crofelemer

crofelemer

(kro-fel-e-mer) ,

Fulyzaq

(trade name)

Classification

Therapeutic: antidiarrheals
Pharmacologic: catechins
Pregnancy Category: C

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 effects

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
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Contraindications/Precautions

Contraindicated in: None noted.
Use Cautiously in: Infectious causes of diarrhea (evaluate and treat prior to use); Obstetric: Use during pregnancy only if clearly needed; Lactation: Breast feeding should be avoided by HIV-infected patients; Pediatric: Safe and effective use in children <18 yr has not been established.

Adverse Reactions/Side Effects

Central nervous system

  • anxiety

Ear, Eye, Nose, Throat

  • nasopharyngitis

Respiratory

  • bronchitis
  • cough
  • upper respiratory tract infection

Gastrointestinal

  • abdominal distention
  • flatulence
  • hemorrhoids
  • nausea
  • ↑ liver function tests

Genitourinary

  • urinary tract infection

Musculoskeletal

  • arthralgia
  • back pain
  • muscuoloskeletal pain

Interactions

Drug-Drug interaction

Due to minimal systemic absorption, interactions are unlikely.

Route/Dosage

Oral (Adults) 125 mg twice daily.

Availability

Delayed-release tablets: 125 mg

Nursing implications

Nursing assessment

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

Potential Nursing Diagnoses

Diarrhea (Indications)

Implementation

  • Oral: 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.
References in periodicals archive ?
Napo Pharmaceuticals is a small botanical-focused pharmaceutical company, which is engaged in the development of a drug called crofelemer, intended for the treatment of diarrhoea.
ENPNewswire-August 27, 2019--Jaguar Health Issues Regulatory Update Regarding Potential Indication for Crofelemer in Dogs
Jaguar Health announced that statistically significant top line results have been achieved in a key preclinical pharmacological study to evaluate the effects of crofelemer on diarrhea induced in healthy dogs by a maximally tolerated dose of a specific tyrosine kinase inhibitor.
The company reported that it achieved statistically significant top-line results in a study evaluating crofelemer for treatment of diarrhea related to targeted cancer therapy.
striking, Fulyzaq (crofelemer), intended for treatment of diarrhea in
M2 PHARMA-August 8, 2017-FDA Grants Jaguar Health Subsidiary Napo Pharmaceuticals Orphan-Drug Designation for Mytesi (crofelemer) for Treatment of Short Bowel Syndrome
Napo's Mytesi (crofelemer) product is approved by the US FDA for the symptomatic relief of noninfectious diarrhea in adults with HIV/AIDS on antiretroviral therapy.
There are four gastrointestinal agents: crofelemer (Fulyzaq; antidiarrheal), linaclotide (Linzess; laxative), teduglutide (Gattex; short bowel syndrome), and the combination of sodium picosulfate, magnesium oxide, and citric acid (Prepopik; osmotic laxative).
To that end, FDA has approved Fulyzaq (crofelemer), which is derived from the red sap of the Croton lechleri plant, to relieve symptoms of diarrhea in HIV/AIDS patients taking antiretroviral therapy, a combination of medicines used to treat HIV infection.
The drug, Crofelemer 125 mg, is aimed at treating diarrhoea in patients with HIV/ AIDS and on anti- retroviral therapy.
According to the US Food and Drug Administration (FDA) the agency is to take some more time to review the Salix Pharmaceuticals' new drug application (NDA) for crofelemer 125 mg tablets, which is designed to provide symptomatic relief of non-infectious diarrhea in patients with HIV/AIDS on anti-retroviral therapy.
METOZOLVTM ODT (metoclopramide), crofelemer, budesonide foam and rifaximin for additional indications are under development.