Diarrhea is usually a symptom of gastrointestinal upset or an infection. While chronic types of diarrhea such as IBS (Irritable bowel syndrome) and IBD (Inflammatory bowel disease) require a doctor’s advice, acute forms of it especially those occuring mildly (at least not every hour) are often let alone to pass. As diarrhea is a defensive response of the body, it helps the system by eliminating irritants and foreign materials through defecation. However, diarrhea frequency is something to be mindful about because of dehydration.
And, as diarrhea is a common disorder, most people would treat it by themselves - buying anti-motility medication like loperamide or an antibacterial drug furazolidone. Interestingly, the latter is also advised for infants and children below twelve years old.
Furazolidone is a nitrofuran antibiotic. It is categorized as antiprotozoal drug but has less potency compared to metronidazole. Furazolidone is indicated for gynecological infections, cholera and other bacterial causative diarrhea. It is also used for giardiasis (protozoal infection of the small intestine) but cited as not the first line of treatment.
Furazolidone is available in 100mg tablet and in 50mg per 5ml suspension. For the adults, one tablet of furazolidone is usually taken four times daily for 2 to 5 days to 7 days. The dose in children is calibrated according to weight. Furazolidone is given in 1.25mg per kg four times daily with the duration of use same as the adults. In giardiasis, furazolidone is generally advised for ten days of use.
Furazolidone is contraindicated in babies below 1 month old because of risk for hemolytic anemia. It is not advised for breastfeeding mothers. Since, furazolidone falls under category C regarding pregnancy (teratogenic in mice with no further studies on people); pregnant women should also avoid this medication. Hemolysis may occur with individuals who have G6PD deficiency thus, they should not take furazolidone.
The common side effects of furazolidone include yellow to brown discoloration of urine, rashes and abdominal discomforts which include nausea, vomiting and diarrhea. Others side effects of this drug include hypoglycemia, orthostatic hypotension and hemolytic anemia.
Furazolidone when used with tyrosine containing food (strong unpasteurized cheese, yogurt, chicken liver etc.), sympathomimetics (phenylpropanolamine), antihistamines, MAO inhibitors and other antidepressants may cause hypertensive crisis –a severe increase of high-blood pressure that can result to stroke.
Image by the author
Treating diarrhea in children with an OTC furazolidone
Before loperamide, attapulgite was a popular antidiarrheal medication. Unlike loperamide, attapulgite can be available in suspension form (Polymagma) and can be indicated for children two years and above. Unfortunately, attapulgite was discontinued in 2003 because of insufficient efficacy and safety data.
While diarrhea can be a serious thing, especially for the children, some adults would inquire a drug from the pharmacy instead of taking them to a doctor. Some drugstore may give a prescription medication in cases of an emergency; others may still advise that they see a physician just to be sure.
Some pharmacy personnel can be confident in dispensing a furazolidone tablet or suspension to a child because of certain experiences with doctors. They tend to give half tablet of a furazolidone to a child not more than 12 years old and calibrate the dose for an infant not less than one month.
However, as furazolidone remains a prescription drug, only a registered physician can recommend this medication. A customer may procure furazolidone without a prescription, a pharmacist may advise this drug for use and they are both accountable for the risk.
© Phoenix Montoya @ June 28, 2012