Hidrasec (Racecadotril)

Hidrasec is indicated for the symptomatic treatment of acute diarrhea in patients who require rapid reduction of stool frequency and volume, and who are able to maintain oral intake.

• Mild to moderate acute infectious diarrhea in adults, especially when caused by bacterial pathogens such as E. coli or Shigella.
• Acute diarrheal episodes in children older than six months, used as part of a rehydration plan to limit fluid loss.
• Traveler’s diarrhea of short duration when dehydration risk is low, providing a non‑antibiotic option for symptom control.
• Diarrhea associated with viral gastroenteritis where antimicrobial therapy is not indicated, helping to reduce stool output while the infection resolves.
• Adjunctive therapy alongside oral rehydration solutions to maintain hydration status during the acute phase.

• Racecadotril is an enkephalinase inhibitor that prevents the breakdown of endogenous enkephalins in the intestinal mucosa. By preserving enkephalin activity, the drug reduces the release of secretagogues that stimulate chloride and water secretion into the lumen, and it modestly decreases intestinal motility. The net effect is a decrease in fluid loss and stool frequency without altering intestinal absorption of nutrients.

Adverse reactions to Hidrasec are generally mild and transient, but rare serious events have been reported in clinical use.

Common

• Mild abdominal discomfort or cramping, usually transient.
• Nausea or brief episodes of vomiting.
• Headache, often mild and short‑lasting.
• Flatulence or bloating, generally mild.
• Dizziness, typically resolving without intervention.
• Mild fatigue, not interfering with daily activities.

Serious

• Allergic skin reactions such as rash, urticaria, or pruritus.
• Severe hypersensitivity reactions, including angioedema or anaphylaxis.
• Persistent diarrhea despite therapy, which may indicate a paradoxical response.
• Severe abdominal pain that is sudden or worsening.
• Signs of intestinal obstruction, such as persistent vomiting, inability to pass gas, and abdominal distension.

When using Hidrasec, certain precautions should be observed to ensure safe and effective therapy.

• Assess hydration status before initiating treatment; severe dehydration requires medical supervision.
• Do not use in patients with known hypersensitivity to racecadotril or any excipients.
• Limit use to short‑term episodes; prolonged therapy has not been established.
• Caution in children under six months of age, as safety data are limited.
• Pregnancy and lactation: consult a healthcare professional because safety has not been fully determined.
• Monitor for worsening diarrhea or signs of infection; seek medical advice if symptoms persist.

Hidrasec may interact with other medicines; consider the following guidance when co‑administering.

Avoid

• Concurrent use with potent enkephalinase inhibitors, as additive effects on intestinal secretion are not established.
• Combination with agents that significantly slow gastrointestinal motility, which could increase the risk of constipation.

Use with caution

• Anticholinergic drugs, because combined effects may alter gut motility.
• Diuretic therapy, as excessive fluid loss from diarrhea could affect electrolyte balance.
• Other over‑the‑counter antidiarrheal products, to avoid overlapping mechanisms.
• Proton pump inhibitors, because altered gastric pH may affect drug absorption.
• Antibiotics for gastrointestinal infections, to ensure that the underlying cause is treated.