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crofelemer

General

Pronunciation:
kro-fel-e-mer


Trade Name(s)

  • Fulyzaq

Ther. Class.
antidiarrheals

Pharm. Class.
catechins

Indications

Symptomatic relief of non-infectious diarrhea in HIV-infected patients currently receiving antiretroviral therapy.

Action

  • A natural product derived from Croton lechleri, a species of flowering plant.
  • Inhibits cyclic adenosine monophosphate (cAMP)-stimulated cystic fibrosis transmembrane conductance regulator (CTFR) chloride ion channels and the calcium-activated chloride channels on luminal membranes of enterocytes. Blocks chloride secretion and water loss by inhibiting chloride channels on the membranes of enterocytes.

Therapeutic Effect(s):

Decreased incidence and severity of diarrhea.

Pharmacokinetics

Absorption: Minimal absorption following oral administration.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

ROUTEONSETPEAKDURATION
POunknownunknownunknown

Contraindication/Precautions

Contraindicated in:

  • None noted.

Use Cautiously in:

  • Infectious causes of diarrhea (evaluate and treat prior to use);
  • OB: Use during pregnancy only if clearly needed;
  • Lactation:Breast feeding should be avoided by HIV-infected patients;
  • Pedi: Safe and effective use in children <18 yr has not been established.

Adverse Reactions/Side Effects

CNS: anxiety

EENT: nasopharyngitis

Resp: bronchitis, cough, upper respiratory tract infection

GI: abdominal distention, flatulence, hemorrhoids, nausea, ↑ liver function tests

GU: urinary tract infection

MS: arthralgia, back pain, muscuoloskeletal pain

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

Due to minimal systemic absorption, interactions are unlikely.

Route/Dosage

PO: (Adults) 125 mg twice daily.

Availability

Delayed-release tablets: 125 mg

Assessment

  • Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
  • Assess color, consistency, and amount of stool produced.

Potential Diagnoses

Implementation

  • PO: Administer tablets twice daily with or without food. Swallow tablets whole; do not crush, break, or chew.

Patient/Family Teaching

  • Instruct patient to take crofelemer as directed.
  • Advise female patients to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

Decreased incidence and severity of diarrhea.

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Citation

Quiring, Courtney, et al. "Crofelemer." Davis's Drug Guide, 16th ed., F.A. Davis Company, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Davis-Drug-Guide/109834/all/crofelemer.
Quiring C, Sanoski CA, Vallerand AH. Crofelemer. Davis's Drug Guide. 16th ed. F.A. Davis Company; 2019. https://peds.unboundmedicine.com/pedscentral/view/Davis-Drug-Guide/109834/all/crofelemer. Accessed April 23, 2019.
Quiring, C., Sanoski, C. A., & Vallerand, A. H. (2019). Crofelemer. In Davis's Drug Guide. Available from https://peds.unboundmedicine.com/pedscentral/view/Davis-Drug-Guide/109834/all/crofelemer
Quiring C, Sanoski CA, Vallerand AH. Crofelemer [Internet]. In: Davis's Drug Guide. F.A. Davis Company; 2019. [cited 2019 April 23]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Davis-Drug-Guide/109834/all/crofelemer.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - crofelemer ID - 109834 A1 - Quiring,Courtney, AU - Sanoski,Cynthia A, AU - Vallerand,April Hazard, BT - Davis's Drug Guide UR - https://peds.unboundmedicine.com/pedscentral/view/Davis-Drug-Guide/109834/all/crofelemer PB - F.A. Davis Company ET - 16 DB - Pediatrics Central DP - Unbound Medicine ER -