ULIFAST

1. Introduction

Ulifast is an anti-secretory medication containing racecadotril, specifically designed to treat acute diarrhea while preserving intestinal motility.

2. Description

• Generic Name: Racecadotril

• Brand Names: Ulifast (India), Hidrasec (international)

• Dosage Forms:

  • Capsules (100mg – adult)

  • Sachets (10mg, 30mg – pediatric)

• Class: Enkephalinase inhibitor

3. Uses

✔ Acute watery diarrhea (viral/bacterial)
✔ Traveler’s diarrhea
✔ Rotavirus diarrhea in children
✔ Post-antibiotic diarrhea

4. Mechanism of Action

• Enkephalinase inhibition → preserves endogenous enkephalins

• Reduces intestinal hypersecretion without affecting motility

• Does NOT cause constipation (unlike loperamide)

• Maintains gut flora balance

5. Dosage

Adults: 100mg 3 times daily
Children:

• 1.5mg/kg/dose (max 10mg) for <9kg infants

• 10mg 3 times daily (9-13kg)

• 30mg 3 times daily (>13kg)

6. Side Effects

Rare (<1%):

• Mild headache

• Drowsiness

• Skin rash

Key Advantage:

• No risk of paralytic ileus

• Safe for children >3 months

7. Storage

• Below 30°C

• Protect from moisture

• Sachets: Use immediately after opening

8. Precautions

⚠ Contraindications:

• Fructose intolerance (sachets contain sorbitol)

• Hypersensitivity

⚠ Special Cases:

• Pregnancy: Use only if clearly needed

• Renal impairment: Monitor closely

9. Clinical Advantages

• Works within 30 minutes
• Reduces stool output by 40-50%
• Can be used with ORS and antibiotics
• Preserves normal intestinal transit

10. Comparison with Loperamide

11. Conclusion

Ulifast offers a physiological approach to diarrhea management by targeting hypersecretion without disrupting normal gut function. Its excellent safety profile makes it particularly valuable for pediatric use and cases where antimotility drugs are contraindicated.