Pills for diarrhea: what are effective, fast-acting and inexpensive

When prescribing certain tablets for diarrhea, doctors are guided by the etiology of this symptom, since diarrhea can occur due to various reasons 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 protozoan parasites in the intestines.

Indications diarrhea pills

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

Regardless of whether antidiarrhea tablets are used for adults, antidiarrhea tablets for the elderly or antidiarrhea tablets for children, with 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 needed. The main names of drugs of these pharmacological groups recommended by doctors include:

• nitrofuran antimicrobial agents Furazolidone, Nifuroxazide (synonym Enterofuril);
• sulfanilamide drug Phthalazol (other trade names – Sulfathalidin, Talisulfazole);
• inexpensive antidiarrhea tablets Metronidazole (Metrogyl, Flagyl, Ginalgin);
• antimicrobial and antiparasitic agents of the 8-hydroxyquinoline derivative group – Enteroseptol (Enteritan, Enterozan, Enterokinol and other trade names), Chlorquinaldol (Chlorosan, Intensol, Septothal);
• antibiotics Ciprolet (Ciprofloxacin, Tsifran, Cipro); Levomycetin (Chloramphenicol, Chloromycetin, Galomycetin), Tetracycline (only for diarrhea associated with amebiasis);
• Pimafucin (Natamycin), which acts on Candida fungi and is used for diarrhea in intestinal candidiasis;

It should be borne in mind that tablets for diarrhea and vomiting are different drugs, for more details see - Tablets for vomiting, as tablets for diarrhea and nausea - Tablets for nausea, as well as tablets for diarrhea and fever. However, the use of drugs aimed at destroying pathogens will have a positive effect in terms of relieving all these symptoms.

Effective tablets for diarrhea, including bacterial enterocolitis and pseudomembranous colitis - Loperamide (other trade names: Loperamide, Imodium, Enterobene, Neo-enteroseptol). Enterosorbents are used, in particular, activated carbon (Carbolene), as well as its capsule form - Sorbex.

For vomiting, the usual Motilium tablets (Domperidone, Motilak, Cilroton) and Motilium - fast-dissolving tablets for diarrhea under the tongue are recommended.

Whether the specified tablets for diarrhea can be used by 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 during pregnancy

For treatment features of intestinal disorders in children, see - Diarrhea in a child

And the article Treatment of food poisoning provides detailed information on which pills for poisoning and diarrhea are recommended by gastroenterologists and infectious disease specialists.

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Pharmacodynamics

Fast-acting tablets for diarrhea - Loperamide (Loperamide, Imodium) - reduce intestinal peristalsis and the urge to defecate by inhibiting the reaction of opioid receptors of the intestinal walls and reducing the release of the neurotransmitter acetylcholine. In addition, the release of prostaglandins from mast cells is reduced, which reduces pain during intestinal spasms, so these tablets help with diarrhea and abdominal pain, as well as with fecal incontinence in old age (with a decrease in the tone of the anal sphincter).

An antibacterial agent of the nitrofuran group - yellow tablets for diarrhea Furazolidone - is active against gram-negative bacteria, protozoa and fungi of the genus Candida. The substance 5-nitrofurfural, which is part of its composition, after entering the gastrointestinal tract is converted 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 similar, the active component of which is a derivative of 5-nitrofuran – nifuroxazide.

The sulfanilamide drug Phthalazol (Phthalylsulfathiazole) neutralizes microorganisms by disrupting the synthesis of folates necessary for their development. And Phthalazol's ability 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 by bacteria and protozoa that have affected the intestines, without which they cannot reproduce their DNA and multiply. And Enteroseptol destroys the cell membranes of bacteria and protozoa, stopping all biochemical processes in them.

Ciprolet (Ciprofloxacin) is an antibiotic of the fluoroquinolone group. It 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 ribosome level, which deprives bacteria of the ability to reproduce.

The antifungal drug Pimafucin (Natamycin) belongs to the polyene antibiotics of the macrolide group and destroys Candida fungi by inhibiting the synthesis of sterols in their cell walls.

Due to its surface activity, activated carbon adsorbs toxins in the intestines, reducing their negative impact on the gastrointestinal tract, that is, detoxifying the body.

The antiemetic effect of Motilium tablets is provided by the active substance domperidone, which blocks dopamine receptors in the gastrointestinal tract and brain.

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Pharmacokinetics

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

Approximately five hours after taking Furazolidone, the amount of the drug required for its active action enters the blood and is found in the intestines. Furazolidone is metabolized in the liver and excreted through the kidneys.

Nifuroxazide (Enterofuril) and Enteroseptol have a complete lack of systemic action, since they are not absorbed into the blood in the gastrointestinal tract, but are concentrated in the intestines (from where they are eliminated during defecation).

Phthalazole is poorly absorbed in the gastrointestinal tract, due to which it is active only in the intestines and is excreted in the feces.

Metronidazole is well absorbed into the blood and all body fluids, having almost 100% bioavailability. The drug is broken down by liver enzymes with therapeutically active metabolites. The main route of their excretion is through the kidneys, with a half-life of about eight hours.

The antibiotic Ciprolet (Ciprofloxacin) enters the blood from the gastrointestinal tract (the maximum concentration is observed 60-90 minutes after taking the tablet), but it binds to plasma proteins in an insignificant amount. However, the required therapeutic concentration of the drug is maintained for 12 hours after a single use. Ciprolet (without splitting) is excreted by the kidneys and intestines.

The 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, Levomycetin is excreted from the body mainly with urine; T1 / 2 - 1.5-4 hours.

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

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

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Dosing and administration

Loperamide tablets (Loperamide, Imodium) are taken orally - 4 mg three times a day (until diarrhea stops, but not more than two days); children 2-8 years old - 0.004 mg per kilogram of body weight. There is a form of release - chewable tablets for diarrhea Diara (containing loperamide). At the first signs of diarrhea, you should chew two tablets (children - one), and then chew one Diara tablet after each loose bowel movement.

Furazolidone is taken after meals - two tablets three to four times a 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; the dosage for adults and children six years of age and older is two tablets every 6 hours.

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

It is recommended to take Enteroseptol three times a day, one or two tablets (after meals) for 10 days (the maximum duration of use of Phthalazole is 28 days).

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

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

It is allowed to take activated charcoal tablets up to four times a day (two to three tablets at a time), and Motilium - no more than two tablets per day.

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Use diarrhea pills during pregnancy

During pregnancy and breastfeeding it is prohibited to use: Loperamide tablets (Lopedium, Imodium), Enteroseptol, Metronidazole, Ciprolet, Levomycetin, Tetracycline, Motilium.

Regarding 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 with the potential risks to the development of the fetus and the condition of the infant.

Contraindications

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

Loperamide (Loperamide, Imodium) - fever, blood in stool, intestinal obstruction, age under two years;

Furazolidone - severe renal failure, age under 12 months;

Nifuroxazide (Enterofuril) – infancy;

Metronidazole – decreased levels of leukocytes in the blood, epilepsy, liver failure;

Enteroseptol - allergy to iodine, problems with the liver and kidneys, damage to the peripheral nervous system, including the optic nerve;

Phthalazole – chronic renal failure and/or glomerulonephritis, acute hepatitis, hyperthyroidism, intestinal obstruction;

Ciprolet - hypersensitivity to fluoroquinolone antibiotics;

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

Tetracycline - leukopenia, mycosis, severe allergies, age under eight years;

Activated carbon - gastric ulcer and ulcerative intestinal pathologies;

Motilium - gastrointestinal bleeding, intestinal obstruction, pituitary neoplasia (in particular, prolactinoma).

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Side effects diarrhea pills

The antidiarrhea tablets included in the review may cause the following side effects:

Loperamide (Loperamide, Imodium) – headache, dizziness, sleep disturbances, dry mouth, pain in the epigastric region;

Furazolidone - nausea, vomiting, abdominal pain, skin rash, anaphylactic reaction;

Nifuroxazide (Enterofuril) – dyspepsia, allergic reactions;

Phthalazole – nausea, vomiting, headache, changes in the blood, vitamin deficiency (in particular, B1, B6, B9, B12).

Metronidazole – nausea, vomiting, dizziness, impaired coordination of movements, psycho-emotional instability, joint pain, convulsions;

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

Ciprolet, Levomycetin and Tetracycline - nausea, vomiting, pain in the epigastric region, increased heart rate, hyperhidrosis, horse rash, increased fatigue, insomnia, leukopenia and thrombocytopenia, impaired diuresis;

Pimafucin - nausea and temporary increase in diarrhea;

Activated carbon – intestinal disorders;

Motilium - skin rashes, intestinal spasms, movement disorders, gynecomastia.

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Overdose

In most cases, an overdose of the listed drugs leads to an increase in their side effects. In addition, exceeding therapeutically justified doses of Furazolidone can cause toxic damage to liver cells (requiring hemodialysis), and an overdose of Levomycetin and tetracycline can damage the hematopoietic organs, hearing and vision.

It is unacceptable to violate the dosage of Motilium tablets: this can cause increased drowsiness and the development of movement disorders. Usually, it is enough to stop taking the drug and wash out the stomach.

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Interactions with other drugs

Medicines of the nitrofuran group and Metronidazole, when interacting with drugs containing ethyl alcohol, cause nausea and vomiting. The simultaneous use of Furazolidone, Levomycetin and Tetracycline is unacceptable. Phthalazole also cannot be used together with Levomycetin - to avoid the development of leukopenia; in addition, it enhances the effect of Metronidazole.

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

The instructions for Levomycetin note its incompatibility with paracetamol, cytostatics, barbiturate sleeping pills. It should be borne in mind that Levomycetin reduces the effectiveness of vitamin and hormonal drugs, as well as antibiotics of other pharmacological groups.

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Storage conditions

Regardless of the pharmacological group to which the antidiarrheal tablets listed in the review belong, they should be stored in a place protected from light and moisture, at a temperature of +10-15°C to +25-28°C.

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Shelf life

According to the manufacturers, the shelf life of Phthalazole is 4 years; Loperamide, Furazolidone, Nifuroxazide, Enteroseptol, Metronidazole, Ciprolet, Levomycetin and Motilium – 3 years; Tetracycline and activated carbon – 2 years.

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How to stop diarrhea without pills?

Traditional medicine and herbal medicine provide an answer to this question. Traditional remedies that help to cope with diarrhea include: a decoction of dried pomegranate peel, dried blueberries or oak bark (a tablespoon of raw materials per 0.5 liters of water), as well as a decoction of walnut shells (for two glasses of water you need to take the shells of three or four nuts).

Herbalists recommend taking decoctions of medicinal plants such as chamomile (flowers), bird cherry (fruit), cinquefoil root or knotweed (bird's knotweed), fireweed (herb), naked hernia, creeping wheatgrass (rhizome), medicinal speedwell, saxifrage, large plantain (leaves), chicory and yarrow (all above-ground parts).

Decoctions are prepared at the rate of a tablespoon of dry raw material per 250 ml of water and are drunk during the day in several doses. Just keep in mind that, for example, knotweed is contraindicated for pregnant women, and chicory - for gastritis and hemorrhoids.

For more useful information, see – What to do if you have diarrhea?