ERCEFURYL 4% SUSPENSION

Indications

• Acute diarrhea
• Diarrhea caused by bacterial infections
• Non-specific diarrhea

Dosage

Children: For children aged 6 to 15 years, the recommended dose is 200 mg three times daily. For children aged 3 to 6 years, the recommended dose is 100 mg three times daily. For children under 3 years, refer to the BNF for Children for specific dosing information.

Adults: The usual adult dose is 800 mg taken in divided doses, typically 200 mg four times daily.

Mechanism of action

Nifuroxazide acts by inhibiting the enzyme activity of bacterial dehydrogenases, which leads to disruption of energy metabolism in bacteria. It is thought to interfere with the synthesis of nucleic acids and proteins in bacterial cells, ultimately resulting in bacteriostatic effects against a range of pathogenic microorganisms.

Pharmacodynamics

Nifuroxazide exhibits broad-spectrum antibacterial activity, particularly against Gram-negative and Gram-positive bacteria. Its unique mechanism allows it to selectively target pathogens in the gastrointestinal tract while sparing the beneficial gut microbiota. This selective action helps reduce the risk of antibiotic-associated complications.

Pharmacokinetics

Nifuroxazide is not absorbed from the gastrointestinal tract, which limits its systemic effects. As a result, its pharmacokinetics are characterized by local action within the gut. The drug is excreted primarily in the feces, maintaining high concentrations at the site of action while minimizing systemic exposure. The onset of action typically occurs within a few hours after administration.

Contra-indications

• Hypersensitivity to nifuroxazide or any of its components
• Severe liver impairment
• Severe renal impairment

Adverse effects

• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Skin rash
• Allergic reactions

Interactions

• May enhance the effects of anticoagulants
• Antibiotics may alter the efficacy of nifuroxazide

Precautions

• Use cautiously in patients with liver or kidney disease
• Monitor for signs of allergic reactions

Pregnancy

Nifuroxazide should be used during pregnancy only if clearly needed, as there is limited data on its safety.

Breast-feeding

Nifuroxazide is excreted in breast milk; caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, protect from light and moisture. Keep out of reach of children.

Formulations

• Oral suspension
• Capsules
• Tablets