From the Guidelines

Racecadotril (Acetorphan) is used to treat diarrhoea, particularly in adult cancer patients and in cases of immunotherapy-induced diarrhoea.

It is used as an antisecretory agent to reduce stool volume and is recommended for the treatment of grade 1 diarrhoea in adult cancer patients, in combination with oral rehydration and antidiarrhoeal treatment 1.
It can be used as an alternative to loperamide for the treatment of mild diarrhoea, although its availability may be limited in some regions 1.
The exact mechanism of action of racecadotril is not fully understood, but it is thought to inhibit the enzyme enkephalinase, which breaks down endogenous opioids, thereby reducing intestinal secretion and motility 1.

The dosage of racecadotril is not specified in the provided evidence, but it is recommended to be used in combination with oral rehydration and antidiarrhoeal treatment 1.
It is essential to note that racecadotril is not available in North America, and its use may be limited to certain regions 1.

The safety and efficacy of racecadotril have been evaluated in several studies, and it has been shown to be effective in reducing stool volume and improving symptoms of diarrhoea 1.
However, its use should be cautious, and patients should be advised about the potential risks and benefits of treatment with racecadotril, particularly in cases of severe or life-threatening diarrhoea 1.

From the Research

Racecadotril is an inhibitor of the enzyme neutral endopeptidase (NEP), which increases exposure to NEP substrates including enkephalins and atrial natriuretic peptide (ANP) 2.
The primary use of racecadotril is in the treatment of acute diarrhea, where it has been shown to be effective in reducing stool output and the duration of diarrhea 2, 3, 4, 5.
Racecadotril has been compared to other treatments such as loperamide, and has been found to be at least as effective with fewer adverse events 2, 4, 5.
The drug has been studied in various populations, including adults and children, and has been found to be safe and well-tolerated 2, 3, 6, 4, 5.

Racecadotril has been tested in three main therapeutic areas: as an analgesic, in cardiovascular diseases, and in the treatment of acute diarrhea 2.
In the treatment of acute diarrhea, racecadotril has been found to be effective in reducing the duration and severity of symptoms 3, 4, 5.
In cardiovascular diseases, results from animal studies were promising, but clinical results have not shown substantial therapeutic benefit over existing treatment options 2.

Several studies have demonstrated the efficacy and safety of racecadotril in the treatment of acute diarrhea in children 6, 4, 5.
A systematic review and meta-analysis of randomized controlled trials found that racecadotril was more efficacious than other treatments except for loperamide, and had a tolerability similar to placebo and better than loperamide 4.
Another systematic review and meta-analysis found that racecadotril was effective in reducing the duration of illness and stool output in children with acute diarrhea, and appeared to be safe and well-tolerated 5.