Document Detail

Racecadotril versus loperamide: antidiarrheal research revisited.
MedLine Citation:
PMID:  12643598     Owner:  NLM     Status:  MEDLINE    
Racecadotril is an enkephalinase inhibitor, presented as a purely antisecretory agent with advantages over the opiate-receptor agonist loperamide in the treatment of diarrhea. A critical review of the literature and the models used was performed. Although pretreatment with high doses of racecadotril reduced cholera toxin-induced secretion and although clinical efficacy was demonstrated in young infants--a population characterized by 10-fold higher plasma enkephalin concentrations compared with adults, the analysis calls into question the peripheral antisecretory selectivity and relative clinical efficacy. Conversely, loperamide can be proposed as an antisecretory agent at therapeutic concentrations. Its efficacy is well established in acute and chronic diarrhea. Current experimental and clinical comparative studies of both drugs have problems with regard to the selection of the doses, the validity of models, and/or the trial design. The conclusion is that more research is needed before reliable conclusions can be drawn on the place of racecadotril in diarrhea treatment.
S Huighebaert; F Awouters; G N J Tytgat
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  48     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-03-19     Completed Date:  2003-04-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  239-50     Citation Subset:  AIM; IM    
Consultant Pharmaceutical Sciences, La Hulpe, Belgium.
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MeSH Terms
Antidiarrheals / administration & dosage*
Child, Preschool
Controlled Clinical Trials as Topic
Diarrhea / diagnosis,  drug therapy*
Dose-Response Relationship, Drug
Drug Administration Schedule
Follow-Up Studies
Loperamide / administration & dosage*
Middle Aged
Severity of Illness Index
Thiorphan / administration & dosage*,  analogs & derivatives*
Treatment Outcome
Reg. No./Substance:
0/Antidiarrheals; 53179-11-6/Loperamide; 76721-89-6/Thiorphan; 81110-73-8/acetorphan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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