Overview
Racecadotril is an antisecretory antidiarrheal medication used for the symptomatic treatment of acute diarrhea. It reduces intestinal hypersecretion without affecting intestinal motility. Unlike opioid antidiarrheals, it does not cause significant constipation or central nervous system effects.
Mechanism of Action
Racecadotril is a prodrug that is rapidly converted to its active metabolite, thiorphan. Thiorphan inhibits neutral endopeptidase (enkephalinase) in the intestinal mucosa. By preventing the degradation of endogenous enkephalins, it prolongs their action on delta-opioid receptors in the gut. This results in: Reduced intestinal secretion of water and electrolytes Decreased hypersecretion induced by inflammatory mediators Importantly, racecadotril does not significantly slow intestinal transit time.
Indications
- Acute diarrhea in infants and children (as adjunct to oral rehydration therapy)
- Symptomatic treatment of acute diarrhea in adults
Dosage
Adults: 100 mg three times daily before meals Continue until two normal stools are passed Typically not more than 7 days Pediatric (dose based on body weight): 1.5 mg/kg per dose, three times daily Always administer alongside oral rehydration therapy.
Contraindications
- Hypersensitivity to racecadotril or any component of the formulation
- Chronic diarrhea
- Diarrhea associated with antibiotic-associated pseudomembranous colitis
- Bloody or purulent diarrhea with fever (suggesting invasive bacterial infection)
Side Effects
- Headache
- Nausea
- Vomiting
- Constipation
- Rash
- Angioedema
- Urticaria
Interactions
- No significant clinically relevant drug interactions reported
- Caution with concomitant ACE inhibitors (rare reports of increased risk of angioedema)
Counseling Points
- Does not cause constipation like Loperamide. Prescription only.