Treatment of diabetic diarrhea with clonidine

What about clonidine for diarrhoea? A systematic review and meta-analysis of its effect in humans

“…The systematic review of the literature resulted in 24 eligible trials/case series and seven eligible case reports (Figure 1 and Table 1). The case reports [Mcarthur et al 1982;Sacerdote, 1986;Zimmermann et al 1986;Roof, 1987;Migliore et al 1988;Scholz et al 1991;Schworer et al 1995] are discussed narratively in a separate section below because of possible high placebo rates and are not included in the meta-analysis. The remaining 24 trials/case series included 10 studies with healthy volunteers (total sample size = 150 participants) [Schiller et al 1985;Baxter et al 1987;Pressman et al 1987;Baumer et al 1989;Gregersen et al 1989;Rubinoff et al 1989;Thollander et al 1997Thollander et al , 1999Mann and Shinkle, 1998;Viramontes et al 2001] and 14 studies (total sample size = 493 patients) with faecal incontinence, irritable bowel syndrome, diabetes, alcohol withdrawal, heroin withdrawal, ultra-rapid opioid detoxification, short bowel syndrome (high output ileostomy or high rectal output), intestinal transplant and cholera patients [Fedorak et al 1985;Bretzke, 1987;Gupta and Jha, 1988;Rabbani et al 1989;Baumgartner and Rowen, 1991;Morali et al 1991;Rovera et al 1997;Camilleri et al 2003Camilleri et al , 2009Mcdoniel et al 2004;Buchman et al 2006;Farzam and Najafi, 2009;Bharucha et al 2010Bharucha et al , 2014.…”

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“…The only side effect noted with mild dermatitis. 15 In conclusion, although the use of clonidine as an antidiarrheal drug is supported by experimental data, its efficacy, incidence of adverse effects, and administration for diabetic diarrhea is based only on a limited number of clinical reports. Although the dosage regimen was at the upper end of the usual antihypertensive dosage range (0.8-1.2 mg/d or 1-2 patches/wk), these patients appeared to tolerate the clonidine well.…”

“…No information was given concerning any previous adverse reactions to TMP-SMX in the 44 patients. 15 Because S-P is similar to TMP-SMX, Navin et al warned that AIDS patients may be at a similar increased risk for adverse reactions. The authors stated that the long half-life of S-P was an additional disadvantage regarding duration of adverse reactions once they occur.…”

“…They recommended that S-P be used with caution in AIDS patients with a history of adverse reaction to TMP-SMX and that patients should be educated to discontinue taking the drug if a rash develops. 15 Gottleib and Young subsequently published a letter to remind physicians who care for AIDS patients of the risk of hypersensitivity reactions involved with any sulfonamide. These authors stated that of the 30 AIDS patients they had seen who had previous hypersensitivity reactions to TMP-SMX, approximately 75 percent have tolerated Sop without a reaction.…”