Drugs List

Therapeutic Indications

Uses

Oral correction of mild to moderate fluid and electrolyte loss.
Treatment of watery diarrhoea of various aetiologies such as gastroenteritis.

Administration

For oral use only.

Handling

The solution should be prepared immediately before use. Any solution remaining may be kept in a fridge for not more than 1 day. If not stored in a fridge, any unused solution should be discarded after 1 hour.

Reconstitution

Reconstitute each sachet with 200ml of drinking water in accordance with the manufacturers' guidelines. Do not add any other substance to the solution.

It is important that the correct volume of water is used for reconstitution as too concentrated a solution may give rise to hyperosmolar diarrhoea or hypernatraemia and solution that is too dilute will not contain the optimal glucose and electrolyte concentration resulting in inadequate replacement.

For infants or where the water is not suitable for drinking, the solution should be prepared from water that has been freshly boiled and cooled. The prepared solution should not be boiled.

Contraindications

Intestinal obstruction
Paralytic ileus
Intractable vomiting
Severe dehydration requiring parenteral fluid therapy
Anuria
Oliguria

Precautions and Warnings

Patients with renal or hepatic diseases should use oral rehydration salts only under medical supervision.

Patients on sodium or potassium restricted diets should use oral rehydration salts only under medical supervision.

Use with caution in patients with glucose-galactose malabsorption syndrome as the products contain glucose.

Take into consideration the glucose content in patients with diabetes mellitus.

Phenylketonuria - some formulations contain aspartame.

If given as a supplement to parenteral fluid replacement therapy, avoid exceeding water and electrolyte requirements.

Chronic or persistent diarrhoea - use only under medical supervision.

If vomiting persists reassess for the possibility of underlying disorders.

If diarrhoea persists reassess for the possibility of underlying disorders.

Infants under 2 years with severe diarrhoea - give under medical advice.

During initial treatment stop all foods (including milk) except breast milk in the case of breast-fed infants.

Advise patient or carers to consult a doctor if symptoms persist for more than 24 - 48hours.

Dioralyte shall not be used for treatment in infants below the age of 24 months without medical supervision.

The solution should be reconstituted only with water. For infants or if the water is not suitable for drinking, the water should be freshly boiled and cooled before use.
Do not boil the solution.
Solution should be used immediately or with in 1 hour of reconstitution. Although solution can be stored for up to 24 hours in the fridge.

Pregnancy and Lactation

Pregnancy

Use oral rehydration salts with caution during pregnancy.

The manufacturer advises medical supervision for use during pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use oral rehydration salts with caution during breastfeeding.

The manufacturer advises medical supervision for use during breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

None stated

Presentation

Oral powder containing:
Sodium chloride
Potassium chloride
Either sodium citrate or sodium bicarbonate, may also contain citric acid
Either anhydrous glucose (dextrose) or glucose (dextrose)

The quantities of the ingredients are such that when reconstituted in accordance with the manufacturers' instructions, the solution contains 50 to 60mmol per litre of sodium ions and are slightly hypo-osmolar.

Drugs List

Therapeutic Indications

Uses

Oral correction of mild to moderate fluid and electrolyte loss.
Treatment of watery diarrhoea of various aetiologies such as gastroenteritis.

Dosage

Doses vary between brands, and so the specific manufacturers' guidelines should be followed.

Adults

Children

Patients with Renal Impairment

Patients with Hepatic Impairment

Additional Dosage Information

Administration

For oral use only.

Handling

The solution should be prepared immediately before use. Any solution remaining may be kept in a fridge for not more than 1 day. If not stored in a fridge, any unused solution should be discarded after 1 hour.

Reconstitution

Reconstitute each sachet with 200ml of drinking water in accordance with the manufacturers' guidelines. Do not add any other substance to the solution.

It is important that the correct volume of water is used for reconstitution as too concentrated a solution may give rise to hyperosmolar diarrhoea or hypernatraemia and solution that is too dilute will not contain the optimal glucose and electrolyte concentration resulting in inadequate replacement.

For infants or where the water is not suitable for drinking, the solution should be prepared from water that has been freshly boiled and cooled. The prepared solution should not be boiled.

Contraindications

Intestinal obstruction
Paralytic ileus
Intractable vomiting
Severe dehydration requiring parenteral fluid therapy
Anuria
Oliguria

Precautions and Warnings

Patients with renal or hepatic diseases should use oral rehydration salts only under medical supervision.

Patients on sodium or potassium restricted diets should use oral rehydration salts only under medical supervision.

Use with caution in patients with glucose-galactose malabsorption syndrome as the products contain glucose.

Take into consideration the glucose content in patients with diabetes mellitus.

Phenylketonuria - some formulations contain aspartame.

If given as a supplement to parenteral fluid replacement therapy, avoid exceeding water and electrolyte requirements.

Chronic or persistent diarrhoea - use only under medical supervision.

If vomiting persists reassess for the possibility of underlying disorders.

If diarrhoea persists reassess for the possibility of underlying disorders.

Infants under 2 years with severe diarrhoea - give under medical advice.

During initial treatment stop all foods (including milk) except breast milk in the case of breast-fed infants.

Advise patient or carers to consult a doctor if symptoms persist for more than 24 - 48hours.

Dioralyte shall not be used for treatment in infants below the age of 24 months without medical supervision.

The solution should be reconstituted only with water. For infants or if the water is not suitable for drinking, the water should be freshly boiled and cooled before use.
Do not boil the solution.
Solution should be used immediately or with in 1 hour of reconstitution. Although solution can be stored for up to 24 hours in the fridge.

Pregnancy and Lactation

Pregnancy

Use oral rehydration salts with caution during pregnancy.

The manufacturer advises medical supervision for use during pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use oral rehydration salts with caution during breastfeeding.

The manufacturer advises medical supervision for use during breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Effects on Ability to Drive and Operate Machinery

None known

Counselling

Advise patients or carers to seek medical advice if the diarrhoea does not resolve promptly or if the patient is a child under 3 years of age.

Advise patient or carers to consult a doctor if symptoms persist for more than 24 - 48hours.

Advise patients to prepare the solution in accordance with the manufacturer's instructions and to discard any solution not used after 1 hour or 24 hours if stored in a fridge.

Side Effects

None stated

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Shelf Life and Storage

Store in a cool dry place.

Further Information

Last Full Review Date: April 2011

Reference Sources

Summary of Product Characteristics, Dioralyte Sachets Natural, Blackcurrant & Citrus. Sanofi-Aventis. Revised March 2020.

Summary of Product Characteristics, Electrolade Banana. Actavis. Revised February 2010

Summary of Product Characteristics, Electrolade Blackcurrant. Actavis. Revised February 2010

Summary of Product Characteristics, Electrolade Lemon and Lime. Actavis. Revised February 2010

Summary of Product Characteristics, Electrolade Orange. Actavis. Revised February 2010

Summary of Product Characteristics, Rehydration Treatment. Boots company plc. Revised March 2010

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 15 September 2017