Kaolin and Pectin

Aka: Kaolin and Pectin, Kaopectate

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II. Background

  1. Listed for historical purposes (but low efficacy)
  2. Kaopectate has been reformulated multiple times since its debut on the U.S. market in 1936
    1. Attapulgite (greater water absorption than Kaolin) was substituted for Kaolin in some formulations (1984)
    2. Loperamide was added/substituted to some formulations
    3. Ultimately, Kaopectate was reformulated in 2003 with Bismuth Subsalicylate (which is effective in Diarrheal illness)

III. Indications

  1. Diarrhea
    1. Not recommended

IV. Contraindications

  1. Bowel Obstruction

V. Mechanism: Original Kaolin/Pectin (Kaopectate)

  1. Kaolin and Pectin (Kaopectate) was first introduced as a commercial product in U.S. in 1936
    1. Binds water, and possibly pathogens within the intestinal tract
  2. Kaolin is a hydrated aluminum silicate powder found naturally in clay
    1. Discovered thousands of years ago by the chinese and used to add consistency to stools
  3. Pectin is extracted from apples
    1. Noted to improve Diarrhea in German Prisoners of war during world war 1

VI. Efficacy

  1. Kaolin and Pectin may increase stool form minimally
    1. However does not modify stool frequency or other associated symptoms
    2. Portnoy (1976) JAMA 236: 844-6 [PubMed]

VII. Adverse Effects

  1. Hypokalemia

VIII. Drug Interactions

  1. May alter gastrointestinal absorption of other drugs

IX. References

  1. McMahan (2007) Aliment Pharmacol Ther 25(7):759-69 +PMID: 17373914 [PubMed]

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