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## Overview Attapulgite is a naturally occurring hydrated magnesium aluminum silicate used as an antidiarrheal agent. It works by adsorbing water and toxins in the gastrointestinal tract, thereby reducing stool liquidity and frequency. ## Primary Indications * Symptomatic treatment of diarrhea. ## Adult Dosing * **Oral:** 1.5 to 3 grams by mouth every 2 to 4 hours as needed, up to a maximum of 12 grams per 24 hours. ## Pediatric Dosing * **Oral (6 years and older):** 1.5 grams by mouth every 4 hours as needed. Maximum daily dose not established; follow adult maximum of 12 grams/24 hours. * **Oral (under 6 years):** Safety and efficacy have not been established. Consult with a pediatrician for appropriate management. ## Dose Adjustments * **Renal Impairment:** No dose adjustment is typically needed. * **Hepatic Impairment:** No dose adjustment is typically needed. ## Contraindications * Known hypersensitivity to attapulgite. * Severe abdominal pain, nausea, vomiting, or fever suggestive of conditions other than simple diarrhea (e.g., appendicitis, significant infection). ## Adverse Effects * **Gastrointestinal:** Constipation is the most common adverse effect. * **Other:** Rarely, abdominal cramping or bloating. ## Key Drug Interactions Attapulgite can adsorb other medications, potentially decreasing their absorption and efficacy. Administer other oral medications at least 2 hours before or 4 hours after attapulgite. ## Monitoring * Monitor for effectiveness (reduction in diarrhea). * Monitor for signs of constipation. * Assess for resolution of symptoms or need for further medical evaluation if symptoms persist or worsen. ## Clinical Pearls * Ensure adequate hydration, especially with diarrhea. * Attapulgite is a symptomatic treatment and does not address the underlying cause of diarrhea. * If diarrhea persists for more than 48 hours, or if fever or bloody stools are present, discontinue use and seek medical attention. *** *Disclaimer: This information is intended for healthcare professionals. It is essential to consult the most current prescribing information and relevant clinical guidelines for definitive patient care decisions.*