Cadot

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Cadot

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Cadot

What Type of Antidiarrheal Medicine is Cadot?

Cadot is an antidiarrheal medicine containing the active ingredient Racecadotril, which is classified as a selective enkephalinase inhibitor. This synthetic compound belongs to a functional class of antisecretory drugs used to manage fluid loss in the intestine, a property utilized for controlling symptoms of watery diarrhea. Racecadotril’s mechanism involves a localized effect in the gut that is distinct from agents that affect central nervous system function. This distinction allows the medication to focus on reducing excessive fluid and electrolyte secretion without disrupting overall gut transit time, a different approach compared to traditional anti-motility medications.

Composition and Available Forms of Racecadotril

The therapeutic effect of Cadot is derived from the single-ingredient compound Racecadotril, which acts as a prodrug and is converted to its active metabolite, thiorphan, following oral administration. This medication is supplied as either capsules or as granules for oral suspension packaged in sachets. The availability of granules is a distinguishing feature of this formulation, intended for administration to infants over three months of age and children, who frequently experience acute diarrhea. The composition involves the active drug and necessary pharmaceutical excipients required for solid or granular dosage forms.

General Purpose: How Racecadotril Provides Benefit

The general purpose of this medication is to alleviate the symptoms of acute diarrhea by controlling temporary fluid loss. Racecadotril functions by protecting the body's natural regulator peptides, endogenous enkephalins, from degradation by the enkephalinase enzyme. This action leads to a reduction in the intestinal hypersecretion of water and electrolytes. The resulting outcome is a decrease in the volume and liquidity of stools, providing symptom control while maintaining physiological intestinal motility.

Regulatory References

  1. NIH Research on Antisecretory Action

What side effects are possible with Cadot?

Possible Side Effects and Safety Information

The official safety information for Cadot (Racecadotril) outlines documented adverse reactions based on their frequency of occurrence and the body systems affected, according to regulatory standards.

Adverse effects are classified by regulatory agencies. Headache is the most frequently documented effect, classified as Common. Less frequent, or Uncommon reactions, include rash, erythema, and tonsillitis.

Serious Adverse Reactions and Safety Constraints

The regulatory profile highlights the risk of serious immune and skin-related reactions. These include severe hypersensitivity reactions such as angioedema (swelling of the face, tongue, or throat) and rare, life-threatening events like Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), which are classified as Not Known frequency due to post-marketing reports.

Safety documents list specific limitations for use. The medicine is not recommended for the management of chronic diarrhea or for use in patients with significant renal impairment or hepatic impairment due to a lack of dedicated safety data. Additionally, it is not for use in infants under three months of age. The label notes an increased risk of angioedema when the medicine is taken concurrently with certain other medications, specifically Angiotensin-Converting Enzyme (ACE) inhibitors. Use is also restricted for patients with severe underlying conditions or specific hereditary carbohydrate intolerances.

Overdose and Emergency Response

Overdose and When to Seek Help

Official regulatory documentation on Racecadotril (Cadot) defines the overdose profile primarily by the absence of acute toxicity at high levels of exposure. This finding influences the official guidance on emergency action.

Documented Overdose Findings

The established findings from regulatory sources indicate a low risk of harm following acute overdose.

Overdose Scope Official Regulatory Statement
Documented Manifestations No harmful effects or adverse events have been described in regulatory reports following acute overdose exposure.
Dose-Related Factors Adult patients have been administered single doses above 2 grams, equivalent to 20 times the therapeutic dose, without experiencing ill effects.
Antidote Availability No specific antidote is listed in the official labeling for management.

Emergency Response and Required Action

Given the documented absence of acute toxicity, regulatory bodies do not mandate specific immediate emergency actions solely for the acute overdose scenario.

  • Required Action: Urgent medical help is not explicitly required based on the documented findings of acute overdose.
  • Management Principle: Should exposure occur, management would align with general symptomatic and supportive treatment principles, as specified in regulatory documents.

Official prescribing information confirms that no specific procedural steps or immediate actions are necessitated by the observed findings of Racecadotril overdose.

Therapeutic Uses of Cadot

What Cadot Treats: Main Uses and Benefits

Cadot (Racecadotril) is commonly used to help with symptoms related to physical discomfort during acute gastrointestinal episodes. It is applied across domains where additional symptomatic support is needed, primarily to manage acute watery diarrhea and acute gastroenteritis.


Symptomatic Management and Stability

The medication is utilized in clinical settings involving acute symptom patterns, characterized by the sudden onset of symptoms associated with heightened physiological activity. It is used when supportive symptom management is appropriate to address the cluster of symptoms associated with excessive fluid output. This application contributes to easing the overall symptom load by supporting a reduction in the volume and liquidity of stools. It is typically used to manage acute episodes in adults, adolescents, children, and infants over three months of age.


Supporting Comfort and Rehydration

Cadot is used across conditions presenting with acute episodes where functional stability may be affected, primarily through the risk of systemic imbalance caused by fluid loss. By addressing these symptoms, the medication offers symptomatic relief that assists patients in managing difficult episodes. This supportive action contributes to improved comfort during the course of the illness. This use is common in scenarios where management of discomfort is required alongside the foundational therapy of Oral Rehydration Solution (ORS).


Quick Fact Block

Quick Fact: Relief for High-Volume Watery Stools The medication is intended for easing symptoms related to high-volume watery stools, which supports general well-being during symptomatic phases.

Regulatory References

  1. Health Products Regulatory Authority (HPRA) Summary of Product Characteristics

Eligibility and Restrictions for Use

Cadot is a combination medication containing amlodipine (a calcium channel blocker) and atorvastatin (an HMG-CoA reductase inhibitor or 'statin'). It is typically prescribed to adults who require treatment for both high blood pressure and high cholesterol or to reduce the risk of cardiovascular events in certain high-risk patients.


Who Cannot Use Cadot?

Cadot is contraindicated (should not be used) in patients with specific conditions, including:

  • Active liver disease or unexplained persistent elevation of liver enzymes.
  • A known allergy or hypersensitivity to amlodipine, atorvastatin, or any components of the tablet.
  • Pregnancy or breastfeeding. Women of childbearing potential must use reliable contraception while taking this medication as atorvastatin can harm an unborn baby.
  • Certain drug interactions exist, such as with the hepatitis C antivirals glecaprevir/pibrentasvir.

Need for Caution

Clinical caution and potential dose adjustments are necessary for patients with a history of kidney problems, heart failure, or those who consume large amounts of alcohol regularly. A healthcare professional must assess the individual risk-benefit profile before initiating treatment.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory documentation for Racecadotril (Cadot) defines its interaction profile primarily through pharmacodynamic risk and a documented low potential for pharmacokinetic conflicts.


Documented Pharmacodynamic Interaction

The most significant officially documented interaction involves medicines used to treat high blood pressure or heart conditions. Co-administration with Angiotensin-Converting Enzyme (ACE) Inhibitors, such as Captopril, Enalapril, Lisinopril, Perindopril, or Ramipril, may increase the risk of angioedema.

A specific population-dependent restriction is noted: patients who have a prior history of angioedema unrelated to Racecadotril therapy may be at an increased risk of this reaction.


Pharmacokinetic and Metabolic Profile

Racecadotril has been documented to have a low potential for pharmacokinetic interference. Regulatory labeling confirms that the active ingredient and its metabolites do not inhibit nor induce major CYP enzyme isoforms, specifically CYP1A2, CYP2C9, CYP2C19, CYP2D6, or CYP3A4, or UGT enzymes.

Furthermore, concomitant treatment with other antidiarrheal agents like Loperamide or Nifuroxazide has been documented to not modify the kinetics (exposure levels) of Racecadotril. No mandatory timing separation rules or universal contraindicated combinations are documented.

Mechanism of Action

How Cadot Works

Cadot's active metabolite, thiorphan, operates through a unique, localized antisecretory mechanism.


Enzyme Inhibition and Endogenous Signal Preservation

Thiorphan is a selective inhibitor of Neutral Endopeptidase (NEP) ( EC 3.4.24.11), an enzyme found on intestinal cells. By blocking NEP, the drug prevents the breakdown of the body's natural regulatory peptides, endogenous enkephalins. The prevention of degradation allows these signals to accumulate and enhance their localized effect on delta-opioid receptors in the intestinal lining.


Pathway Modulation and Fluid Secretion Control

Enhanced enkephalin signaling inhibits the cellular enzyme adenylyl cyclase, leading to a reduction in the key messenger cAMP. This reduction in cAMP directly modulates ion channels, resulting in a physiological decrease in the active secretion of chloride ions ( Cl^-) and subsequently water into the intestine. The mechanism acts to inhibit hypersecretion while maintaining existing patterns of intestinal fluid and motility.


Specificity and Localization of Action

Since the active metabolite does not cross the blood-brain barrier, its action is strictly peripheral and confined to the gastrointestinal tract. This localization restricts the modulation of the opioid-related delta-receptor pathway to the intestine, avoiding activity in the central nervous system or alteration of inherent gut motility.

Dosage and Administration Information

How to use Cadot — Administration Guidelines

The administration of Cadot (Racecadotril) follows a structured protocol to ensure its use as a complementary therapy. The medicine is for oral administration and is supplied as 100 mg hard capsules for adults and adolescents, and 10 mg or 30 mg granules for oral suspension for pediatric patients.


Administration Scope

Route of administration: Oral only.

Dosing schedule:

  • Adults and Adolescents (aged 15 years and older): An initial dose of one 100 mg capsule is followed by one 100 mg capsule three times daily (t.i.d.).
  • Infants and Children (from 3 months of age): Dosage is weight-based, calculated at 1.5 mg/kg per dose, administered three times daily.

Timing in relation to meals:

  • Capsules are administered preferably before the main meals. Food consumption may delay the time to peak activity.

Preparation requirements:

  • The granules are dispersed in water, mixed with food, or added to a feeding bottle; the mixture is administered immediately after preparation.

Age-group administration rules:

  • The 100 mg capsules are for patients aged 15 years and older. Use is indicated for infants older than 3 months of age. No dosage adjustment is required for elderly patients.

Missed-dose rules:

  • If a dose is missed, administration continues with the next scheduled dose. A double dose should not be taken.

Special procedural conditions:

  • Treatment is continued until the recording of two normal stools. The total duration of treatment should not exceed 7 days.
  • The medicine is administered as an adjunct to Oral Rehydration Solution (ORS).

Instruction Classifications (High-Level)

Administration method type: Oral.

Frequency pattern: Three times daily (t.i.d.) for maintenance.

Classification: Oral antidiarrheal protocol.

Use-context constraints: Adjunctive therapy with Oral Rehydration Solution (ORS).


Resulting procedural structure

Step sequence:

  • The first dose is administered to initiate the regimen.
  • The medicine is subsequently administered three times daily at intervals of approximately 8 hours.
  • Administration ceases upon the recording of two stools of normal consistency.

Connection to the overall use protocol: The administration protocol for Cadot is characterized by an oral route, age-dependent formulation choice, and a three-times-daily frequency. This sequence is linked to a maximum treatment duration and a defined, symptom-based stopping criteria, used in conjunction with Oral Rehydration Solution.

Recent Clinical Evidence

Research Evidence / Overview of Studies

Research Focus: Pharmacological Action

Studies suggest that the drug is thought to modulate the action of dopamine and norepinephrine reuptake. Studies have explored whether use of the drug was associated with changes in symptoms of inattention and hyperactivity. Further research evaluated whether this resulted in observed changes in core ADHD symptoms.

Clinical Research in Core Symptoms

Children and Adolescents (Ages 6-17) Randomized controlled trials (RCTs) have examined the drug's use in children and adolescents with ADHD. Changes were observed in some study populations during the initial weeks of treatment.

Adults with ADHD Trials focusing on adults examined the drug's impact on executive function and attention persistence. The findings were mixed regarding changes in overall quality of life. Research has explored whether the addition of a low dose in adults with residual symptoms was associated with changes in focus.

Safety and Tolerability Profile

The most frequently studied adverse events include insomnia, appetite reduction, and headache. Studies examined whether changes in laboratory markers were associated with adverse events such as increased heart rate. Long-term studies evaluating the use over several years continue to examine growth and cardiac health metrics.

Adjunctive Use and Behavioral Outcomes

Combination Therapy Research has examined the use of the drug alongside behavioral interventions to evaluate whether this approach is associated with different outcomes. The evidence on whether this combination is associated with different functional outcomes, compared to the drug used alone, is still under investigation.

Impact on Associated Behaviors Studies have examined whether use of the drug is associated with changes in the incidence of risky behaviors associated with ADHD. Further research is exploring whether the drug is associated with changes in academic performance metrics.

Frequently Asked Questions (FAQ)

Common questions about Cadot (FAQ)

Q: How quickly should I expect to see an improvement after starting Cadot?

A: Official information indicates that the drug begins working to inhibit fluid secretion in the intestine approximately 30 minutes after taking a dose. Maximum antisecretory activity is typically observed within two hours, based on pharmacological studies.

Q: Can Cadot be taken long-term for a chronic condition?

A: Regulatory documents explicitly state that Cadot is intended for short-term use in acute watery diarrhea and that treatment should not exceed 7 days. It is not recommended for the management of chronic diarrhea due to insufficient safety and effectiveness data for long-term use.

Q: What makes Cadot different from other treatments for the same condition?

A: Cadot is classified as an antisecretory drug. According to regulatory documents, its unique mechanism reduces the excessive secretion of water and electrolytes into the intestine. This is distinct from anti-motility drugs (which slow the movement of the gut), as Cadot works to reduce fluid loss without affecting normal intestinal transit time.

Q: Are headaches a common side effect of Cadot?

A: Yes, official safety information classifies headache as a Common side effect. This means it is one of the more frequently reported adverse reactions experienced by people taking the medicine.

Q: Does Cadot interact with common pain relievers like ibuprofen or acetaminophen?

A: Regulatory interaction studies indicate that Cadot has a low potential for causing drug interactions because it does not significantly interfere with the major liver enzymes (CYP enzymes) that metabolize many common medications. Therefore, a low potential for interaction with many common medications is indicated based on its known metabolic profile.

Q: Is Cadot safe for use during pregnancy?

A: Official regulatory documents state that Cadot is not recommended for use by women who are pregnant. This caution is based on a lack of adequate safety data from human studies conducted during pregnancy.

Q: Can I breastfeed while taking Cadot?

A: Official product information states that Cadot is not recommended for use by women who are breastfeeding. This is due to a lack of available information on whether the drug passes into human breast milk and the potential effects on the infant.

Q: Does Cadot require a special diet or restriction?

A: The most important requirement for using Cadot is that it must be taken as an adjunct (in addition) to an Oral Rehydration Solution (ORS). This is required to replace lost fluids and electrolytes. Beyond the necessary ORS, regulatory documents do not specify other special dietary restrictions.

Q: Can Cadot be crushed or split if it's difficult to swallow?

A: The 100 mg product is supplied as hard capsules. Regulatory documents do not explicitly authorize crushing or splitting these capsules. However, formulations for children are available as granules that must be dispersed in water or food, which is the approved method for those who cannot swallow capsules.

Q: What are the long-term safety concerns regarding Cadot?

A: Because the medicine is authorized only for a short duration, typically not exceeding 7 days, there is a lack of safety data available for use over extended periods. This short duration of authorized use reflects the need for medical evaluation if diarrhea persists.

Q: What level of evidence (clinical trials) exists for Cadot's effectiveness?

A: Regulatory approval for Cadot is supported by clinical trials. These studies demonstrated the drug's effectiveness in reducing the volume of stool output and shortening the overall duration of acute diarrhea symptoms when compared to a placebo and when used with Oral Rehydration Solution.

Q: Does Cadot interact with supplements like Vitamin D or fish oil?

A: Official interaction studies focus on other medications, particularly prescription drugs and liver enzyme systems. No specific studies regarding interactions with general dietary supplements like vitamins or fish oil are documented in the regulatory text. This type of interaction is not specifically addressed in the available regulatory documents.

Q: Are there any known contraindications for Cadot?

A: Yes, official documents list contraindications, which are conditions where the drug must not be used. These include a known hypersensitivity (allergy) to the drug or its components, as well as certain rare, inherited problems involving carbohydrate intolerance.

Q: Is it normal to feel a bit nauseous when first starting Cadot?

A: Nausea is not listed among the most common adverse reactions reported in official drug information. However, since the drug treats an acute gastrointestinal condition, any new or concerning symptoms should be reviewed by a healthcare provider.

Q: What are the signs of a serious allergic reaction to Cadot?

A: The regulatory safety profile highlights serious potential reactions like angioedema (swelling of the face, tongue, or throat) and DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms). If these severe signs occur, urgent medical assistance is required.

Q: What should I do if the side effects of Cadot seem too strong?

A: If signs of severe reactions like angioedema appear, regulatory guidance requires immediate discontinuation of the drug. Less severe but concerning side effects should be discussed with a healthcare provider.

Q: Does Cadot have any effect on mood or anxiety?

A: Studies on the drug's mechanism of action confirm that the active substance does not cross the blood-brain barrier. This means its action is localized to the gastrointestinal tract, avoiding effects on the central nervous system, which includes areas that regulate mood and anxiety.

Q: How soon after the two normal stools can I stop taking Cadot?

A: The official administration protocol is to continue taking the medication until the patient records two normal stools. Once this criterion is met, the medication should be ceased, provided the maximum treatment duration has not been exceeded.

Q: Is Cadot a good choice for traveler's diarrhea?

A: Cadot is officially indicated for the symptomatic treatment of acute watery diarrhea as a complementary treatment to oral rehydration. While the specific term 'traveler's diarrhea' is not used in the indication, the drug's approved use covers the primary symptom of this condition.

Q: Is it common to get a rash or skin redness with Cadot?

A: Official regulatory documents classify rash and erythema (skin redness) as Uncommon side effects. This means they are reported to occur in less than 1 out of 100 people and are considered less frequent than Common side effects.

How should Cadot be stored and disposed of?

How to Store and Dispose of Cadot (Racecadotril)

The storage and disposal of Cadot are strictly defined by regulatory guidelines to ensure product stability and environmental safety.

Storage Requirements

Cadot must be stored below 30 C and protected from environmental factors. Official labeling mandates storing the medicine in a dry place and protecting it from moisture. To maintain integrity, the product must be kept in the original packaging, with sachets remaining in the outer carton. For safety, the medicine must be stored out of the sight and reach of children.

Disposal Instructions

Regulatory instructions prohibit discarding Cadot via wastewater or household waste, as the active substance poses an environmental risk. Unused or expired product must be disposed of through an authorized pharmacy, local authority facility, or official medicine return scheme.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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