Racecadotril for Acute Diarrhea Management

Clinical Applications and Evidence

• The European Society for Medical Oncology (ESMO) guidelines provide Level III evidence with Grade A recommendation for using racecadotril as part of symptomatic treatment for Grade 1 immunotherapy-induced diarrhea in cancer patients, alongside oral rehydration, and it can be used interchangeably with loperamide 1, 2, 3, 4, 5
• Racecadotril is distinguished from loperamide by its antisecretory mechanisms (enkephalinase inhibition) rather than antimotility effects, providing a safety advantage by not slowing intestinal transit or increasing the risk of toxic megacolon in inflammatory conditions 6