A randomized, open-label comparison of nonprescription loperamide and attapulgite in the symptomatic treatment of acute diarrhea
Article Abstract:
Acute diarrhea is a common, transient disorder characterized by the frequent passage of watery, unformed stools. It can be caused by viral and bacterial infections; irritating foods or alcohol; and anxiety. Since the condition usually resolves spontaneously, most patients do not consult a physician; they treat themselves with over-the-counter (OTC) antidiarrheal medications. Some nonprescription drugs, such as attapulgite, bind and inactivate intestinal irritants. Other nonprescription drugs, such as loperamide, decrease intestinal movement and slow the transit time for food passing through the intestine. This allows more water to be absorbed from the stool. A prior report claimed that attapulgite and loperamide were equally effective in the treatment of acute diarrhea, but this study may not have been properly conducted. The effectiveness of loperamide and attapulgite were compared in the management of 194 adults with moderately-severe acute diarrhea. Patients receiving an initial dose of 4 milligrams (mg) of loperamide followed by a 2 mg dose after every watery bowel movement had a significantly decreased number of watery stools than patients who were initially given 3 grams of attapulgite, followed by repeat doses according to a particular schedule. This difference was most pronounced 12 hours after the initial doses were administered. Patients were unaware of the drug they received, and 75 percent of all patients reported that they were satisfied with the results of their therapy. Both treatments were well-tolerated and had a low incidence of side effects, such as nausea and constipation. These results indicate that loperamide is a more effective antidiarrheal agent than attapulgite in the management of moderately-severe acute diarrhea in adults. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Over-the-counter antidiarrheal medications used for the self-treatment of acute nonspecific diarrhea
Article Abstract:
The Food and Drug Administration (FDA) defines diarrhea as a condition with no definable cause, characterized by an increased frequency of excretion of loose, watery stools (three or more daily) during a 24- to 48-hour period. The FDA exists to assure, among other things, that prescription and nonprescription drugs are safe and effective. Patients frequently treat themselves with one or more of the over-the-counter (OTC) antidiarrheal drugs currently available. These medications typically contain one or more of the 25 ingredients that supposedly have antidiarrheal properties. In 1975, the Advisory Review Panel on OTC Laxative, Antidiarrheal, Emetic and Anti-emetic Drug Products presented its findings to the FDA regarding which medications it considered safe and effective. The FDA published its preliminary safe and effective antidiarrheal list, which included only three medications: attapulgite, polycarbophil, and loperamide. Attapulgite and polycarbophil are not absorbed by the body and act locally to bind intestinal irritants and water, thus decreasing the water content of stool. Loperamide slows intestinal movement and increases the time that the stool remains in the intestine. This allows more water to be reabsorbed by the large intestine, and also decreases the water content of the stool. Upon publication of the FDA's final list, it will be legal to sell only these antidiarrheal medications. Health care professionals, especially pharmacists, should advise patients on when and how to treat their diarrhea, and when to seek medical attention. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
User Contributions:
Comment about this article or add new information about this topic: