Drug Monograph
Full clinical overview, indications, dosage references & safety notes.
Available forms2 forms · 7 strengths documentedShow all ↓
Kaolin light 0.99 g/5 mL Kaogel VP®Kaolin/pectin 5.8 g/0.268 g per 30 mLKaolin/pectin 5.8 g/0.13 g per 30 mL800 mg/80 mg per 5 mL generic veterinary900 mg/50 mg per 5 mL generic veterinary90 grains/2 grains per 30 mL Kaopectolin®, generic humanKaolin 100 mg/mL and pectin 8 mg/mL Pet Pectillin®
Oral paste Pro-Kolin® · concentration not specified
Overview
Kaolin/Pectin (Kaopectolin®) is an oral gastrointestinal adsorbent and protectant used primarily in dogs and cats for the symptomatic management of diarrhea. It has also been used as an adsorbent following the ingestion of certain toxins.
Although commonly used in veterinary medicine, evidence supporting the clinical efficacy of kaolin/pectin is limited: no studies demonstrating effectiveness in either human or veterinary patients were identified, experimental work found it an ineffective binder of Escherichia coli enterotoxin, and clinical studies have failed to show a benefit. Administration may be challenging in some patients because relatively large oral volumes may be required.
Kaolin/pectin may improve stool consistency within 24–48 hours; however, it does not reduce fluid or electrolyte losses from the gastrointestinal tract and does not shorten the duration of the illness. Therefore, it should be considered a supportive therapy rather than a substitute for appropriate management of underlying disease.
Mechanism of Action (MOA): Kaolin/pectin is believed to exert adsorbent and protective effects within the gastrointestinal tract, with a possible additional antisecretory effect. Kaolin may adsorb bacteria and toxins, while the suspension coats irritated gastrointestinal mucosa. The pectin component forms galacturonic acid within the intestinal lumen, lowering intestinal pH.
Indications
- Diarrhea: Used as an oral antidiarrheal agent for the symptomatic treatment of acute diarrhea of nonspecific origin.
- Toxin ingestion: May be used as an adsorbent following ingestion of certain toxins.
Dosage (Reference)
Evidence supporting the efficacy of kaolin/pectin is limited. All reported doses are extra-label and based primarily on anecdotal use.
Dogs & Cats
| Indication | Route | Dose | Frequency | Notes |
|---|---|---|---|---|
| Noninfectious diarrhea | PO | 15–45 mL/animal | At the first sign of diarrhea and after each loose bowel movement. | (label dosage; not FDA-approved). The volume is per animal, not per kilogram. |
| Diarrhea | PO | 5 mL (2.3–6.8 kg); 10 mL (7.3–22.7 kg); 15 mL (>23.2 kg). | Once daily or every 12 hours. | (label dosage; not FDA-approved). PET PECTILLIN® is given every 4 hours according to the labeled weight bands. Because the kilogram values are rounded, use the animal’s weight in pounds when it falls near a boundary; consult a veterinarian for animals weighing <5 lb (2.3 kg). |
| Diarrhea and loose stools | PO | 1–2 mL/kg | 4–6 times daily as needed | Extra-label. Supported by anecdotal use rather than by clinical evidence. |
| Diarrhea of nonspecific origin | PO | 0.5–1 mL/kg | Total daily dose, which may be divided into 3–4 administrations | UK formulary regimen. Expressed as a total for the day rather than as an amount per administration. |
• The 15–45 mL dose is administered per animal, NOT per kg.
Warnings & Precautions
Kaolin/pectin should be used as a supportive therapy and should not delay or replace appropriate treatment of the underlying condition.
- Contraindications: Avoid use in animals with intestinal obstruction or perforation; other references report no specific or absolute contraindications in animals.
- Severe diarrhea: Should not be relied upon as the sole treatment for severe diarrhea.
- Fluid and electrolyte therapy: Does not replace appropriate fluid and electrolyte monitoring or replacement in patients with severe or chronic diarrhea.
- Product formulation differences: Some products previously containing kaolin/pectin may now contain different active ingredients, such as bismuth subsalicylate; in the United States, Kaopectate no longer contains kaolin and all of its formulations contain bismuth subsalicylate. Product labels should be checked carefully before use.
- Cats: Products containing bismuth subsalicylate should be used cautiously, if at all, because of the salicylate component, which is described as toxic to cats.
- Dogs with GI ulceration or bleeding disorders: Bismuth subsalicylate-containing products should also be avoided in dogs with gastroduodenal ulceration and in dogs with bleeding disorders.
- Pregnancy and lactation: Safety has not been established in animals. Use only when the potential maternal benefit outweighs the potential risk to offspring; adsorbent antidiarrheal products should be safe to use during pregnancy and lactation, but at least one current product label directs that it not be used in pregnant dogs or cats.
- When to stop and reassess: Reassess if the animal becomes listless or develops a high fever, and — following the current PET PECTILLIN label — if diarrhea worsens or persists for more than two days.
- Handling raw kaolin powder: If raw kaolin powder is handled, wear an appropriate particulate mask, as pneumonitis can occur if it is inhaled.
Drug Interactions
Kaolin/pectin may reduce the oral absorption of certain medications. When concurrent administration is necessary, separating doses is recommended.
- General management: Unless otherwise stated, concurrent use is not necessarily contraindicated; weigh the potential risks and perform additional monitoring when appropriate.
- Digoxin: May impair oral absorption. Administer at least 2 hours apart.
- Clindamycin and Lincomycin: May reduce oral absorption. Administer kaolin/pectin at least 2 hours before or 3–4 hours after the antibiotic.
- Penicillamine: May reduce oral absorption. Administer at least 2 hours apart.
- Sulfonamides/Trimethoprim: May reduce oral absorption. Administer at least 2 hours apart.
- Tetracyclines: May reduce the absorption of tetracyclines, including doxycycline. Give all oral tetracyclines at least 1 to 2 hours before or after kaolin/pectin.
- Phenothiazines: May reduce the gastrointestinal absorption of oral phenothiazines such as acepromazine. Separate the administrations by at least 2 hours, giving the phenothiazine first.
Side Effects & Overdose
Side Effects
Kaolin/pectin is generally well tolerated, with adverse effects occurring infrequently.
- Constipation: The most commonly reported adverse effect, usually transient and associated with higher doses.
- Fecal impaction: Rarely reported with high doses, particularly in debilitated, very young, or very old patients.
- Salicylate content: Products that contain salicylate can affect animals sensitive to salicylates; the regular-strength formulation contains 8.7 mg/mL of salicylate and the extra-strength formulation 16 mg/mL.
- Fecal electrolyte loss: In rats, kaolin/pectin has been shown to increase fecal sodium and potassium loss during diarrhea.
Overdose
Kaolin/pectin is not systemically absorbed, and serious toxicity following overdose is unlikely.
- Constipation: Excessive dosing may result in constipation requiring treatment.
- Fecal impaction: May rarely occur following administration of large quantities, particularly in debilitated, very old, or very young patients.
Key Notes
Practical clinical points regarding the use of kaolin/pectin in dogs and cats:
- Limited evidence of efficacy: Published evidence supporting the clinical effectiveness of kaolin/pectin is weak.
- Primarily a symptomatic treatment: Used to improve stool consistency rather than treat the underlying cause of diarrhea.
- No effect on fluid loss: May improve stool consistency within 24–48 hours but does not reduce fluid or electrolyte losses from the gastrointestinal tract.
- Not systemically absorbed: Neither kaolin nor pectin is absorbed to a significant extent following oral administration, and up to 90% of the pectin given may be decomposed in the gut.
- Large administration volumes: Oral administration may be difficult in some patients because relatively large volumes may be required.
- Storage: Store in airtight containers at room temperature, between 15°C and 30°C (59°F–86°F), protected from light; protect from freezing.
- Physical incompatibilities: Do not mix with alkalis, heavy metals, salicylic acid, tannic acid or strong alcohol; kaolin/pectin is physically incompatible with all of them.
- Administration: Shake the suspension well before measuring each dose.
- Regulatory status: Kaolin/pectin products are sold over the counter; several are veterinary-labeled but none has been through the FDA approval process, and the current PET PECTILLIN listing carries unapproved-drug status.
