Basic information Pharmacology and mechanism of action Indications Side effects Contraindications and precautions Interactions Preparations References Safety Related Supplier
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diloxanide

Basic information Pharmacology and mechanism of action Indications Side effects Contraindications and precautions Interactions Preparations References Safety Related Supplier
diloxanide Basic information
diloxanide Chemical Properties
  • Melting point:175°
  • Boiling point:356.2±42.0 °C(Predicted)
  • Density 1.439±0.06 g/cm3(Predicted)
  • pka9.95±0.15(Predicted)
diloxanide Usage And Synthesis
  • Pharmacology and mechanism of actionDiloxanide is a dichloroacetanilide derivative that was introduced in 1956. It is amoebicidal in vivo and in vitro. It is highly effective in asymptomatic patients passing cyst forms. Sufficient data are not available on its efficacy when used alone in acute amoebiasis[1]. The mechanism of action of diloxanide is unknown. Like the structurally related chloramphenicol, diloxanide has been suggested to block the protein synthesis in the microorganism [2].
  • IndicationsDiloxanide is the drug of choice in the treatment of asymptomatic passers of cysts of Entamoeba histolytica in non-endemic countries. It is also given after metronidazole treatment to eradicate residual amoeba in the intestine.
  • Side effectsDiloxanide is usually well tolerated even at high doses. In one study [3], excessive flatulence was the only significant side effect recorded in 87% of the patients, but was also a common complaint among the patients (31%) even before treatment. Other minor side effects included anorexia (3%), nausea (6%), diarrhoea (2%), and abdominal cramps (2%). Flatulence as a frequent side effect of diloxanide has also been reported in a large retrospective study covering more than 4000 patients who used the drug during 1977 until 1990 in the United States[4]. Other less frequent side effects reported in the survey included headache, lethargy, dizziness, diplopia, and paraesthesia. The percentage of persons reporting adverse effects varied significantly by racial group. The existence of racial differences in the metabolism of diloxanide is unknown.
  • Contraindications and precautionsThere are no known contraindications to the drug.
  • InteractionsThere have been no reports.
  • PreparationsAvailable as diloxanide furoate.
    • Furamide® (Boots) Tablets 500 mg.
  • References1. Krogstad DJ, Spencer HC Jr, Healy GR (1978). Amoebiasis. N Engl J Med, 298, 262–265.
    2. Knight R (1980). The chemotherapy of amoebiasis. J Antimicrob Chemother, 6, 557–593.
    3. Wolfe MS (1973). Non-dysenteric intestinal amoebiasis: Treatment with diloxanide furoate. J Am Med Ass, 224, 1601–1604.
    4. McAuley JB, Herwaldt BL, Stokes SL, Becher JA, Roberts JM, Michelson MK, Juranek DD (1992). Diloxanide furoate for treating asymptomatic Entamoeba histolytica cyst passers: 14 years’ experience in the United States. Clin Infect Dis, 15, 464–468.
  • Antimicrobial activityDiloxanide inhibits E. histolytica with unusually high specificity at concentrations of 0.01–0.1 mg/L.
  • Acquired resistanceNo resistance has been reported. Patients with dysentery have lower cure rates than cyst excreters.
  • Pharmaceutical ApplicationsDichloro(hydroxyphenyl)methylacetamide. Available as an insoluble ester, the furoate, for oral administration.
  • PharmacokineticsHuman pharmacokinetic data are limited. Animal data show that diloxanide furoate is rapidly absorbed from the intestine. The furoate is hydrolyzed in the gut, leaving high intraluminal concentrations of free diloxanide. About 75% is excreted via the kidney within 48 h, mostly as a glucuronide.
  • Clinical UseFuramide, or eutamide, is the 2-furoate ester of 2,2-dichloro-4 -hydroxy-N-methylacetanilide. It was developed as a resultof the discovery that various α,α-dichloroacetamidespossessed amebicidal activity in vitro. Diloxanide itself andmany of its esters are also active, and drug metabolism studiesindicate that hydrolysis of the amide is required for theamebicidal effect. Nonpolar esters of diloxanide are morepotent than polar ones. Diloxanide furoate has been used inthe treatment of asymptomatic carriers of E. histolytica. Itseffectiveness against acute intestinal amebiasis or hepaticabscesses, however, has not been established. Diloxanidefuroate is a white crystalline powder. It is administered orallyonly as 500-mg tablets and may be obtained in the UnitedStates from the CDC in Atlanta, Georgia.
  • Clinical UseAsymptomatic intestinal infection with E. histolytica
    It is also used in invasive amebiasis in conjunction with nitroimidazoles in order to eradicate luminal cysts.
  • Side effectsIt is well tolerated, but flatulence is common, and nausea and vomiting may occur.
diloxanide(579-38-4)Related Product Information
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