Hidrasec (Racecadotril)

Hidrasec is indicated for the symptomatic relief of acute, non‑bloody diarrhea in patients where rapid reduction of stool output is desired.

• Short‑term treatment of acute infectious diarrhea to reduce stool frequency and volume.
• Adjunctive therapy for traveler’s diarrhea, used together with oral rehydration to maintain hydration.
• Management of diarrhea associated with viral or bacterial gastroenteritis in pediatric patients.
• Use in adults experiencing acute watery diarrhea of unknown etiology, when rapid symptom control is required.
• Supportive care alongside oral rehydration solutions to help restore fluid balance.

• Racecadotril is a peripheral enkephalinase inhibitor. After oral absorption it is converted to the active metabolite thiorphan, which blocks the enzyme neutral endopeptidase (NEP) in the intestinal mucosa. Inhibition of NEP prevents degradation of endogenous enkephalins, allowing them to activate opioid receptors on enteric neurons. This reduces secretion of water and electrolytes into the intestinal lumen without affecting intestinal motility, thereby decreasing stool output in acute diarrhea.

Like many antidiarrheal agents, racecadotril may be associated with adverse reactions, most of which are mild and transient.

Common

• Nausea or mild abdominal discomfort that usually resolves without treatment.
• Headache of mild to moderate intensity.
• Dizziness or light‑headed feeling, especially after standing quickly.
• Transient increase in constipation or hard stools.

Serious

• Allergic skin reactions such as maculopapular rash or urticaria that may require medical attention.
• Severe abdominal pain or signs of intestinal obstruction requiring evaluation.
• Elevated liver enzymes indicating hepatic stress, monitored in prolonged use.
• Anaphylactic reaction characterized by breathing difficulty, swelling, or hypotension (very rare).

Before using Hidrasec, certain precautionary measures should be considered to ensure safe and appropriate use.

• Verify that diarrhea is acute, non‑bloody, and not caused by invasive pathogens before starting treatment.
• Use with caution in patients with known hypersensitivity to racecadotril or any component of the formulation.
• Assess renal or hepatic impairment, as dose adjustment may be needed in severe dysfunction.
• Avoid use in infants younger than 3 months without medical supervision.
• Do not substitute Hidrasec for rehydration therapy; continue oral rehydration solutions as primary treatment.
• Monitor for persistent diarrhea lasting more than 48‑72 hours, which may require medical evaluation.

Racecadotril can interact with other medicines; awareness of potential interactions helps minimize risk.

Avoid

• Concomitant use of potent opioid agonists that may enhance central opioid effects.
• Combination with other antidiarrheal agents that suppress gut motility, such as loperamide, without medical guidance.

Use with caution

• Concurrent administration of drugs metabolized by hepatic enzymes that could be inhibited by thiorphan, e.g., certain antihypertensives.
• Use alongside medications that may cause electrolyte imbalance, requiring monitoring of serum electrolytes.
• Patients receiving diuretics should be observed for additive fluid‑loss effects.
• Co‑administration with other enkephalinase inhibitors may increase risk of adverse reactions.