Diloxanide is a medication used to treat amoeba infections. In places where infections are not common, it is a second line treatment after paromomycin when a person has no symptoms. For people who are symptomatic, it is used after treatment with

metronidazole Metronidazole, sold under the brand name Flagyl and Metrogyl among others, is an antibiotic and antiprotozoal medication. It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vagino ...

tinidazole Tinidazole, sold under the brand name Tindamax among others, is a medication used against protozoan infections. It is widely known throughout Europe and the developing world as a treatment for a variety of anaerobic amoebic and bacterial infecti ...

. It is taken

by mouth Oral administration is a route of administration whereby a substance is taken through the Human mouth, mouth, swallowed, and then processed via the digestive system. This is a common route of administration for many medications. Oral administ ...

. Diloxanide generally has mild side effects. Side effects may include

flatulence Flatulence is the expulsion of gas from the Gastrointestinal tract, intestines via the anus, commonly referred to as farting. "Flatus" is the medical word for gas generated in the stomach or bowels. A proportion of intestinal gas may be swal ...

, vomiting, and itchiness. During

pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...

it is recommended that it be taken after the

first trimester Pregnancy is the time during which one or more offspring gestates inside a woman's uterus. A multiple pregnancy involves more than one offspring, such as with twins. Conception usually occurs following vaginal intercourse, but can also ...

. It is a luminal amebicide meaning that it only works on infections within the

intestines The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. ...

. Diloxanide came into medical use in 1956. It is on the

World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...

. It is not commercially available in much of the

developed world A developed country, or advanced country, is a sovereign state that has a high quality of life, developed economy, and advanced technological infrastructure relative to other less industrialized nations. Most commonly, the criteria for eval ...

as of 2012.

Medical uses

Diloxanide furoate works only in the digestive tract and is a lumenal amebicide. It is considered second line treatment for infection with amoebas when no symptoms are present but the person is passing cysts, in places where infections are not common. Paromomycin is considered the first line treatment for these cases. For people who are symptomatic, it is used after treatment with ambecides that can penetrate tissue, like

. Diloxanide is considered second-line, while paromomycin is considered first line for this use as well.

Adverse effects

Side effects include flatulence, itchiness, and hives. In general, the use of diloxanide is well tolerated with minimal toxicity. Although there is no clear risk of harm when used during pregnancy, diloxanide should be avoided in the first trimester if possible. Diloxanide furoate is not recommended in women who are breast feeding, and in children <2 years of age.

Pharmacology

Diloxanide furoate destroys

trophozoites A trophozoite (G. ''trope'', nourishment + ''zoon'', animal) is the activated, feeding stage in the life cycle of certain protozoa such as malaria-causing ''Plasmodium falciparum'' and those of the ''Giardia'' group. The complementary form of the t ...

of ''E. histolytica'' and prevents amoebic cyst formation. The exact mechanism of diloxanide is unknown. Diloxanide is structurally related to chloramphenicol and may act in a similar fashion by disrupting the

ribosome Ribosomes () are molecular machine, macromolecular machines, found within all cell (biology), cells, that perform Translation (biology), biological protein synthesis (messenger RNA translation). Ribosomes link amino acids together in the order s ...

The

prodrug A prodrug is a pharmacologically inactive medication or compound that, after intake, is metabolized (i.e., converted within the body) into a pharmacologically active drug. Instead of administering a drug directly, a corresponding prodrug can be ...

, diloxanide furoate, is metabolized in the gastrointestinal tract to release the active drug, diloxanide. 90% of each dose is excreted in the urine and the other 10% is excreted in the feces.

Society and culture

It is on the

. The drug was discovered by

Boots UK Boots UK Limited (formerly Boots the Chemists Limited) is a British health and beauty retailer and pharmacy chain that operates in the United Kingdom. It also operates internationally, including Ireland, Italy, Norway, the Netherlands, Thailand ...

in 1956, and introduced as ''Furamide''; it was not available in much of the developed world as of 2012.

References

{{Portal bar , Medicine Anilides Antiprotozoal agents 2-Furyl compounds Dichloromethyl compounds World Health Organization essential medicines Wikipedia medicine articles ready to translate Phenylene compounds