Hidrasec (Racecadotril)

Hidrasec is indicated for the short‑term management of acute diarrhea in patients who need rapid symptom control, and it can be used alongside oral rehydration solutions to support fluid balance.

• Adults experiencing acute watery or loose stools.
• Children (including infants) with sudden onset diarrhea.
• Travelers who develop diarrhea during short trips.
• Diarrhea secondary to viral or bacterial gastroenteritis.
• Use as an adjunct to oral rehydration therapy for fluid replacement.
• Patients with diarrhea due to food intolerance.
• Individuals needing temporary reduction of intestinal secretions.

• Racecadotril acts as an enkephalinase inhibitor. By blocking the enzyme that degrades endogenous enkephalins in the intestinal mucosa, it increases the local concentration of these opioid peptides. The elevated enkephalins bind to δ‑opioid receptors, which reduces cyclic AMP‑mediated chloride secretion and slows intestinal motility, leading to decreased fluid loss and stool frequency in acute diarrheal states. The effect is localized to the gut, minimizing systemic opioid activity.

Adverse reactions are generally mild and self‑limiting, but patients should be aware of both common and rare serious events that may require medical attention, especially if symptoms persist or worsen.

Common

• Nausea or mild stomach discomfort.
• Headache.
• Dizziness.
• Transient abdominal cramps.
• Dry mouth.
• Mild fatigue.
• Transient taste alteration.
• Mild constipation.

Serious

• Allergic skin rash or urticaria.
• Severe abdominal pain.
• Signs of anaphylaxis (rare).
• Marked liver enzyme elevation.
• Severe electrolyte imbalance.
• Renal function impairment.

When using Hidrasec, certain precautions should be considered to ensure safe and effective use, particularly in specific populations or clinical situations.

• Do not use if you have a known hypersensitivity to racecadotril or any excipients.
• Assess hydration status and replace fluids appropriately before starting treatment.
• Use with caution in patients with severe renal or hepatic impairment.
• Consult a healthcare professional before use in infants younger than 3 months.
• Avoid prolonged use beyond the recommended duration for acute diarrhea.
• Monitor for worsening diarrhea or signs of infection.
• Pregnant or breastfeeding women should seek medical advice prior to use.

Racecadotril may interact with other medicines, affecting its efficacy or safety profile; reviewing concomitant drugs is advisable.

Avoid

• Concurrent use of potent enkephalinase inhibitors that could amplify opioid‑like effects.
• Co‑administration with drugs that significantly alter intestinal motility, such as strong anticholinergics.
• Combination with other opioid‑like agents may increase risk of central side effects.

Use with caution

• Diuretics, because changes in fluid balance may affect hydration status.
• Antihypertensive agents, as dehydration from diarrhea could potentiate blood pressure lowering.
• Other antidiarrheal agents, to avoid excessive reduction of gut motility.
• Medications that affect liver enzymes (e.g., CYP inhibitors) may modify racecadotril metabolism.
• Antacids or agents that alter gastric pH could affect absorption.
• Herbal supplements with laxative properties should be used cautiously.