Crofelemer

What is crofelemer?

Crofelemer (brand name Canlevia®-CA1) is an antidiarrheal drug that is conditionally approved by the U.S. Food and Drug Administration (FDA) to treat chemotherapy-induced diarrhea in dogs. Due to conditional approval, crofelemer must be used as labeled. Do not confuse crofelemer with sevelamer. Crofelemer is currently not available in Canada.

How do I give my pet crofelemer?

• Crofelemer comes in tablet form (delayed release).
• Tablets are given orally (by mouth).
• Delayed-release tablets should not be broken, crushed, or chewed.
• Give this medication with food or within 30 minutes of feeding. If stomach upset occurs, try giving the medication with food.
• Give this medication to your pet for the entire time prescribed by your veterinarian, even if it appears that your pet is feeling better.

This medication will take effect in about 1 to 2 hours; however, effects may not be noted outwardly for a few days. 

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and continue with the regular schedule. Do not give the pet two doses at once.

Are there any potential side effects from crofelemer?

Crofelemer may cause the following side effects:

• Changes in stool appearance
• Vomiting 
• Decreased appetite
• Decreased energy

These signs should go away during treatment; if they continue, contact your veterinarian. Serious adverse reactions may occur. If any of the following signs develop, stop giving crofelemer and contact your veterinarian immediately:

• Significant vomiting or loss of appetite
• Extreme tiredness
• Coughing
• Lack of coordination
• An allergic reaction such as irregular breathing, rash, fever, puffiness and swelling around the face

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment and notify your veterinarian if you have any concerns.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE in:

• Dogs experiencing diarrhea caused by a toxin or infection
• Dogs that are pregnant, nursing, or used for breeding
• Dogs with a small body size

Are there any drug interactions I should be aware of?

Several medications should be USED WITH CAUTION when given with crofelemer, including:

• Anticholinergic agents (e.g., atropine)
• H1 receptor antihistamines (e.g., diphenhydramine)
• Opioids (e.g., buprenorphine)
• Other antidiarrheal agents (e.g., loperamide)
• Phenothiazines (e.g., acepromazine)

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Your veterinarian may prescribe two different medications, and a drug interaction may be anticipated. In this case, your veterinarian may vary the dose and monitor your pet more closely.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store crofelemer?

• Store tablets in a tightly sealed container, protected from light, at room temperature.
• Leave tablets in the manufacturer's packaging until needed to ensure they are protected from air.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.