Racecadotril Dosage for a 1-Year-Old Child
The recommended dosage of racecadotril for a 1-year-old child is 1.5 mg/kg administered orally every 8 hours (three times daily) for up to 3 days, given as adjunctive therapy to oral rehydration solution. 1, 2
Weight-Based Dosing Calculation
- For a typical 1-year-old weighing approximately 9-11 kg, the dose would be 13.5-16.5 mg per dose (1.5 mg/kg × body weight), administered three times daily at 8-hour intervals 1, 2
- The medication should be continued for a maximum of 3 days alongside standard oral rehydration therapy 3, 4
Administration Guidelines
- Always combine racecadotril with oral rehydration solution—it is not a replacement for rehydration therapy but rather an adjunctive antisecretory agent 1, 2
- Administer the dose orally every 8 hours (three times per day) 1, 4
- Treatment duration should not exceed 3 days in most clinical scenarios 3
Evidence Quality and Clinical Context
The dosing recommendation of 1.5 mg/kg three times daily is based on multiple randomized controlled trials in children aged 3 months to 4 years, including specific studies in hospitalized boys 3-35 months of age 1, 2. However, the clinical benefit of racecadotril remains controversial:
- Early studies from 2000-2002 showed significant reductions in stool output (46-50% reduction) and duration of diarrhea in hospitalized children 1, 2, 4
- More recent evidence from 2016 and a 2019 Cochrane review found no significant benefit in reducing diarrheal duration, stool volume, or fluid replacement requirements in both rotavirus and non-rotavirus diarrhea 5, 3
- The 2019 Cochrane review concluded that racecadotril has little benefit and does not support routine use outside of placebo-controlled trials 5
Safety Profile
- Racecadotril appears to be well-tolerated with mostly mild and transient adverse effects 1, 2
- The overall rate of adverse events is similar to placebo (RR 0.90,95% CI 0.66 to 1.22) 5
- Most adverse events reported were mild or moderate in severity 5
Critical Availability Caveat
Racecadotril is not available in North America 6. This medication is primarily used in Europe, Latin America, and parts of Asia. If you are practicing in the United States or Canada, this medication cannot be prescribed.
Clinical Recommendation
Given the conflicting evidence and lack of availability in North America, prioritize standard oral rehydration therapy as the primary treatment for acute diarrhea in a 1-year-old child 5. If racecadotril is available in your region and you choose to use it despite limited evidence of benefit, the dose is 1.5 mg/kg every 8 hours for up to 3 days as adjunctive therapy only 1, 2.