Racecadotril indication
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racecadotril indication clinical use
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Racecadotril — Indication
Primary Indication: Acute Diarrhea (in both adults and children)
Racecadotril (acetorphan) is an antisecretory antidiarrheal indicated for the treatment of acute diarrhea. It is also used specifically for acute infectious gastroenteritis.
Mechanism (why it works)
Racecadotril is a prodrug converted to thiorphan, which inhibits enkephalinase (neutral endopeptidase, NEP). This blocks the breakdown of endogenous enkephalins in the gut, potentiating their action on mu-opioid receptors (MOR) in the GI tract. The result is reduced intestinal hypersecretion — without affecting gut motility (unlike loperamide).
Because it does not slow motility, it does not cause rebound constipation.
Dosing
| Population | Dose |
|---|---|
| Adults | 100 mg orally every 8 hours (up to 7 days) |
| Children | 1.5 mg/kg orally three times daily |
Key Advantages Over Loperamide
- Does not penetrate the CNS → no CNS effects
- Does not reduce intestinal motility → no rebound constipation
- Proven safety in children (listed explicitly in formulary tables)
- Better tolerability profile overall
Summary
Racecadotril is indicated for acute diarrhea (including acute infectious gastroenteritis) in adults and children, acting as a purely antisecretory agent via enkephalinase inhibition.
Sources: Goodman & Gilman's The Pharmacological Basis of Therapeutics; Goldman-Cecil Medicine; Sleisenger and Fordtran's Gastrointestinal and Liver Disease
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