In Adults with Acute Diarrhea, Which Treatment is More Effective between Loperamide and Racecadotril?

OBJECTIVE: The objective of this selective EBM review is to determine which treatment is more effective between loperamide and racecadotril to treat acute diarrhea in adults. STUDY DESIGN: Review of three English language primary randomized controlled studies published from 1999-2005. DATA SOURCES: First study was a RCT that was double blinded, double placebo, parallel study group and second and third study was RCT single blinded, comparative parallel group that all compared efficacy of loperamide and racecadotril. These were all found by using PubMed, COCHRANE and NCBI. OUTCOMES MEASURED: Each of the studies measured the efficacy of each medication by counting the number of diarrhea stools until recovery was made. Recovery is defined as having 2 consecutive normal stools or having no stools for more than 12 hrs. The number of days the patient had diarrhea were also counted. RESULTS: Overall, these studies were clinically significant where both racecadotril and loperamide treat acute diarrhea rapidly. It was also observed that loperamide causes more adverse events such as abdominal distention and constipation when compared to racecadotril. CONCLUSIONS: Racecadotril has been shown to be equally effective as loperamide to treat acute diarrhea in these three studies. Racecadotril also effectively resolves abdominal symptoms and causes less constipation than loperamide.