Context

Treatment alternatives

The BNF states that antimotility drugs may be used to relieve symptoms of uncomplicated acute diarrhoea in adults; it may also be necessary to use oral rehydration salt (ORS) solution.

Costs of treatment alternatives

Drug

Usual dosage a

7-day cost excluding VAT

Racecadotril 100 mgb

1 capsule 3 times a day

£8.42c

Loperamide 2 mgd

6 to 8 mg daily

Oral solution 1 mg/5 ml £2.46 to £3.28e

2 mg capsules £0.66 to £0.88e

2 mg tablets £1.51 to £2.01e

2 mg oral lyophilisates (Instants) £5.86 to £7.81e

Codeine phosphated

30 mg 3 to 4 times daily

Oral solution 25 mg/5 ml £1.33 to £1.78e

30 mg tablets £1.12 to £1.49e

Co-phenotrope 2.5/0/025 mg tabletsd

4 tablets, followed by 2 tablets every 6 hours until diarrhoea is controlled

£6.23e

a The doses shown do not all represent the full range that can be used and they do not imply therapeutic equivalence.

b Dose taken from the Hidrasec summary of product characteristics.

c Cost taken from MIMS February 2013.

d Doses taken from the British national formulary.

e Costs taken from Drug Tariff February 2013.

In adults, ORS solution may be used alone as a treatment alternative to racecadotril and other antidiarrhoeal drugs, or it may be used with these drugs. It is difficult to give a 7-day cost because the dosage of ORS solution is imprecise. According to fluid loss, 1 to 2 sachets are usually used after every loose motion. The cost of a 20-sachet pack is (excluding VAT; costs taken from MIMS, February 2013):

  • £6.72 for Dioralyte

  • £7.13 for Dioralyte Relief

  • £4.99 for Electrolade.