Kaolin-Pectin Suspension

Charge 600 mL of water into a suitable j acketed mixing tank. 

Cool to 70°C, add the magnesium aluminum silicate, and mix for 30 minutes or until evenly dispersed. 

Add kaolin with constant mixing at 70°C until evenly dispersed. 

Add the sodium CMC premium low viscosity and mix for at least 30 minutes, maintaining the temperature at 70°C. 

Cool to 60°C and hold at this temperature. Add in order cyclamate calcium and saccharin calcium and mix thoroughly for 20 minutes. While mixing, cool to room temperature and allow standing overnight to hydrate. After overnight standing (minimum 12 hours), mix for 30 minutes. 

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Albert KS, Ayres JW, Di Santo AR, et al. Influence of kaolin-pectin suspension on digoxin bioavailability. J Pharm Sci 1978 67 1582-1586. 

Drug Interactions - Absorption half-life of the antibiotic, clindamycin, was prolonged in human subjects when a kaolin-pectin antidiarrheal suspension was coadministered, although the extent of absorption remained the same. On the other hand, both the rate and the extent of absorption of digoxin were lower when it was coadministered with the same kaolin-pectin suspension. Physical absorption and alterations in gut transit time appeared to partly explain the findings. 

Co-trimoxazole suspension (trimethoprim 160 mg with sulfamethoxazole 800 mg) was given to 8 healthy subjects, with and without 20 mL of kaolin-pectin suspension. The kaolin-pectin reduced the AUC and the maximum serum levels of the trimethoprim by about 12% and 20%, respectively. Changes in the sulfamethoxazole pharmacokinetics were not significant. The probable reason for this reduction in AUC is that trimethoprim is adsorbed onto the kaolin-pectin, which reduces the amount available for absorption. However, the reductions are small and unlikely to be clinically relevant. 

Albert KS, Elliott WJ, Abbott RD, Gilbertson TJ, Data JL. Influence of kaolin-pectin suspension on steady-state plasma digoxin levels. J Clin Pharmacol (1981) 21, 449-55. 

The concurrent use of kaolin-pectin suspension and digoxin reduced the peak plasma digoxin levels of 7 patients by 36%, while the AUCq 24 was reduced by 15%. Conversely, when two doses of kaolin-peetin were taken, the first 2 hours before and the other 2 hours after the digoxin, no significant changes were seen. ... 

Kaolin, Pectin Kao-Spen, Kapectolin 60-120 mL regular-strength suspension after each loose, bowel movement... 

The bioavailability of a single 500-mg dose of metronidazole in 5 healthy subjeets was not significantly changed by 30 mL of a kaolin-pectin antid-iarrhoeal mixture. However, a 14.5% reduction in metronidazole bioavailability occurred with 30 mL of an aluminiiim hydroxide/simeticone suspension, and a 21.3% reduction occurred with a single 4-g dose of colestyramine. The clinical importance of these reductions is probably small, and no special precautions seem necessary. 

Oral (typical) 5.85 g kaolin and 260 mg pectin per 30 mL suspension Loperamide (generic, Imodium, others)... 

Giq)ta KQ Desai NK, Satoskar RS, Gi la C, Gos mi SN. Effect of pectin and kaolin on bioavailability of co-trimoxazole suspension. IntJCtin Pharmacol TherT[Pg.302]

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