Perenterol: Indications, Mechanism of Action, Dosage, Side Effects, Warnings, Contraindications and Interactions

Saccharomyces boulardii is a tropical yeast strain first isolated from lychee and mangosteen fruits in 1923.

The active ingredient in perenterol is a fungus, yeast type, Saccharomyces boulardii is a microorganism which exerts an antidiarrheal action in the body .

Saccharomyces boulardii is a “probiotic”, which helps fight disease-causing organisms in the gut, such as pathogenic bacteria and yeasts.

Active ingredient

The active ingredient in perenterol is a yeast: lyophilized Saccharomyces boulardii.

Presentation

Perenterol is presented to the market in:

  • Sachets:  contains lyophilized Saccharomyces boulardii, at least 2 billion live cells (250 mg), lactose (32.5 mg), vanillin, flavors and other excipients.
  • Capsules:  Contains lyophilized Saccharomyces boulardii, at least 2 billion live cells (250 mg), lactose (32.5 mg) and other excipients.

Indications

Perenterol is indicated in the treatment of diarrhea such as:

Diarrhea in people taking antibiotics

Saccharomyces boulardii is used in the treatment and prevention of diarrhea due to antibiotics in adults and children.

For every 9 to 13 patients treated with Saccharomyces boulardii during antibiotic treatment, at least one will develop antibiotic-related diarrhea.

Diarrhea after tube feeding

In patients who have had feeding tubes or tubes, Saccharomyces boulardii can prevent diarrhea.

Infant diarrhea

Saccharomyces boulardii also appears to shorten the duration of diarrhea in children with persistent diarrhea.

Helps reduce the time that acute diarrhea persists in infants and children between 12 hours and 1 day.

Rotavirus diarrhea

Research shows that giving Saccharomyces boulardii to infants and children can shorten the duration of diarrhea caused by a rotavirus by approximately 1 day.

Acne

Oral administration of Saccharomyces boulardii improves the appearance of acne skin.

Diarrhea caused by the bacteria Clostridium difficile

Taking Saccharomyces boulardii along with antibiotics appears to help prevent the recurrence of Clostridium difficile-associated diarrhea in people with a history of recurrence.

Taking Saccharomyces boulardii along with antibiotics also appears to help prevent the first bouts of diarrhea associated with Clostridium difficile.

But specialists do not recommend the use of Saccharomyces to prevent the first episodes.

Helicobacter pylori

Oral administration of Saccharomyces boulardii in conjunction with Helicobacter pylori treatment helps in the treatment of this infection, it also helps in the prevention of side effects such as diarrhea and nausea caused by the effects of the standard Helicobacter pylori treatment.

HIV-related diarrhea

Oral administration of Saccharomyces boulardii reduces diarrhea related to the Human Immunodeficiency Virus.

Traveler’s diarrhea

Oral administration of Saccharomyces boulardii prevents traveler’s diarrhea.

Mechanism of action

The main function of Saccharomyces boulardii is to replace the pathogenic flora of the intestine.

Saccharomyces boulardii acts in the digestive tract and restores the balance of the intestinal ecosystem.

Saccharomyces boulardii exerts a protective, preventive and / or curative effect on diarrhea of ​​various origins: enterotoxigenic diarrhea due to Escherichia coli, colitis due to Clostridium difficile, digestive infestations due to Candida, intestinal amebiasis due to Entamoeba histolytica.

The effects observed in animal models can be explained by the following mode of action:

  • Inhibiting the effects or production of bacterial toxins, such as Escherichia coli heat stable enterotoxin, cholera toxin, Clostridium difficile cytotoxin.
  • Reinforcing non-specific anti-infective defenses.
  • Microbial antagonism to various pathogenic microorganisms such as: Escherichia coli, Salmonella typhi, Shigella dysenteriae, Candida albicans.
  • Increased activity of intestinal disaccharidases.

Dose

Oral administration of perenterol is carried out as follows:

For diarrhea

Attack treatment: on the first day 2 sachets or 2 capsules (1 in the morning and 1 in the afternoon).

On medical prescription, the attack treatment can continue if necessary for several days.

Maintenance treatment: the following days 1 sachet or 1 capsule per day until the symptoms disappear.

If vomiting occurs within an hour after taking the medicine, repeat the administration.

Perenterol can be given to babies, children, and adults in the same dose.

Antibiotic-induced diarrhea (prevention and treatment)

Dosage: up to 1 g per day, up to 4 capsules or 4 sachets per day.

Diarrhea after a T4 feeding tube

Dosage: up to 2 g per day, up to 8 sachets per day.

Dlperenterol how to use is:

Envelopes

Mix the contents of the sachet in a liquid or food in the form of a puree and in babies, pour the contents of the sachet over a puree or in a bottle. It must be ensured that the temperature is not too high (it must not exceed 50 ° C).

Capsules

Swallow the capsule with a sip of liquid.

Perenterol can be taken at any time of the day. Administration before meals promotes faster action.

Due to the risk of contamination in the air, the sachets or capsules should not be opened in the patient’s room.

Side effects

The side effects that may occur are:

  • Fever (systemic infections with Saccharomyces).
  • Fungemia in critically ill or immunocompromised patients or patients with central venous catheters.
  • Itching, hives, local or generalized rash, redness of the skin, and Quincke’s edema.
  • Anaphylactic shock.
  • Shortness of breath
  • Swelling of the gastrointestinal tract.

Warnings and Contraindications

Because the risk of systemic colonization with Saccharomyces boulardii has not been evaluated so far, this drug should not be used in patients with weak immune defenses such as HIV, organ transplantation, leukemia, malignancies, radiotherapy, chemotherapy, cortisone treatment in long-term high doses.

Sufficient rehydration should be provided depending on the condition and age of the patient, as well as the severity of the diarrhea.

Very rare cases of fungemia, with positive blood culture for Saccharomyces, have been reported, mainly in patients with central venous catheters, critically ill patients or immunocompromised patients.

In these cases they have manifested most of the time due to fever.

In most of these cases, the course was favorable after discontinuation of Saccharomyces boulardii treatment, administration of antifungal therapy, and, if appropriate, removal of the catheter.

As with any drug containing live microorganisms, special care should be taken when handling the product in the presence of patients, mainly carriers of a central venous catheter, but also peripheral ones, even if these patients are not treated with Saccharomyces boulardii.

Healthcare professionals should wear gloves when handling probiotics during administration, then dispose of them carefully and wash their hands immediately after use.

The product can also be taken with an antibiotic, but not with an antifungal medicine.

Interactions

The active substance, Saccharomyces boulardii, is sensitive to antifungal medications, therefore Perenterol cannot be used at the same time as these medications.

Since Perenterol is made from living cells, it should not be mixed with liquids or foods that are very hot (over 50 ° C), with ice, or with alcohol.

Saccharomyces boulardii can give false positive results in microbiological stool tests.