drug-drug interactions using current, institutional-specific, or official formulary databases (e.g., Lexicomp, UpToDate) before prescribing.
