Kaolin/ Pectin/ Potassium Chloride/ Sodium Chloride/ Sodium Lactate

Registered South African indications:

• Diarrhoea

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Kaolin
Contraindications 

• Intestinal obstruction
• Spastic bowel conditions

Cautions 

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly

Pectin
Contraindications 

• Intestinal obstruction
• Spastic bowel conditions

Cautions 

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly

Potassium chloride
Contraindications

• Hypersensitivity to the active ingredient or any of its excipients 
• Hyperkalaemia 
• Impaired renal function with oliguria, anuria or azotaemia 
• Hyperchloraemia 
• Addison's disease 
• Acute dehydration
• Heat cramps

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment 
• Elderly
• Adrenal insufficiency  
• Intestinal stricture 
• History of peptic ulcer 
• Cardiac disease 
• Severe burns 
• Myotonia congenita 
• Severe haemolysis 
• Acidosis 
• Hypertension

Sodium chloride
Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Oedema
• Heart disease
• Cardiac decompensation
• Primary or secondary hyperaldosteronism
• Coadministration with diuretics

Cautions

• Renal impairment
• Elderly
• Hypertension
• Cardiac failure
• Pre-eclampsia
• Children
• Diabetes mellitus
• Hyperlipidaemia
• Conditions associated with sodium retention
• Hyperproteinaemia
• Patients on a controlled sodium diet

Sodium lactate
Contraindications

• Hypersensitivity to the active ingredient or to any of its excipients
• Severe renal impairment
• Severe hepatic impairment
• Lactic acidosis
• Severe acidosis
• Hypernatraemia
• Conditions where sodium administration would be harmful

Cautions

• Pregnancy
• Elderly
• Metabolic or respiratory acidosis
• Congestive heart failure
• Sodium retaining conditions
• Conditions impairing lactate utilization
• Diabetes mellitus

Forms avail. in SA and covered in this monograph: sus

Acute diarrhoea - mild to moderate 

Kaolin/ Pectin/ Potassium chloride/ Sodium chloride/ Sodium lactate
6g/120mg/41.4mg/78.9mg/86.4mg (per 30ml)

• Oral (sus): 60-80ml, 6-8hrly

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If symptoms persist for > 48 hours or the condition of the patient deteriorates, the treatment must be discontinued

Paed. forms avail. in SA and covered in this monograph: sus

Acute diarrhoea - mild to moderate 

Kaolin/ Pectin/ Potassium chloride/ Sodium chloride/ Sodium lactate
6g/120mg/41.4mg/78.9mg/86.4mg (per 30ml)

• Younger than 3 years: Not established for use
• Between 3-6 years: Oral (sus): 15-20ml, 6-8hrly
• Between 6-12 years: Oral (sus): 30-40ml, 6-8hrly
• Older than 12 years: Oral (sus): 60ml, 6-8hrly

Recommendations for this combination product as per highest risk category when comparing individual active ingredients

Pregnancy

• FDA Pregnancy Category Not Rated (NR) (Kaolin, Pectin, Sodium chloride, Sodium lactate)

Breastfeeding

• Caution (Kaolin, Pectin, Potassium chloride)

Renal Impairment

• Mild to moderate: Caution; dose adjustment recommended (Potassium chloride, Sodium chloride) 
• Severe: Contraindicated (Sodium lactate)

Hepatic Impairment

• Mild to moderate: Caution; no information available (Kaolin, Pectin) 
• Severe: Contraindicated (Sodium lactate)

Elderly

• Caution; dose adjustment recommended (Potassium chloride)

Drugs in Sport

• Permitted - No warning

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Kaolin
Gastrointestinal Disorders

• Constipation
• Flatulence and distension
• Intestinal obstruction

Pectin
Gastrointestinal Disorders

• Constipation
• Flatulence and distension
• Intestinal obstruction

Potassium chloride
Cardiovascular Disorders

• Arrhythmias 

Gastrointestinal Disorders

• Nausea and vomiting 
• Oesophageal ulceration
• Small bowel ulceration

Endocrine and Metabolic System Disorders

• Hyperkalaemia 

Skin and Subcutaneous Tissue Disorders

• Pain at the injection site 
• Phlebitis 

Sodium chloride
Central Nervous System Disorders

• Headache
• Dizziness
• Restlessness
• Irritability
• Weakness
• Fever

Cardiovascular Disorders

• Tachycardia
• Hypertension
• Hypotension
• Oedema

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea
• Abdominal cramps
• Thirst
• Reduced salivation

Endocrine and Metabolic Disorders

• Sodium accumulation
• Hyperchloraemic acidosis

Musculoskeletal Disorders

• Muscular twitching
• Muscular rigidity

Skin and Subcutaneous Tissue Disorders

• Sweating

Sensory Disorders

• Reduced lacrimation

Sodium lactate
Central Nervous System Disorders

• Anxiety
• Panic attacks
• Paraesthesia
• Tremor
• Dizziness
• Fear

Cardiovascular Disorders

• Tachycardia

Respiratory Disorders

• Dyspnoea

Endocrine and Metabolic Disorders

• Hypokalaemia
• Metabolic acidosis
• Hypocalcaemia
• Sweating

Musculoskeletal Disorders

• Drug-induced myasthenia gravis

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Kaolin

• No information available

Pectin

• No information available

Potassium chloride

• Potassium-sparing diuretics 
• Angiotensin-converting enzyme inhibitors 
• Angiotensin II receptor antagonists 
• Ciclosporin 
• Blood transfusions 
• Digitalis 
• Thiazide diuretics 
• Tacrolimus 
• Beta blockers 
• Non-steroidal anti-inflammatory drugs 
• Potassium-containing agents 
• Quinidine 
• Adrenocorticoids 
• Corticosteroids 
• Glucose Infusion

Sodium chloride

• Antihypertensives
• Lithium
• Diuretics

Sodium lactate

• Corticosteroids
• Agents that increase serum potassium
• Ephedrine
• Dexamphetamine

• ECG
• Urine output 
• Serum potassium 

Specific cases may require

• Serum glucose
• Electrolytes

Kaolin
Kaolin absorbs water, toxins and bacteria from the gastrointestinal tract, leading to firmer stools and reducing fluid loss.

Pectin
Pectin reduces stool volume.

Potassium Chloride
Potassium is the principle cation of intracellular fluid. Potassium ions are involved in numerous cellular metabolic processes, including intracellular tonicity, transmission of nerve impulses, contraction of cardiac, smooth, and skeletal muscles and renal function. It is also involved in synthesis of protein, metabolism of carbohydrates and storage of energy reserves. 

Sodium Chloride
Sodium chloride is the principle salt involved in maintaining the osmotic tension in blood and tissues. Changes in osmotic tension influence the movement of fluids and diffusion of salts in cellular tissues.

Sodium Lactate
Sodium lactate has alkalinising effects due to its simultaneous removal of lactate and hydrogen ions.

COMBINATION PREPARATIONS

Kaolin/ Pectin/ Potassium chloride/ Sodium chloride/ Sodium lactate

Suspension (per 30ml) 6g/ 120mg/ 41.4mg/ 78.9mg/ 86.4mg

• Enterolyte (Adcock)
• Kaostatex (Pharmacare)