Neostep

Neostep Uses, Dosage, Side Effects, Food Interaction and all others data.

A nitrofuran derivative with antiprotozoal and antibacterial activity. Furazolidone binds bacterial DNA which leads to the gradual inhibition of monoamine oxidase. (From Martindale, The Extra Pharmacopoeia, 30th ed, p514)

Furoxone has a broad antibacterial spectrum covering the majority of gastrointestinal tract pathogens including E. coli, staphylococci, Salmonella, Shigella, Proteus, Aerobacter aerogenes, Vibrio cholerae and Giardia lamblia. Its bactericidal activity is based upon its interference with DNA replication and protein production; this antimicrobial action minimizes the development of resistant organisms.

Loperamide inhibits the peristaltic activity of longitudinal and circular smooth muscle in the intestine by interacting with cholinergic and noncholinergic neuronal mechanisms responsible for producing the peristaltic reflex.

Loperamide binds to the opiate receptor in the gut wall, reducing propulsive peristalsis, and increase intestinal transit time.Loperamide is orally administered capsule. After administration absorption is more than 65% which occurs at a modest rate, with peak serum levels of 2-3 µgm/litre occurring at about 4 hours later after oral administration. The rest 35% is excreted unchanged in the faeces. Loperamide undergoes an extensive presystemic first pass metabolism in the gut wall and in the liver. Loperamide does not act centrally due to its high affinity for the gut wall and its presystemic metabolism. This is why it reaches the systemic circulation in very minute amount. The route of elimination is 0.63-1.4% in urine as unchanged drug, 58% is excreted in the bile and 15-23% appears in the faeces.

Loperamide is a synthetic anti-diarrheal indicated for the control and symptomatic relief of acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease. Loperamide is also indicated for reducing the volume of discharge from ileostomies. In man, Loperamide prolongs the transit time of the intestinal contents. It reduces the daily fecal volume, increases the viscosity and bulk density, and diminishes the loss of fluid and electrolytes. Tolerance to the antidiarrheal effect has not been observed. Loperamide is an opioid receptor agonist and acts on the mu opioid receptors in the myenteric plexus large intestines; it does not affect the central nervous system like other opioids. It works specifically by decreasing the activity of the myenteric plexus which decreases the motility of the circular and longitudinal smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the fecal matter. Loperamide also decreases colonic mass movements and suppresses the gastrocolic reflex.

Neostep
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Neostep
Generic	Furazolidone + Loperamide
Weight	100mg
Type	Tablet
Therapeutic Class
Manufacturer	Swastik Pharmaceuticals
Available Country	India
Last Updated:	September 19, 2023 at 7:00 am

Uses

Furazolidone is a drug for the treatment of infectious diarrhea.

For the specific and symptomatic treatment of bacterial or protozoal diarrhea and enteritis caused by susceptible organisms.

Loperamide is used for a symptomatic treatment of acute and chronic diarrhoea

Neostep is also used to associated treatment for these conditions: Dysentery, Infectious diarrheaChronic Functional Diarrhea, Diarrhoea, Intestinal stoma leak, Traveler's Diarrhea

How Neostep works

Furazolidone and its related free radical products are believed to bind DNA and induce cross-links. Bacterial DNA is particularly susceptible to this drug leading to high levels of mutations (transitions and transversions) in the bacterial chromosome.

In vitro and animal studies show that Loperamide acts by slowing intestinal motility and by affecting water and electrolyte movement through the bowel. Loperamide inhibits peristaltic activity by a direct effect on the circular and longitudinal muscles of the intestinal wall. It is a non-selective calcium channel blocker and binds to opioid mu-receptors. Evidence also suggests that at higher concentrations it binds to calmodulin.

Dosage

Neostep dosage

Acute diarrhoea-

The initial dose is 2 capsules for adults and 1 capsule for children older than eight; in addition 1 capsule should be taken at any subsequent loose stool. The daily dose, however should not exceed 8 capsules for adults, for children 4-6 capsules according to age.

Chronic diarrhoea-

Initial dose:

Adults: 2 capsules daily.
Children older than eight: 1 capsule daily.

Maintenance dose: One should aim at obtaining normal stools (e.g., one or two stools of good consistency a day). For this it may be necessary to adjust the initial dose (by increasing or decreasing it as required). Maintenance dose as a rule will vary from 1 to 6 capsules daily

Side Effects

On occasions paralytic ileus, abdominal cramps and bloating have been reported. Other side effects observed are skin reactions including urticaria, nausea, vomiting, constipation, tiredness, drowsiness, dizziness and dry mouth.

Toxicity

Reactions to Furoxone have been reported including a fall in blood pressure, urticaria, fever, arthralgia, and a vesicular morbilliform rash. Other adverse effects can include a brown discoloration of the urine; hemolysis can occur in G6PDH-deficient patients. The drug has a monoamine oxidase (MAO) inhibitory effect and should never be given concurrently to individuals already taking MAO inhibitors.

Oral, mouse: LD₅₀ = 105 mg/kg. Symptoms of overdose include constipation, drowsiness, lethargy, and nausea.

Precaution

It should be used with caution in patients with defective hepatic function as this might result in a relative overdose.

Interaction

No drugs are known to be incompatible with Loperamide

Elimination Route

Radiolabeled drug studies indicate that furazolidone is well absorbed following oral administration

Not significantly absorbed from the gut

Half Life

10 minutes

9.1 to 14.4 hours (average 10.8 hours)

Elimination Route

Excretion of the unchanged loperamide and its metabolites mainly occurs through the feces.

Pregnancy & Breastfeeding use

Safety of use of Loperamide during pregnancy has not been established, although studies in animal did not demonstrate any teratogenic effects. Therefore, it should not be administered to the patients during pregnancy. Although the fraction of loperamide secreted in the human milk is very low, caution is advised if it is to be administered to nursing mothers.

Contraindication

It should not be used in children less than 4 years of age. It must not be used when inhibition of peristalsis is to be avoided in particular when constipation are present or when abdominal distension develops particularly severely dehydrated children or in patients with acute ulcerative colitis or pseudomembranous colitis associated with broad spectrum antibiotics. It should not be used alone in acute dysentery associated with blood in stools and elevated temperature.