Diloxanide for Amoebiasis

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Metronidazole and furazolidone are generally recognized as antiprotozoal drugs. But, while metronidazole is considered as the first line of treatment for amoebiasis, furazolidone has been cited as a weaker type. Diloxanide is also an amoebicide – a

Amoebiasis or amebiasis is an infectious disease that involves protozoal infestation particularly with the Entamoeba histolytica specie. Generally, its symptoms include stomach cramps and diarrhea. However, serious cases of amoebiasis can also consist of vomiting, fever and bloody feces. Amoeba infection can spread throughout the organs of the body invading the liver, the lungs and even the brain.  As amoebiasis usually affects the colon wall, it can puncture its lining causing colitis, a swelling of the large intestine.  Untreated or serious amoeba infection may result to acute dysentery or chronic diarrhea.

Metronidazole is a recognized drug for amoebiasis. It is often the choice of most physicians to treat amoebiasis and to prevent its complications. However, diloxamide may also be promising. Compared to furazolidone, another anti-protozoal medicine which has lesser potency than metronidazole, diloxamide may be as efficient as metronidazole for amoebiasis.

Diloxamide facts

Diloxamide furoate was known for the brand name Furamide. It was discovered by the Boots Company PLC in 1956 and was used for the treatment of different cases of amoebiasis infection from 1977 to 1990. However, the brand name Furamide is non-existent anymore. While, diloxanide is available under the brandname Amicline 500mg (Franco- Indian) in India, diloxanide is generally popular in its generic name. In India and Vietnam, diloxanide can be found in combination with metronidazole or tinizole.

Diloxanide is categorized as luminal amoebicide. It can be used alone for eliminating amoeba cysts and can be used with tinidazole or metronidazole for severe amoebiasis.

In single or in combination form, Diloxanide can be available in tablet and suspension dosage forms. Diloxanide in single form is usually given one tablet three times a day for 10 days. In children, the dose of diloxanide is calibrated according to weight - 20mg of diloxanide per kilogram is given three times a day for ten days.

Some Diloxamide tradenames in combination formula:

ALDEZOL-DF (Alb. David) suspension with metronidazole 100 mg, diloxanide furoate 125 mg/5 ml ; tablet containing metronidazole 400 mg, diloxanide furoate 500 mg

AMEBIS FORTE (Zydus Cadila) tablet containing tinidazole 300 mg, diloxanide furoate 500 mg

ARISTOGYL PLUS (Aristo) tablet containing metronidazole 400 mg, diloxanide furoate 500 mg, simethicone 100 mg

  • Special precautions and contraindications

Diloxamide should be used in precaution to breastfeeding mothers. It is contraindicated in pregnancy particularly during the first trimester.

  • Side effects

The common side effects of diloxamide includes nausea, vomiting, flatulence, urticaria (skin allergy) and anorexia

  • Drug interactions

Interestingly, diloxamide has no known drug interactions.

Diloxanide VS furazolidone VS metronizole for amoebiasis

Diloxanide is an effective treatment for intestinal amoebiasis. Furazolidone is also used for an amoeba infection of the small intestine which is giardiasis. However, furazolidone is commonly indicated for symptomatic treatment of mild cases of diarrhea caused by amoeba and bacteria. Between diloxamide and furazolidone, diloxamide is the better intestinal amoebicide.

With metronidazole, a nitroimidazole derivative, diloxanide works better in destroying the trophozoites and parasitic cysts within the intestines. Unfortunately, unlike metronidazole, diloxamide is least effective in eliminating E. histolica trophozoites (grown parasites) outside the intestines.

Image source

Finally

Diloxanide maybe better than furazolidone but it is still not comparable to metronidazole. As an orphan drug, diloxanide is considered as the third line for treatment. Diloxanide can be in combination with nitroimidazole like metronidazole or tinidazole for invasive amoebiasis. But, medical specialist cites that diloxanide works best after the nitroimidazole treatment, eradicating existing trophozites and cysts within the intestines.

© Phoenix Montoya @ July 14, 2012

References:

  1. http://emedicine.medscape.com/article/996092-treatment
  2. http://books.google.com.ph/books?id=EaP1yJz4fkEC&pg=PA441&lpg=PA441&dq=diloxanide+drug+interactions&source=bl&ots=3Uq8EFs9v7&sig=D9zE4AiYs2e9jv4wJULzTOMQS-g&hl=en&sa=X&ei=2oL-T_nCC4rAiQfUuszmBg&ved=0CFUQ6AEwAw#v=onepage&q=diloxanide%20drug%20interactions&
  3. http://mims.com/

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2 comments

chy99
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Posted on Jul 18, 2012
Francois Hagnere
0
Posted on Jul 14, 2012