Welcome to International Network for Natural Sciences | INNSpub

Paper Details

Review Paper | August 1, 2019

| Download

A comprehensive review on racecadotril drug

Wajeeha Ishtiyaq, Arslan Tariq, Nasir Abbas, Muhammad Zia Ud Din, Kanwal Ashiq, Mayyda Bajwa, Samreen Tanveer, Mehwish Qayyum, Farah Abid, Saleha Yasir, Afshan Arshad, Sana Ashiq

Key Words:

Int. J. Biosci.15(2), 405-413, August 2019

DOI: http://dx.doi.org/10.12692/ijb/15.2.405-413


IJB 2019 [Generate Certificate]


Around the globe, diarrhea is a continuing health problem and also a leading cause of sickness and death in both children and adults. It is one of the major causes of morbidity and mortality in developing countries and can be occurred in any age irrespective of the geological location. The chief reason of the deaths is because of electrolytes loss and dehydration by increased intestinal secretions and poor absorption. For this study, previously published papers were reviewed and key words for the search of literature, included: Racecadotril, enkephalinase inhibitor, diarrhea, oral rehydrating solutions, diarrhea treatment, infectious diarrhea, and epidemiology of diarrhea. Oral rehydrating solutions are used to recover water and electrolytes and these are considered as a mainstay of the anti-diarrheal therapy. Inhibition of fluid secretion and stimulation of fluid absorption from the intestinal mucosa is necessary in acute diarrhea, so that the loss of water and electrolytes can be prevented. Racecadotril (acetorphan) belongs to the pharmacological class of enkephalinase inhibitor. Its mechanism of action involves the minimizing of the intestinal secretions by protecting the endogenous enkephalins, which are secreted by the gastrointestinal tract. It is taken orally and proved to be safe and effective for the treatment of diarrhea in both adults and children. Racecadotril has a rapid onset of action and shows greater tolerability than loperamide in patients with acute diarrhea. Racecadotril gives better results in children and infants when taken as an adjuvant to oral rehydrate solutions (ORS) and also cut the overall cost of treatment with better outcomes.


Copyright © 2019
By Authors and International Network for
Natural Sciences (INNSPUB)
This article is published under the terms of the Creative
Commons Attribution Liscense 4.0

A comprehensive review on racecadotril drug

Archbald-Pannone L.  2014. Survey of C. difficile-Specific Infection Control Policies in Local Long-Term Care Facilities. International Journal of Clinical Medicine 5(7), 414-419. http://dx.doi.org/10.4236/ijcm.2014.57056

Ashiq K. Rehman K, Ashiq S, Sundus A. 2017. Influence of osteoporosis on quality of life and current strategies for its management and treatment. GSC Biological and Pharmaceutical Sciences 1(2), 34-40.  https://doi.org/10.30574/gscbps.2017.1.2.0051

Basniwal P, Srivastava PK, Jain SK, Jain D. 2008. RP-LC Analysis and Hydrolytic Degradation Profile of Racecadotril. Chromatographia 68(7-8), 641. https://doi.org/10.1365/s10337-008-0734-z

Baumer PH, Dorval ED, Bertrand J, Vetel JM, Schwartz JC, Lecomte JM. 1992. Effects of acetorphan, an enkephalinase inhibitor, on experimental and acute diarrhoea. Gut 33(6), 753-758. http://dx.doi.org/10.1136/gut.33.6.753

Bergmann JF, Chaussade S, Couturier D, Baumer P, Schwartz JC, Lecomte JM. 1992. Effects of acetorphan, an antidiarrhoeal enkephalinase inhibitor, on oro‐caecal and colonic transit times in healthy volunteers. Alimentary Pharmacology and Therapeutics 6(3), 305-313. https://doi.org/10.1111/j.1365-2036.1992.tb00052.x

Brown JW. 1979. Toxic megacolon associated with loperamide therapy. JAMA 241(5), 501-502. http://dx.doi.org/10.1001/jama.1979.03290310041015

DuPont HL, Hornick RB. 1973. Adverse Effect of Lomotil Therapy in Shigellosis. JAMA 226(13), 1525-1528.

DuvalIflah Y, Berard H, Baumer P, Guillaume P, Raibaud P, Joulin Y, Lecomte JM. 1999. Effects of racecadotril and loperamide on bacterial proliferation and on the central nervous system of the newborn gnotobiotic piglet. Alimentary Pharmacology and Therapeutics 13, 9-14. http://dx.doi.org/10.1001/jama.1973.03230130013006

Eberlin M, Mück T, Michel M. 2012. A Comprehensive Review of the Pharmacodynamics, Pharmacokinetics, and Clinical Effects of the Neutral Endopeptidase Inhibitor Racecadotril. Frontiers in Pharmacology 3, 93. http://dx.doi.org/10.3389/fphar.2012.00093

Edelman R. 1985. Prevention and treatment of infectious diarrhea. Speculations on the next 10 years. American Journal of Medicine 78(6b), 99-106. http://dx.doi.org/10.1016/0002-9343(85)90371-7

Fine KD. 1993. Diarrhea. Sleisenger and Fordtran’s Gastrointestinal Disease: Pathophysiology/ Diagnosis /Management 2, 1043-1072.

Fischbach W, Andresen V, Eberlin M, Mueck T, Layer P. 2016. A comprehensive comparison of the efficacy and tolerability of racecadotril with other treatments of acute diarrhea in adults. Frontiers in Pharmacology 3, 44. http://dx.doi.org/10.3389/fmed.2016.00044

Gordon M, Akobeng A. 2016. Racecadotril for acute diarrhoea in children: systematic review and meta-analyses. Archives of Disease in Childhood 101(3), 234-240. http://dx.doi.org/10.1136/archdischild-2015-309676

Hamza H, Ben Khalifa H, Baumer P, Berard H, Lecomte JM. 1999. Racecadotril versus placebo in the treatment of acute diarrhoea in adults. Alimentary Pharmacology and Therapeutics 13, 15-19. https://doi.org/10.1046/j.1365-2036.1999.00002.xi1

Heel RC, Brogden RN, Speight TM, Avery GS. 1978. Loperamide: a review of its pharmacological properties and therapeutic efficacy in diarrhoea. Drugs 15(1), 33-52. https://doi.org/10.2165/00003495-19781501000003

Huijghebaert S, Awouters F, Tytgat GNJ. 2003. Racecadotril versus loperamide: antidiarrheal research revisited. Digestive Disease and Science 48(2), 239-250. https://doi.org/10.1023/A:1021989606317

Kachel G, Ruppin H, Hagel J, Barina W, Meinhardt M, Domschke W. 1986. Human intestinal motor activity and transport: effects of a synthetic opiate. Gastroenterology 90(1), 85-93.

Kanwal A, Latif A, Ashiq S, Sundus A. 2018. A systematic review on the prevalence, pathophysiology, diagnosis, management and treatment of gout (2007-2018). GSC Biological and Pharmaceutical Sciences 5(1), 50-55.https://doi.org/10.30574/gscbps.2018.5.1.0077

Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, Wu Y, Sow SO, Sur D, Breiman RF, Faruque AS. 2013. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. The Lancet 382(9888), 209-222. https://doi.org/10.1016/S0140-6736(13)60844-2

Kozuch PL, Hanauer SB. 2008. Treatment of inflammatory bowel disease: a review of medical therapy. World Journal of Gastroenterology 14(3), 354. http://dx.doi.org/10.3748/wjg.14.354

Lecomte JM. 2000. An overview of clinical studies with racecadotril in adults. International Journal of Antimicrobial Agents 14(1), 81-87. http://dx.doi.org/10.1016/S0924-8579(99)00152-1

Marcais-Collado H, Uchida G, Costentin J, Schwartz JC, Lecomte JM. 1987. Naloxone-reversible antidiarrheal effects of enkephalinase inhibitors. European Journal of Pharmacology 144(2), 125-132. https://doi.org/10.1016/0014-2999(87)90510-3

Matheson AJ, Noble S. 2000. Racecadotril. Drugs 59(4), 829-835.

Mehta S. 2012. A Novel Approach in the Treatment of Acute Infective Diarrhea. Medecine Update 22, 430-434.

Pessi MA, Zilembo N, Haspinger ER, Molino L, Di Cosimo S, Garassino M, Ripamonti CI. 2014. Targeted therapy-induced diarrhea: a review of the literature. Critical Reviews Oncology/Hematology 90(2), 165-179. https://doi.org/10.1016/j.critrevonc.2013.11.008

Pollard H, Moreau J, Ronco P, Verroust P, Schwartz JC. 1991. Immunoautoradiographic localisation of enkephalinase (EC 3.4. 24.11) in rat gastrointestinal tract. Neuropeptides 19(3), 169-178. https://doi.org/10.1016/0143-4179(91)90115-Y

Prado D. 2002. A multinational comparison of racecadotril and loperamide in the treatment of acute watery diarrhoea in adults. Scandinavian Journal of Gastroenterology 37(6), 656-661. https://doi.org/10.1080/00365520212495

Primi MP, Bueno L, Baumer PH, Berard H, Lecomte JM. 1999. Racecadotril demonstrates intestinal antisecretory activity in vivo. Alimentary Pharmacology and Therpeutics 13, 3-7. https://doi.org/10.1046/j.1365-2036.13.s6.3.x

Roge J, Baumer P, Berard H, Schwartz JC, Lecomte JM. 1993. The enkephalinase inhibitor, acetorphan, in acute diarrhoea. A double-blind, controlled clinical trial versus loperamide. Scandinavian Journal of Gastroenterology 28(4), 352-354. https://doi.org/10.3109/00365529309090255

Ruppin H. 1987. Review: loperamide–a potent antidiarrhoeal drug with actions along the alimentary tract. Alimentary Pharmacology and Therapeutics 1(3), 179-190.

Salazar-Lindo E. 2011. Acute Infectious Diarrhoea in Children–The Role of Drug Treatment. European Journal of Gastroenterology & Hepatology 7, 31-36. https://doi.org/10.1111/j.1365-2036.1987.tb00617.x

Schiller LR, Pardi DS, Spiller R, Semrad CE, Surawicz CM, Giannella RA, Krejs GJ, Farthing MJ, Sellin JH. 2014. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis. Journal of Gastroenterology and Hepatology 29(1), 6-25. https://doi.org/10.1111/jgh.12392

Schwartz JC. 2000. Racecadotril: a new approach to the treatment of diarrhoea. International Journal of Antimicrobial Agents 14(1), 75-79. https://doi.org/10.1016/S0924-8579(99)00151-X

Sharma P, Singh N, Verma OP. 2011. First Report of Leaf Blight on Ficusreligiosa caused by Phyllosticta sp. Journal of Plant Pathology and Microbiology 2, 106-108.

Shook JE, Lemcke PK, Gehrig CA, Hruby VJ, Burks TF. 1989. Antidiarrheal properties of supraspinal mu and delta and peripheral mu, delta and kappa opioid receptors: inhibition of diarrhea without constipation. Journal of Pharmacology and Experimental Therapeutics 249(1), 83-90.

Singh N, Narayan S. 2008. Racecadotril: A Novel Antidiarrheal. Medical Journal Armed Forces India 64(4), 361-362. http://dx.doi.org/10.1016/S0377-1237(08)80022-6

Sonia R, Ramanibai R. 2011. New Report on Hydra viridissima Pallas, 1766 (Cnidaria, Hydrozoa, Hydridae) from Chingleput lake, Tamil Nadu- Indian Journal of Experimental Biology 1(4), 276-278.

Späth C, Sjöström ES, Ahlsson F, Ågren J, Domellöf M. 2017. Sodium supply influences plasma sodium concentration and the risks of hyper-and hyponatremia in extremely preterm infants. Pediatric Research 81(3), 455.

Sykes NP. 1996. An investigation of the ability of oral naloxone to correct opioid-related constipation in patients with advanced cancer. Palliative Medicine 10(2), 135-144. https://doi.org/10.1177/026921639601000208

Tanveer S, Latif A, Ashiq K, Qayyum M,  Mayyda AB.  2019. A comprehensive review on pharmacological and phytochemical potential of Cassia Fistula Linn: A magical herb. International Journal of Biology, Pharmacy and Allied Sciences 8(6), 1134-1157. https://doi.org/10.31032/IJBPAS/2019/8.6.4734

Thiagarajah JR, Donowitz M, Verkman AS. 2015. Secretory diarrhoea: mechanisms and emerging therapies. Nat Rev Gastroenterol Hepatol 12(8), 446.

Thielman NM, Guerrant RL. 2004. Clinical practice. Acute infectious diarrhea. New England Journal of Medicine 350(1), 38-47. https://www.nejm.org/doi/full/10.1056/NEJMcp031534

Tormo R, Polanco I, SalazarLindo E, Goulet O. 2008. Acute infectious diarrhoea in children: new insights in antisecretory treatment with racecadotril. Acta Paediatrica 97(8), 1008-1015. https://doi.org/10.1111/j.1651-2227.2008.00830.x

Turvill J, Farthing M. 1997. Enkephalins and enkephalinase inhibitors in intestinal fluid and electrolyte transport.  European Journal of Gastroenterology & Hepatology 9(9), 877-880. https://europepmc.org/abstract/med/9355786

Vetel JM, Berard H, Fretault N, Lecomte JM. 1999. Comparison of racecadotril and loperamide in adults with acute diarrhoea. Alimentary Pharmacology and Therapeutics 13, 21-26. https://doi.org/10.1046/j.1365-2036.1999.00003.x-i1

Vishwakarma AK, Pant I, Patel MK, Pandey A. (2018). Formulation, development and optimization of fast dissolving oral film of racecadotril. International Journal of Indigenous Herbs and Drugs 3(3), 1-6.

Wang HH, Shieh MJ, Liao KF. 2005. A blind, randomized comparison of racecadotril and loperamide for stopping acute diarrhea in adults. World Journal of Gastroenterology 11(10), 1540. http://dx.doi.org/10.3748/wjg.v11.i10.1540

Wingate D, Phillips SF, Lewis SJ, Malagelada JR, Speelman P, Steffen R, Tytgat GNJ. 2001. Guidelines for adults on self‐medication for the treatment of acute diarrhoea. Alimentary Pharmacology and Therapeutics 15(6), 773-782. https://doi.org/10.1046/j.1365-2036.2001.00993.x


Style Switcher

Select Layout
Chose Color
Chose Pattren
Chose Background