Neomycin, Kaolin and Pectin: Indications, Mechanism of Action, Precautions, Interactions, Contraindications and Side Effects

It is a medication prescribed to reduce bacteria in the intestines. It can also be used for other conditions as determined by your doctor.

Neomycin, kaolin, and pectin are aminoglycoside antibiotic compounds. It kills sensitive bacteria by stopping the production of essential proteins that bacteria need to survive. Bacteria are the cause of diarrheal processes.


The efficacy of any antidiarrheal medication for treating most cases of nonspecific diarrhea is questionable, especially in children.

The preferred treatment for acute nonspecific diarrhea consists of fluid and electrolyte replacement, nutritional therapy, and, if possible, elimination of the underlying cause of diarrhea.

Treatment for diarrhea

The administration of neomycin, kaolin, and pectin can be an adjunct to rest, fluids, and an adequate diet in the symptomatic treatment of mild to moderate acute diarrhea.

It is recommended for use in chronic diarrhea only as a temporary symptomatic treatment until the etiology is determined. The combination of neomycin kaolin and pectin should not be used if diarrhea is accompanied by fever or blood or mucus in the stool.

Mechanism of action/effect

Absorbent and protective

Kaolin is a hydrated natural aluminum silicate that is believed to adsorb large numbers of bacteria and toxins and reduce water loss.


Pectin is a polychronic polymer for which the mechanism of action is unknown. Pectin consists of purified carbohydrates extracted from citrus or apple pomace.

Studies have shown no decrease in stool frequency or stool weight and water content with this combination, even though the stool appeared more formed.


It is not absorbed (up to 90% of pectin is broken down in the gastrointestinal tract).

Precautions to consider

Pregnancy / reproduction

Problems in humans have not been documented. The combination of neomycin, kaolin, and pectin is poorly absorbed after oral administration.


Lactation problems in humans have not been documented. The combination of kaolin and pectin is poorly absorbed after oral administration.


In infants and children up to 3 years of age with diarrhea, its use is not recommended unless directed by a doctor due to the risk of fluid and electrolyte loss. Oral rehydration therapy is recommended in children with diarrhea to prevent fluid and electrolyte loss.


In geriatric patients with diarrhea, caution is advised due to the risk of fluid and electrolyte loss; these patients must be referred to a physician.

Drug interactions and related problems

The following drug interactions and related problems have been selected based on their potential clinical significance (possible mechanism in parentheses where appropriate), not necessarily inclusive.

Combinations containing any of the following medications, depending on the amount present, may also interact with this medication:

  • Anticholinergics or other drugs with anticholinergic activity.
  • Antidyskinetic.
  • Glucoside digital.
  • Lincomycins.
  • Loxapine.
  • Phenothiazine

Oral medications, other (prolonged use of adsorbents may interfere with the absorption of other oral agents administered simultaneously; it is recommended that neomycin, kaolin, and pectin combination should be administered at least 2 to 3 hours before or after other oral medications

Medical considerations / contraindications

The medical considerations/contraindications included have been selected based on their potential clinical importance (reasons are indicated in parentheses, where applicable), not necessarily inclusive.

Risk and benefits to consider when the following medical problems exist:

Dehydration: Although adsorbent antidiarrheals can increase the consistency of stools and decrease the frequency of evacuation, they do not reduce the amount of fluid loss; they only mask its extent.

Rehydration therapy is essential if you have signs or symptoms of dehydration, such as dry mouth, excessive thirst, wrinkled skin, decreased urination, and dizziness or lightheadedness; fluid loss can have serious consequences, such as circulatory collapse and kidney failure, especially in young children.

Suspicion of diarrhea, associated with parasites: adsorbing antidiarrheals can make it challenging to recognize the parasitic causes of diarrhea; If parasitic agents are suspected pathogens, appropriate stool tests should be performed before adsorbent treatment.

Acute dysentery characterized by bloody stools and elevated temperature:  single treatment with adsorbing antidiarrheals may be inappropriate; antibiotic therapy may be required.

Side / adverse effects

The following side / adverse effects have been selected based on their possible clinical significance (possible signs and symptoms) that are not necessarily inclusive:

  • Those indicate they need medical attention only if they continue or are bothersome.
  • Dose-related incidence.
  • Constipation – is usually mild and transient but can rarely lead to fecal impaction.


Use in children: not used in infants and children up to 3 years of age unless prescribed by a doctor due to the risk of dehydration associated with diarrhea; oral rehydration therapy is recommended in children with diarrhea.

Use in the elderly: risk of dehydration associated with diarrhea

Proper use of this medicine
  • Do not use if diarrhea is accompanied by fever, blood, or mucus in the stool; medical contact.
  • It should be given after each loose stool until diarrhea is controlled.
  • It is essential to maintain adequate hydration and a proper diet.


The treating physician will prescribe the dosage as the case may be.

Proper storage

Store below 40 ° C (104 ° F), preferably between 15 and 30 ° C (59 and 86 ° F), in a tightly-closed container unless otherwise specified by the manufacturer. Protect from freezing.