Racecadotril: An antidiarrhoeal suitable for use in infants and young children

Racecadotril (acetorphan) is an oral enkephalinase inhibitor for use in the treatment of acute diarrhoea. By preventing the degradation of endogenous enkephalins, racecadotril reduces hypersecretion of water and electrolytes into the intestinal lumen. Treatment with racecadotril reduces the incidence and duration of acute diarrhoea and reduces diarrhoea-associated symptoms compared with placebo in adults. Racecadotril treatment also results in significant reductions in stool output compared with placebo in infants and young children aged 2 months to 4 years with acute diarrhoea. Both rotavirus-negative and rotavirus-positive infections appear to respond to treatment in the paediatric populations investigated for this infection. Racecadotril shows similar or slightly reduced efficacy to loperamide in the treatment of diarrhoea in adults and children aged up to 10 years. However, in comparative trials racecadotril was associated with fewer adverse events than loperamide, in particular post-treatment constipation. Racecadotril has been well tolerated in all age groups evaluated showing an adverse event profile similar to placebo.