Diloxanide Furoate

Diloxanide furoate is an antiprotozoal medication used to treat intestinal amebiasis caused by the parasite Entamoeba histolytica. It is a “luminal amebicide,” meaning it acts primarily within the gastrointestinal tract to kill amoeba and clear the cysts they produce. 

Indications

Diloxanide furoate is used for the following conditions: 

• Asymptomatic intestinal amebiasis (cyst passers):It is a primary agent for individuals who show no symptoms but are excreting cysts of  histolytica.
• Mild intestinal amebiasis:For patients with noninvasive or symptomatic but mild intestinal infections.
• Following tissue amebicide treatment:It is used in conjunction with other drugs, like metronidazole or tinidazole, to clear cysts from the intestines after treating more invasive forms of amebiasis, such as liver abscesses.
• Giardiasis:It can be used in combination with metronidazole to treat this intestinal parasitic infection, though its efficacy alone is not well-established. 

Mechanism of action

Diloxanide furoate is a prodrug that is hydrolyzed in the gut to release its active form, diloxanide. While its exact mechanism is not fully known, it is believed to work by inhibiting the parasite’s protein synthesis. The active compound kills the trophozoites (the active, feeding stage of the amoeba) and prevents them from maturing into infectious cysts. 

Contraindications and precautions

• Hypersensitivity:The medication should not be used in individuals with a known allergy to diloxanide furoate.
• Pregnancy and breastfeeding:It is not recommended during the first trimester of pregnancy and should be used with caution during breastfeeding.
• Children:It is generally not recommended for children under 2 years of age or weighing less than 25 kg.
• Invasive disease:The medication is not effective for invasive or extraintestinal amebiasis and must be used in combination with other drugs for these conditions. 

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