KAOLIN / PECTIN
Chemistry - Kaolin is a naturally occurring hydrated aluminum silicate which is powdered andrefined for pharmaceutical use. Kaolin is a white/light, odorless, almost tasteless powder that ispractically insoluble in water.
Pectin is a carbohydrate polymer consisting primarily of partially methoxylated polygalacturonicacids. Pectin is a course or fine, yellowish-white, almost odorless with a mucilagenous flavor. It isobtained from the inner rind of citrus fruits or from apple pomace. One gram of pectin is soluble in20 ml of water and forms a viscous, colloidal solution.
In the United States, the two compounds generally are used together in an oral suspension formulation in most proprietary products.
In one study in children with acute nonspecific diarrhea, stool fluidity was decreased, but stoolfrequency, water content and weight remained unchanged. No studies documenting the clinicalefficacy of this combination in either human or veterinary species were located.
Uses, Indications - Although its efficacy is in question, kaolin/pectin is used primarily in veterinarymedicine as an oral anti-diarrheal agent. It has also been used as an adsorbent agent following theingestion of certain toxins.Administration may be difficult due to the large volumes that may benecessary to give orally.
Contraindications/Precautions - There are no absolute contraindications to kaolin/pectin therapy, but it should not be relied on to control severe diarrheas. Kaolin/pectin should also not replaceadequate fluid/electrolyte monitoring or replacement therapy in severe or chronic diarrheas.
Constipation may occur, but is usually transient and associated with high dosages. High doses indebilitated patients or in very old or young patients may rarely cause fecal impaction to occur. Inrats, kaolin/pectin has been demonstrated to increase fecal sodium loss in diarrhea.
In humans, kaolin/pectin is only recommended to be used in patients less than 3 years of age orfor longer than 48 hours under the direct supervision of a physician.
Overdosage - Overdosage is unlikely to cause any serious effects, but constipation requiringtreatment may occur.
Some evidence exists that kaolin/pectin may impair the oral absorption of digoxin. While theclinical significance of this potential interaction is unknown, it is recommended to separate thedosages as outlined above for lincomycin.
Pectin is a carbohydrate polymer consisting primarily of partially methoxylated polygalacturonicacids. Pectin is a course or fine, yellowish-white, almost odorless with a mucilagenous flavor. It isobtained from the inner rind of citrus fruits or from apple pomace. One gram of pectin is soluble in20 ml of water and forms a viscous, colloidal solution.
In the United States, the two compounds generally are used together in an oral suspension formulation in most proprietary products.
Storage, Stability, Compatibility
Kaolin/pectin should be stored in airtight containers; protectfrom freezing. It is incompatible with alkalis, heavy metals, salicylic acid, tannic acid or strongalcohol.Pharmacology - KAOLIN/PECTIN
Kaolin/pectin is thought to posses adsorbent and protective qualities. Presumably, bacteria and toxins are adsorbed in the gut and the coating action of the suspension may protectinflamed GI mucosa. The pectin component, by forming galcturonic acid, has been demonstrated todecrease pH in the intestinal lumen.In one study in children with acute nonspecific diarrhea, stool fluidity was decreased, but stoolfrequency, water content and weight remained unchanged. No studies documenting the clinicalefficacy of this combination in either human or veterinary species were located.
Uses, Indications - Although its efficacy is in question, kaolin/pectin is used primarily in veterinarymedicine as an oral anti-diarrheal agent. It has also been used as an adsorbent agent following theingestion of certain toxins.Administration may be difficult due to the large volumes that may benecessary to give orally.
Pharmacokinetics - KAOLIN/PECTIN
Neither kaolin nor pectin are absorbed after oral administration. Up to 90%of the pectin administered may be decomposed in the gut.Contraindications/Precautions - There are no absolute contraindications to kaolin/pectin therapy, but it should not be relied on to control severe diarrheas. Kaolin/pectin should also not replaceadequate fluid/electrolyte monitoring or replacement therapy in severe or chronic diarrheas.
Adverse Effects, Warnings
At usual doses, kaolin/pectin generally have no adverse effects.Constipation may occur, but is usually transient and associated with high dosages. High doses indebilitated patients or in very old or young patients may rarely cause fecal impaction to occur. Inrats, kaolin/pectin has been demonstrated to increase fecal sodium loss in diarrhea.
In humans, kaolin/pectin is only recommended to be used in patients less than 3 years of age orfor longer than 48 hours under the direct supervision of a physician.
Overdosage - Overdosage is unlikely to cause any serious effects, but constipation requiringtreatment may occur.
Drug Interactions
Kaolin/pectin may inhibit the oral absorption of lincomycin. If both drugsare to be used, administer kaolin/pectin at least 2 hours before or 3-4 hours after the lincomycindose.Some evidence exists that kaolin/pectin may impair the oral absorption of digoxin. While theclinical significance of this potential interaction is unknown, it is recommended to separate thedosages as outlined above for lincomycin.