Hidrasec (Racecadotril)

Hidrasec is indicated for the symptomatic treatment of acute watery diarrhea in a variety of patient groups.

• Children with acute watery diarrhea, typically caused by viral or bacterial infections.
• Adults experiencing sudden onset of watery stools without blood or mucus.
• Patients requiring rapid reduction of intestinal fluid loss to prevent dehydration.
• Situations where maintaining normal gut motility is important, such as in postoperative care.
• Use as part of rehydration therapy in conjunction with oral rehydration solutions.
• Individuals with travel‑related diarrhea where quick symptom control is desired.

• Racecadotril acts as a peripheral enkephalinase inhibitor. By blocking the enzyme that degrades endogenous enkephalins, the drug increases the local concentration of these peptides in the intestinal mucosa. The elevated enkephalins bind to opioid receptors on enterocytes, reducing cyclic AMP‑mediated chloride secretion and consequently decreasing water and electrolyte loss into the lumen, while preserving normal intestinal motility during infection and inflammation.

The safety profile of Hidrasec includes a range of reported adverse reactions, most of which are mild and transient.

Common

• Mild abdominal discomfort or cramping, usually resolving without treatment.
• Nausea, occasionally accompanied by brief vomiting episodes.
• Transient headache that does not require medication.
• Slight increase in flatulence or gas production.
• Dizziness or light‑headed feeling, generally brief.

Serious

• Allergic skin reactions such as rash or urticaria, requiring discontinuation.
• Severe hypersensitivity including angioedema, which may affect breathing.
• Rare reports of acute liver enzyme elevation, monitored with laboratory tests.

When considering Hidrasec, several precautionary measures should be observed to ensure safe use.

• Assess hydration status and replace fluids before initiating therapy.
• Use with caution in patients with known hypersensitivity to racecadotril or excipients.
• Monitor renal function in individuals with severe kidney impairment.
• Avoid use in cases of inflammatory or dysenteric diarrhea where motility reduction may be harmful.
• Consider pediatric dosing adjustments according to age and weight, following clinical guidelines.
• Pregnant or breastfeeding individuals should consult a healthcare professional before use.
• Concomitant use with other antidiarrheal agents should be evaluated to prevent additive effects.

Hidrasec may interact with other medicines, and certain combinations should be avoided or used carefully.

Avoid

• Concurrent use with opioid analgesics that act centrally, which could amplify opioid‑related effects.
• Combination with other antidiarrheal agents such as loperamide, increasing risk of constipation.

Use with caution

• Co‑administration with drugs that affect renal clearance, for example certain diuretics.
• Use alongside medications metabolized by the same hepatic pathways (e.g., CYP2C9 substrates) may alter plasma levels.
• Patients receiving immunosuppressants should be monitored for potential changes in drug exposure.