attapulgite
Children’s Kaopectate, Diasorb, Donnagel, Fowler’s ◆, Kaopectate, Kaopectate Advanced Formula, Kaopectate Maximum Strength, K-Pek, Parepectolin, Rheaban, Rheaban Maximum Strength

Available forms
Available without a prescription
Oral suspension: 600 mg/15 ml, 750 mg/5 ml, 750 mg/15 ml ◆, 900 mg/15 ml ◆
Tablets: 300 mg, 600 mg ◆, 630 mg ◆, 750 mg
Tablets (chewable): 600 mg

Indications and dosages
 Acute, nonspecific diarrhea. Adults and adolescents: 1.2 to 1.5 g (unless using Diasorb, in which case dose can be as high as 3 g) P.O. after each loose bowel movement; don’t exceed 9 g within 24 hours.
Children ages 6 to 12: 600 mg (suspension) or 750 mg (tablet) P.O. after each loose bowel movement; don’t exceed 4.2 g (suspension and chewable tablets) or 4.5 g (tablet) within 24 hours.
Children ages 3 to 6: 300 mg P.O. after each loose bowel movement; don’t exceed 2.1 g within 24 hours.

Pharmacodynamics
Antidiarrheal action: Although its exact action is unknown, it’s believed that attapulgite absorbs large numbers of bacteria and toxins and reduces water loss in the GI tract.

Pharmacokinetics
Absorption: Not absorbed.
Distribution: Not applicable.
Metabolism: Not applicable.
Excretion: Excreted unchanged in feces.

Contraindications and precautions
Contraindicated in patients with dysentery or suspected bowel obstruction. Use cautiously in dehydrated patients.

Interactions
Drug-drug. Oral drugs: Impair absorption. Give attapulgite at least 2 hours before or 3 to 4 hours after oral drugs. Monitor patient for decreased effectiveness.

Adverse reactions
GI: constipation.

Effects on lab test results
None reported.

Overdose and treatment
Because attapulgite isn’t absorbed, an overdose is unlikely to pose a significant health problem.

Special considerations
• Make sure patient achieves adequate fluid intake to compensate for fluid loss from diarrhea.
• Drug shouldn’t be used if diarrhea is accompanied by fever or blood or mucus in the stool. Discontinue drug if any of these signs occurs during treatment.
• Monitor patient for signs and symptoms of dehydration.
Pediatric patients
• Use only under medical supervision in children younger than age 3.
Geriatric patients
• Use cautiously and only under medical supervision.

Patient education
• Tell patient to take drug after each loose bowel movement until diarrhea is controlled.
• Instruct patient to call if diarrhea isn’t controlled within 48 hours or if fever develops.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use