Crofelemer for the treatment of secretory diarrhea

Expert Rev Gastroenterol Hepatol. 2012 Feb;6(1):17-23. doi: 10.1586/egh.11.87.


Secretory diarrhea is a leading cause of morbidity and mortality worldwide. Crofelemer is a first-in-class antidiarrheal agent that simultaneously targets two distinct channels, the cystic fibrosis conductance regulator and calcium-activated chloride channel, responsible for chloride and fluid secretion in the GI tract. Crofelemer is a novel compound extracted from the stem bark latex of the Croton lechleri tree found in the western Amazonian region of South America. There is little to no systemic absorption of crofelemer when given orally and studies have shown minimal toxicity beyond mild gastrointestinal effects. In studies in diarrheal illness associated with primarily a secretory component, such as cholera, travelers' diarrhea and acute infectious diarrhea, crofelemer has shown improvements in stool consistency and duration of symptoms. Less clear, but interesting, results have been observed in other diarrheal diseases associated with a mixed pathology, including diarrhea in patients with HIV and diarrhea-predominant irritable bowel syndrome.

Publication types

  • Review

MeSH terms

  • Antidiarrheals / pharmacology
  • Antidiarrheals / therapeutic use*
  • Chloride Channels / drug effects
  • Cystic Fibrosis Transmembrane Conductance Regulator / drug effects*
  • Diarrhea / drug therapy*
  • Diarrhea / etiology
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Humans
  • Male
  • Proanthocyanidins / pharmacology
  • Proanthocyanidins / therapeutic use*
  • Travel


  • Antidiarrheals
  • Chloride Channels
  • Proanthocyanidins
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • crofelemer