Tablets against diarrhea: which are effective, fast-acting and inexpensive

By appointing these or other tablets against diarrhea, doctors are guided by the etiology of this symptom, since diarrhea can occur due to various causes and be infectious (bacterial, viral or fungal), dyspeptic or toxic. Diarrhea can be associated with shigellosis (dysentery) or amebiasis, as well as with the presence of other protozoal parasites in the intestine.

Indications of the diarrhea tablets

In any case, indications for the use of drugs included in this review are a condition accompanied by a frequent stool of a liquid consistency with or without bloating, intestinal spasms due to excessive gas production, with possible abdominal pain, nausea and vomiting (especially with rotavirus infection, gastroenteritis and food poisoning).

Regardless of whether diarrhea tablets are used in adults, tablets for diarrhea for the elderly, or tablets for diarrhea for children, for the infectious origin of diarrhea caused by Salmonella spp., Shigella dysenteria and Shigella boydii, Esherichia coli, Proteus spp, Klebsiella spp, Clostridium spp., Enterobacter spp., intestinal antiseptics and antibacterial agents are necessary. The main names of medicaments recommended by these pharmacological groups include:

• Nitrofuran antimicrobials Furazolidone, Nifuroxazide (synonym for Enterofuril);
• sulfanilamide preparation Ftalazol (other trade names - Sulfatalidin, Talisulfazol);
• inexpensive pills for diarrhea Metronidazole (Metrogil, Flagil, Ginalgin);
• antimicrobial and antiparasitic agents of the group of derivatives of 8-hydroxyquinoline - Enteroseptol (Enteritis, Enterosan, Enterokinol and other trade names), Chlorinaldol (Chlorozan, Intenzol, Septotal);
• antibiotics Ciprolet (Ciprofloxacin, Cyphran, Cipro); Levomycetin (Chloramphenicol, Chloromycetin, Halomycetin), Tetracycline (only with diarrhea associated with amebiasis);
• Pimafucin (Natamycin), which acts on Candida fungi and is used against diarrhea in intestinal candidiasis;

It should be borne in mind that pills for diarrhea and vomiting are different drugs, for more details see -  Tablets from vomiting, like tablets for diarrhea and nausea -  Tablets for nausea, as well as pills for diarrhea and temperature. However, the use of funds aimed at the destruction of pathogens will also have a positive effect on the removal of all these symptoms.

Effective tablets against diarrhea, including bacterial enterocolitis and pseudomembranous colitis - Loperamide (other trade names are Lopeum, Imodium, Enterobene, Neo-Enteroseptol). Applied enterosorbents, in particular, activated carbon (Carbolen), as well as its capsule release form - Sorbeks.

From vomiting, the usual tablets Motilium (Domperidone, Motilac, Cilroton) and Motilium - instant tablets against diarrhea under the tongue are advised.

Whether it is possible to apply these tablets against diarrhea to a nursing mother, will be noted in the section Use during pregnancy and lactation. What tablets for diarrhea during pregnancy can be used, read in the publication -  Diarrhea in Pregnancy

Features of treatment of intestinal disorders in children see -  Diarrhea in a child

And in the material  Treatment of food poisoning  provides detailed information, which tablets for poisoning and diarrhea are recommended by gastroenterologists and infectious disease specialists.

[1], [2], [3], [4], [5]

Pharmacodynamics

Rapid anti- diarrhea tablets - Loperamide (Lopeidium, Imodium) - reduce intestinal peristalsis and the urge to defecate due to inhibition of the reaction of opioid receptors in the intestinal walls and decrease in the release of the neurotransmitter acetylcholine. In addition, the yield of prostaglandins from mast cells is reduced, which reduces pain in spasms of the intestine, so these tablets are helped by diarrhea and abdominal pain, as well as by incontinence in the elderly (with a decrease in the tone of the anal sphincter).

Antibacterial agent of the group of nitrofurans - yellow tablets against diarrhea. Furazolidone - actively against gram-negative bacteria, protozoa and fungi of the genus Candida. The substance 5-nitrofurfurol, included in its composition, after entering the gastrointestinal tract is transformed into a toxin for pathogenic microorganisms, under the influence of which many processes in microbial cells stop and they die.

The pharmacodynamics of the antimicrobial drug Nifuroxazide (Enterofuril) in capsules is active, the active component of which is the 5-nitrofuran derivative nifuroxazide.

Sulfanilamidny drug Ftalazol (Phtalylsulfatiazol) detoxifies microorganisms due to a violation of the synthesis necessary for their development of folates. And the ability of Ftalazol to increase the synthesis of endogenous corticosteroids gives the drug anti-inflammatory properties.

The drug Metronidazole has an antimicrobial and antiprotozoal effect by inhibiting the production of nucleic acids that infect the intestines with bacteria and protozoa, without which they can not reproduce their DNA and multiply. And Enteroseptol destroys the cellular membranes of bacteria and protozoa, stopping all the biochemical processes in them.

Ciprolet (Ciprofloxacin), an antibiotic of the fluoroquinolones group, blocks the activity of bacterial enzymes and disrupts the replication of their DNA. Levomycetin and Tetracycline have a similar effect: they inhibit protein synthesis in the cells of microorganisms at the level of the ribosomes, which prevents the bacteria from multiplying.

Antifungal preparation Pimafucin (Natamycin) refers to polyene antibiotics of the macrolide group and destroys Candida fungi by inhibiting the synthesis of sterols of their cell walls.

Due to its surface activity activated charcoal adsorbs toxins in the intestines, reducing their negative impact on the digestive tract, that is, by carrying out detoxification of the body.

Antiemetic effect of tablets Motilium provides active substance domperidone, which blocks receptors of dopamine GIT and brain.

[6], [7], [8], [9], [10]

Pharmacokinetics

Unabatedly absorbed in the intestine, more than 93% of the drug Loperamide (Lodepinum, Imodium) binds to blood plasma proteins; biotransformation occurs in the liver, a drug with feces is excreted; T1 / 2 is from 9 to 12 hours.

Approximately five hours after the administration of Furazolidone, the amount of drug necessary for active action enters the blood and is found in the intestine. Metabolism Furazolidon passes in the liver, and it is excreted through the kidneys.

Complete absence of systemic action is characterized by Nifuroxazide (Enterofuril) and Enteroseptol, as they are not absorbed into the blood in the digestive tract, but are concentrated in the intestine (where they are eliminated during defecation).

Poorly absorbed in the gastrointestinal tract and phthalazole, due to which it is active only in the intestines and is excreted with feces.

Well absorbed into the blood and all body fluids is the drug Metronidazole, which has almost 100% bioavailability. The drug is cleaved by liver enzymes with therapeutically active metabolites. The main way of their excretion is through the kidneys, with a half-life of about eight hours.

Antibiotic Ciprolet (Ciprofloxacin) comes from the digestive tract into the blood (the maximum concentration is noted 60-90 minutes after taking the pill), but with plasma proteins binds in an insignificant amount. However, the desired therapeutic concentration of the drug is maintained for 12 hours after a single application. Ciprolet (without cleavage) is excreted by the kidneys and intestines.

Bioavailability of Levomycetin when taking tablets is almost 80%, the drug penetrates into the blood, and half of the active substance binds to plasma proteins. Metabolism occurs in the liver, from the body Levomycetin is excreted mainly with urine; T1 / 2 -1,5-4 hours.

Used for amebiotic diarrhea Tetracycline is more than 65% adsorbed in the gastrointestinal tract and at the same level binds to blood plasma proteins. It is not metabolized, eliminated through the kidneys and intestines with a half-life of 6 to 12 hours.

The active substance Motilium domperidone is found in the blood after 60 minutes after taking the pill, binding to serum proteins almost 90%. After cleavage, metabolites and part of unchanged domperidone are excreted in urine and feces within 14-18 hours.

[11], [12]

Dosing and administration

Loperamide (Lediumum, Imodium) tablets are taken orally - 4 mg three times a day (until the diarrhea stops, but no more than two days); children 2-8 years - 0,004 mg per each kilogram of body weight. There is a form of release - chewing tablets against Diarrhea diarrhea (containing loperamide). At the first sign of diarrhea, two tablets should be chewed (children - one), and then bother to chew one Diara tablet after each liquid bowel movement.

Furazolidone is taken after a meal - two tablets three to four times during the day (the standard duration of use is three days, in severe cases - up to a week).

Taking Nifuroxazide (Enterofuril) tablets does not depend on food, their dosage for adults and children six years and older - every 6 hours for two tablets.

Ftalazol in tablets of 0.5 g is also prescribed two tablets, but every 4 hours for three days, after which two more days the drug is taken every 6-8 hours. The daily dosage for children under seven years is calculated by body weight - 0.2 g per kilogram, and older than this age take half the dose of adults.

Enteroseptol is recommended to take three times a day for one to two tablets (after meals) for 10 days (the maximum duration of application of phthalazole is 28 days).

In case of bacterial diarrhea, Ciprolet should be taken before meals - 250-500 mg twice a day for five to seven days. The same dose for Levomycetin tablets, but they should be drunk up to four times a day for ten days.

Tetracycline (250 mg tablets) is usually prescribed to be taken twice a day (children up to seven children - half a tablet). One dose of Pimafucin - one tablet (100 mg), the number of receptions per day - at least four, the course of treatment of intestinal candidiasis with diarrhea - from 5 to 10 days.

Up to four times a day, it is allowed to drink activated charcoal tablets (two or three tablets at a time), and Motilium - no more than two tablets during the day.

[21], [22],

Use of the diarrhea tablets during pregnancy

During pregnancy and lactation, it is forbidden to use: Loperamide (Lediumum, Imodium) tablets, Enteroseptol, Metronidazole, Ciprolet, Levomycetin, Tetracycline, Motilium.

With regard to the use of Furazolidone, Nifuroxazide (Enterofuril), Phthalazole and Pimafucin during pregnancy and lactation, the decision is made by the attending physician, based on an assessment of the expected benefit to the mother and its relationship to potential risks for fetal development and infant status.

Contraindications

According to official instructions to the drugs, contraindications for use include:

Loperamide (Lopeidium, Imodium) - febrile condition, blood in the stool, intestinal obstruction, age younger than two years;

Furazolidone - a severe form of renal failure, age less than 12 months;

Nifuroxazide (Enterofuril) - infantile age;

Metronidazole - a decrease in the level of leukocytes in the blood, epilepsy, liver failure;

Enteroseptol - an allergy to iodine, problems with liver and kidney function, lesions of the peripheral nervous system, including the optic nerve;

Ftalazol - chronic kidney failure and / or glomerulonephritis, acute form of hepatitis, hyperthyroidism, intestinal obstruction;

Tsiprolet - increased sensitivity to antibiotics-fluoroquinolones;

Levomycetin - functional insufficiency of the liver and / or kidneys, blood diseases, age less than three years;

Tetracycline - leukopenia, fungal infections, severe allergies, age less than eight years;

Activated charcoal - peptic ulcer and ulcerative bowel pathology;

Motilium - gastrointestinal bleeding, intestinal obstruction, neoplasia of the pituitary gland (in particular, prolactin).

[13], [14], [15], [16], [17], [18]

Side effects of the diarrhea tablets

Included in the review tablets against diarrhea can cause the following side effects:

Loperamide (Lopeium, Imodium) - headache, dizziness, sleep disturbances, dry mouth, epigastric pain;

Furazolidone - nausea, vomiting, abdominal pain, rashes on the skin, anaphylactic reaction;

Nifuroxazide (Enterofuril) - dyspepsia, allergic reactions;

Ftalazol - nausea, vomiting, headache, changes in the blood, a deficiency of vitamins (in particular, B1, B6, B9, B12).

Metronidazole - nausea, vomiting, dizziness, impaired coordination of movements, psycho-emotional instability, pain in the joints, convulsions;

Enteroseptol - dyspepsia, skin reactions, arthralgia, rhinitis, cough;

Ciprolet, Levomycetin and Tetracycline - nausea, vomiting, epigastric pain, palpitations, hyperhidrosis, equine rashes, fatigue, insomnia, leukopenia and thrombocytopenia, diuresis;

Pimafucin - nausea and temporary enhancement of diarrhea;

Activated charcoal - disorders of the intestine;

Motilium - rashes on the skin, intestinal cramps, movement disorders, gynecomastia.

[19], [20]

Overdose

In most cases, an overdose of these medicines leads to an increase in their side effects. In addition, the excess of the therapeutically justifiable doses of Furazolidone can cause toxic damage to the liver cells (requiring hemodialysis), and in case of an overdose of Levomycetin and tetracycline, hematopoietic organs, hearing and vision may suffer.

It is inadmissible to break the dosage of Motilium tablets: this can cause increased drowsiness and development of motor disorders. Usually, it is enough to stop taking the drug and rinsing the stomach.

[23], [24], [25]

Interactions with other drugs

Drugs of the group of nitrofurans and metronidazole, when interacting with preparations containing ethyl alcohol, cause nausea and vomiting. It is inadmissible to simultaneously use Furazolidone, Levomycetin and Tetracycline. Phthalazole can also not be used together with Levomycetin - in order to avoid the development of leukopenia; In addition, it enhances the action of Metronidazole.

Fluoroquinolones (Ciprolet) are not used in parallel with anticoagulants of indirect action, NSAIDs, but their combination with aminoglycoside antibiotics with cephalosporin group drugs is possible.

In the instruction to Levomycetin, its incompatibility with paracetomol, cytostatics, barbiturate sleeping pills is noted. It should be borne in mind that Levomycetin reduces the effectiveness of vitamin and hormone drugs, as well as antibiotics of other pharmacological groups.

[26], [27], [28]

Storage conditions

Whichever pharmacological groups belong to the diabetic tablets mentioned in the review, they should be stored in a place protected from light and moisture, with a temperature regime of + 10-15 ° C to + 25-28 ° C.

[29], [30], [31], [32],

Shelf life

According to manufacturers, the shelf life of Ftalazol is 4 years; Loperamide, Furazolidon, Nifuroxazide, Enteroseptol, Metronidazole, Tziprolet, Levomycetin and Motilium - 3 years; Tetracycline and activated carbon - 2 years.

[33]

How to stop diarrhea without pills?

This question is answered by alternative medicine and herbal medicine. Alternative means to help cope with diarrhea include: a decoction of dried pomegranate peel, dried blueberries or oak bark (a tablespoon of raw material for 0.5 liters of water), as well as a decoction of the walnut shell (two cups of water should be taken from three- four nuts).

And phytotherapists recommend taking decoctions of such medicinal plants as chamomile pharmacy (flower), bird cherry (fruit), root of cinquefoil erect or sporicha (mountaineer of bird), ivan-tea (grass), nails herring, creeping grass (rhizome), medicinal veronica, heather-saxifrage, plantain large (leaves), chicory and yarrow (all aboveground parts).

Decoctions are prepared based on a tablespoon of dry raw material for 250 ml of water and drunk during the day in several receptions. Only it is necessary to take into account that, for example, sporis is contraindicated in pregnant women, and chicory is contraindicated for gastritis and hemorrhoids.

For more information, see -  What to do with diarrhea?