Attapulgite
Place in Therapy
Place in Therapy
Attapulgite is officially indicated for symptomatic relief/treatment of diarrhea and cramps in Canada.(3) Primary sources studying attapulgite were conducted in mild to moderate disease or in illness which was not severe suggesting the most appropriate use of attapulgite products would be in mild or moderate diarrhea only.(4,5) Given the removal of attapulgite from the American OTC market and the ambiguity of existing studies regarding efficacy, the use of attapulgite in Canada is considered secondary to products such as bismuth subsalicylate and loperamide which appear to have a stronger efficacy evidence base.(4,5,6) Finally, attapulgite was demonstrated to be slightly less efficacious when compared head-to-head with loperamide, although concerns regarding this study were addressed in terms of a lack of placebo control.(5)
References:
(1) Health Canada. Licensed Natural Health Products Database: Attapulgite. http://webprod5.hc-sc.gc.ca/lnhpd-bdpsnh/search-recherche.do?lang=eng&field_Champ2=&field_Champ3=&field_Champ4=&field_Champ5=&field_Champ6=&condition2=&condition3=&
condition4=&condition5=&crit2=&crit3=&crit4=&crit5=&crit6=&op2=&op3=&op4=&op5=&op6=&productStatus_EtatPro
duit=2&field_Champ1=4&op1=0&crit1=attapulgite&condition1=0&dateOp2=0&monthLicensing_MoisHomologation=&ye
arLicensing_AnneeHomologation=&dateOp1=0&monthRevised_MoisModifiee=&yearRevised_AnneeModifiee=&action=
Search. Updated February 27, 2014. Accessed July 8, 2014.
(2) E-Therapeutics. Kaopectate monograph. https://www.e-therapeutics.ca/cps.select.preliminaryFilter.action?simplePreliminaryFilter=activated+attapulgite#. Updated 2014. Accessed July 10, 2014.
(3) Lexicomp®. Attapulgite (Lexi-Drugs). http://online.lexi.com.proxy.lib.uwaterloo.ca/lco/action/doc/retrieve/docid/patch_f/6401. Updated 2014. Accessed July 8, 2014.
(4) Zaid MRB, Hasan M, Khan AA. Attapulgite in the treatment of acute diarrhoea: A double-blind placebo-controlled study. J Diarrhoeal Dis Res. 1995;13(1):44-46.
(5) DuPont HL, Ericsson CD, DuPont MW, Luna AC, Mathewson JJ. A randomized, open-label comparison of non-prescription loperamide and attapulgite in the symptomatic treatment of acute diarrhea. Am J Med. 1990;88(Suppl6A):20S-23S.
(6) Shuren J. Department of Health and Human Services & Food and Drug Administration. Antidiarrheal Drug Products for Over-the-Counter Human Use; Final Monograph. Available at: https://www.federalregister.gov/articles/2003/04/17/03-9380/antidiarrheal-drug-products-for-over-the-counter-human-use-final-monograph. Accessed June 21, 2014.
Attapulgite is officially indicated for symptomatic relief/treatment of diarrhea and cramps in Canada.(3) Primary sources studying attapulgite were conducted in mild to moderate disease or in illness which was not severe suggesting the most appropriate use of attapulgite products would be in mild or moderate diarrhea only.(4,5) Given the removal of attapulgite from the American OTC market and the ambiguity of existing studies regarding efficacy, the use of attapulgite in Canada is considered secondary to products such as bismuth subsalicylate and loperamide which appear to have a stronger efficacy evidence base.(4,5,6) Finally, attapulgite was demonstrated to be slightly less efficacious when compared head-to-head with loperamide, although concerns regarding this study were addressed in terms of a lack of placebo control.(5)
References:
(1) Health Canada. Licensed Natural Health Products Database: Attapulgite. http://webprod5.hc-sc.gc.ca/lnhpd-bdpsnh/search-recherche.do?lang=eng&field_Champ2=&field_Champ3=&field_Champ4=&field_Champ5=&field_Champ6=&condition2=&condition3=&
condition4=&condition5=&crit2=&crit3=&crit4=&crit5=&crit6=&op2=&op3=&op4=&op5=&op6=&productStatus_EtatPro
duit=2&field_Champ1=4&op1=0&crit1=attapulgite&condition1=0&dateOp2=0&monthLicensing_MoisHomologation=&ye
arLicensing_AnneeHomologation=&dateOp1=0&monthRevised_MoisModifiee=&yearRevised_AnneeModifiee=&action=
Search. Updated February 27, 2014. Accessed July 8, 2014.
(2) E-Therapeutics. Kaopectate monograph. https://www.e-therapeutics.ca/cps.select.preliminaryFilter.action?simplePreliminaryFilter=activated+attapulgite#. Updated 2014. Accessed July 10, 2014.
(3) Lexicomp®. Attapulgite (Lexi-Drugs). http://online.lexi.com.proxy.lib.uwaterloo.ca/lco/action/doc/retrieve/docid/patch_f/6401. Updated 2014. Accessed July 8, 2014.
(4) Zaid MRB, Hasan M, Khan AA. Attapulgite in the treatment of acute diarrhoea: A double-blind placebo-controlled study. J Diarrhoeal Dis Res. 1995;13(1):44-46.
(5) DuPont HL, Ericsson CD, DuPont MW, Luna AC, Mathewson JJ. A randomized, open-label comparison of non-prescription loperamide and attapulgite in the symptomatic treatment of acute diarrhea. Am J Med. 1990;88(Suppl6A):20S-23S.
(6) Shuren J. Department of Health and Human Services & Food and Drug Administration. Antidiarrheal Drug Products for Over-the-Counter Human Use; Final Monograph. Available at: https://www.federalregister.gov/articles/2003/04/17/03-9380/antidiarrheal-drug-products-for-over-the-counter-human-use-final-monograph. Accessed June 21, 2014.