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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]" /><meta name="citation_title" content="Crofelemer" /><meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="citation_date" content="2017/11/02" /><meta name="citation_pmid" content="31643647" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK548325/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Crofelemer" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="DC.Date" content="2017/11/02" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK548325/" /><meta name="description" content="Crofelemer is an antidiarrheal agent derived from the red sap of the South American plant Croton lechleri, which is used to treat noninfectious diarrhea in HIV positive patients on antiretroviral therapy. Crofelemer is associated with occasional instances of serum enzyme elevations during therapy, but has not been linked to cases of clinically apparent acute liver injury." /><meta name="og:title" content="Crofelemer" /><meta name="og:type" content="book" /><meta name="og:description" content="Crofelemer is an antidiarrheal agent derived from the red sap of the South American plant Croton lechleri, which is used to treat noninfectious diarrhea in HIV positive patients on antiretroviral therapy. Crofelemer is associated with occasional instances of serum enzyme elevations during therapy, but has not been linked to cases of clinically apparent acute liver injury." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK548325/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/livertox/Crofelemer/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK548325/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK548325_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK548325_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Crizotinib/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/CyclizineChlorcycl/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK548325_"><span class="title" itemprop="name">Crofelemer</span></h1><p class="small">Last Update: <span itemprop="dateModified">November 2, 2017</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="Crofelemer.OVERVIEW"><h2 id="_Crofelemer_OVERVIEW_">OVERVIEW</h2><div id="Crofelemer.Introduction"><h3>Introduction</h3><p>Crofelemer is an antidiarrheal agent derived from the red sap of the South American plant Croton lechleri, which is used to treat noninfectious diarrhea in HIV positive patients on antiretroviral therapy. Crofelemer is associated with occasional instances of serum enzyme elevations during therapy, but has not been linked to cases of clinically apparent acute liver injury.</p></div><div id="Crofelemer.Background"><h3>Background</h3><p>Crofelemer (kroe fel' e mer) is a botanical antidiarrheal agent that is used to treat noninfectious diarrhea in HIV seropositive patients taking antiretroviral medications. Crofelemer is derived from the red sap of the South American plant Croton lechleri, which has been used for centuries to treat diarrheal illness. The active antidiarrheal product in crofelemer appears to be a large macromolecular, oligomeric proanthocyanidin which has been shown to decrease chloride secretion in the intestine by inhibition of the cystic fibrosis transmembrane conductance regulator (CFTR), as well as calcium-activated chloride channels. In large clinical trials, daily therapy with crofelemer was found to decrease watery bowel movements and improve stool consistency in patients with HIV infection receiving antiretroviral therapy, and who had persistent diarrhea that could not be attributed to an infectious cause. Crofelemer was approved for use in the United States in 2013, the first herbal medication to be approved for a specific medical use and first agent approved for therapy of noninfectious diarrhea in HIV positive patients. Crofelemer is available in tablets of 125 mg under the commercial name Mytesi. The typical dose is one tablet twice daily. Side effects are uncommon and generally mild, but can include flatulence, bloating, nausea, constipation, increased bilirubin, cough and symptoms of upper respiratory illness.</p></div><div id="Crofelemer.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>During long term use of crofelemer in preregistration studies, serum <a class="def" href="/books/n/livertox/glossary/def-item/glossary.alanine-aminotransferase-alt-/">ALT</a> elevations occurred in 2.7% of treated subjects, but the background rate of serum enzyme elevations in this population was not defined in these open label studies. The elevations were generally mild and self-limited, rarely leading to dose reduction or discontinuation of therapy. There have been no reports of clinically apparent liver injury attributable to crofelemer, although it has had only limited wide scale use.</p><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.likelihood-score/">Likelihood score</a>: E (unlikely cause of clinically apparent liver injury).</p></div><div id="Crofelemer.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The mechanism by which crofelemer might lead to serum enzyme elevations or liver injury is not known. Very little of the agent is absorbed systematically and, although it can be metabolized by the hepatic cytochrome P450 system, there is little evidence that adequate levels are achieved during oral therapy to cause clinically significant drug-drug interactions with other agents. In clinical trials of crofelemer, no evidence of drug-drug interactions was identified.</p></div><div id="Crofelemer.Outcome_and_Management"><h3>Outcome and Management</h3><p>Serum enzyme elevations during crofelemer therapy are generally mild and self-limited, resolving even without drug interruption or dose reduction. Other causes of liver injury should be sought before assuming that the abnormalities are due to crofelemer.</p><p>Drug Class: <a href="/books/n/livertox/GastrointestinalAgen/">Gastrointestinal Agents</a>; <a href="/books/n/livertox/HerbalDietarySuppl/">Herbal and Dietary Supplements</a></p></div></div><div id="Crofelemer.PRODUCT_INFORMATION"><h2 id="_Crofelemer_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><div id="Crofelemer.BPI" class="box"><p>
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<b> REPRESENTATIVE TRADE NAMES</b>
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</p><p>Crofelemer – Mytesi®</p><p>
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<b>DRUG CLASS</b>
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</p><p>Antidiarrheal Agents</p><p>
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<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Crofelemer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
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</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div></div><div id="Crofelemer.CHEMICAL_FORMULA_AND_STRUCTUR"><h2 id="_Crofelemer_CHEMICAL_FORMULA_AND_STRUCTUR_">CHEMICAL FORMULA AND STRUCTURE</h2><div id="Crofelemer.T1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548325/table/Crofelemer.T1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Crofelemer.T1_lrgtbl__"><table><thead><tr><th id="hd_h_Crofelemer.T1_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">DRUG</th><th id="hd_h_Crofelemer.T1_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">CAS REGISTRY NUMBER</th><th id="hd_h_Crofelemer.T1_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Crofelemer.T1_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Crofelemer.T1_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">Crofelemer</td><td headers="hd_h_Crofelemer.T1_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135030308" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">148465-45-6</a>
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</td><td headers="hd_h_Crofelemer.T1_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">Unspecified</td><td headers="hd_h_Crofelemer.T1_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">
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<div class="graphic"><img src="/books/NBK548325/bin/Crofelemer_Structure.jpg" alt="Crofelemer Chemical Structure" /></div>
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</td></tr></tbody></table></div></div></div><div id="Crofelemer.ANNOTATED_BIBLIOGRAPHY"><h2 id="_Crofelemer_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 02 November 2017</p><ul class="first-line-outdent"><li><div class="bk_ref" id="Crofelemer.R1">Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and diagnostic chemicals. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999: pp. 731-4.<div><i>(Expert review of hepatotoxicity published in 1999; crofelemer is not discussed).</i></div></div></li><li><div class="bk_ref" id="Crofelemer.R2">Seeff L, Stickel F, Navarro VJ. Hepatotoxicity of herbals and dietary supplements. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 631-58.<div><i>(Review of hepatotoxicity of herbal and dietary supplements [HDS]; crofelemer is not discussed).</i></div></div></li><li><div class="bk_ref" id="Crofelemer.R3">Tradtrantip L, Namkung W, Verkman AS. Crofelemer, an antisecretory antidiarrheal oligomer extracted from Croton lechleri, targets two distinct intestinal chloride channels. Mol Pharmacol 2010; 77: 69-78. [<a href="/pmc/articles/PMC2802429/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2802429</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19808995" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19808995</span></a>]<div><i>(Investigation of the antidiarrheal mechanism of action of crofelemer found that it inhibited two different chloride channels [CFTR and calcium-activated chloride channels] in vitro in human intestinal cell lines).</i></div></div></li><li><div class="bk_ref" id="Crofelemer.R4">MacArthur RD, Hawkins TN, Brown SJ, LaMarca A, Clay PG, Barrett AC, Bortey E, et al. Efficacy and safety of crofelemer for noninfectious diarrhea in HIV-seropositive individuals (ADVENT trial): a randomized, double-blind, placebo-controlled, two-stage study. HIV Clin Trials 2013; 14: 261-73. [<a href="https://pubmed.ncbi.nlm.nih.gov/24334179" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24334179</span></a>]<div><i>(Among 374 adults with HIV infection and noninfectious diarrhea attributed to antiretroviral therapy enrolled in a two stage, placebo controlled study of different doses of crofelemer, serum levels were undetectable in 96% of patients and adverse event rates were similar to those of placebo; during an open label extension study, serum ALT elevations occurred in 2.7% of crofelemer treated subjects, but all resolved and there were no serious adverse hepatic events or instances of clinically apparent liver injury).</i></div></div></li><li><div class="bk_ref" id="Crofelemer.R5">Crofelemer (Fulyzaq) for antiretroviral-induced diarrhea. Med Let Drug Therap 2013; 55 (1421): 59-60. [<a href="https://pubmed.ncbi.nlm.nih.gov/23863919" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23863919</span></a>]<div><i>(Concise review of the mechanism of action, efficacy, safety and costs of crofelemer as therapy of noninfectious diarrhea in patients with HIV infection taking antiretroviral agents mentions that adverse events are uncommon and mild; no mention of ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Crofelemer.R6">Frampton JE. Crofelemer: a review of its use in the management of non-infectious diarrhea in adult patients with HIV/AIDS on antiretroviral therapy. Drugs 2013; 73: 1121-9. [<a href="https://pubmed.ncbi.nlm.nih.gov/23807722" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23807722</span></a>]<div><i>(Systematic review of the literature on the mechanism of action, efficacy and safety of crofelemer in noninfectious diarrhea among antiretroviral treated adults with HIV infection, mentions that adverse events were uncommon and mild, but could include flatulence [3.1%], abdominal distention [1/7%], constipation [1.7%], dyspepsia [1.3%], nausea [1.3%] and ALT elevations [1.3%]).</i></div></div></li></ul></div><div id="bk_toc_contnr"></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK548325/?report=reader">PubReader</a></li><li><a href="/books/NBK548325/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK548325" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK548325" style="display:none" title="Cite this Page"><div class="bk_tt">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Crofelemer. 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<a href="https://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&pubmedfilters=true&term=(Crofelemer/AE)+AND+Human%5BMH%5D+AND+(drug+induced+liver+injury+OR+jaundice/CI+OR+bile+duct+diseases/CI+OR+liver/DE+OR+liver+diseases/CI)+AND+(%221900/1/1%22%5BEDat%5D%3A%222999/12/31%22%5BEDat%5D)" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Recent References on Crofelemer: from PubMed.gov</a>
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<a href="https://clinicaltrials.gov/ct2/results?term=Crofelemer" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Trials on Crofelemer: from ClinicalTrials.gov</a>
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</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="discovery_db_links" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pmc&DbFrom=books&Cmd=Link&LinkName=books_pmc_refs&IdsFromResult=4857668" ref="log$=recordlinks">PMC</a><div class="brieflinkpop offscreen_noflow">PubMed Central citations</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pcsubstance&DbFrom=books&Cmd=Link&LinkName=books_pcsubstance&IdsFromResult=4857668" ref="log$=recordlinks">PubChem Substance</a><div class="brieflinkpop offscreen_noflow">Related PubChem Substances</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pubmed&DbFrom=books&Cmd=Link&LinkName=books_pubmed_refs&IdsFromResult=4857668" ref="log$=recordlinks">PubMed</a><div class="brieflinkpop offscreen_noflow">Links to PubMed</div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/23888120" ref="ordinalpos=1&linkpos=1&log$=relatedarticles&logdbfrom=pubmed">Crofelemer for the treatment of chronic diarrhea in patients living with HIV/AIDS.</a><span class="source">[HIV AIDS (Auckl). 2013]</span><div class="brieflinkpop offscreen_noflow">Crofelemer for the treatment of chronic diarrhea in patients living with HIV/AIDS.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Patel TS, Crutchley RD, Tucker AM, Cottreau J, Garey KW. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">HIV AIDS (Auckl). 2013; 5:153-62. Epub 2013 Jul 15.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/24070150" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Crofelemer, a novel agent for treatment of non-infectious diarrhea in HIV-infected persons.</a><span class="source">[Expert Rev Gastroenterol Hepat...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Crofelemer, a novel agent for treatment of non-infectious diarrhea in HIV-infected persons.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Chordia P, MacArthur RD. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Expert Rev Gastroenterol Hepatol. 2013 Sep; 7(7):591-600. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/22149578" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Crofelemer for the treatment of secretory diarrhea.</a><span class="source">[Expert Rev Gastroenterol Hepat...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Crofelemer for the treatment of secretory diarrhea.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Cottreau J, Tucker A, Crutchley R, Garey KW. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Expert Rev Gastroenterol Hepatol. 2012 Feb; 6(1):17-23. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/19808995" ref="ordinalpos=1&linkpos=4&log$=relatedarticles&logdbfrom=pubmed">Crofelemer, an antisecretory antidiarrheal proanthocyanidin oligomer extracted from Croton lechleri, targets two distinct intestinal chloride channels.</a><span class="source">[Mol Pharmacol. 2010]</span><div class="brieflinkpop offscreen_noflow">Crofelemer, an antisecretory antidiarrheal proanthocyanidin oligomer extracted from Croton lechleri, targets two distinct intestinal chloride channels.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Tradtrantip L, Namkung W, Verkman AS. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Mol Pharmacol. 2010 Jan; 77(1):69-78. Epub 2009 Oct 6.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/23807722" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Crofelemer: a review of its use in the management of non-infectious diarrhoea in adult patients with HIV/AIDS on antiretroviral therapy.</a><span class="source">[Drugs. 2013]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Crofelemer: a review of its use in the management of non-infectious diarrhoea in adult patients with HIV/AIDS on antiretroviral therapy.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Frampton JE. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Drugs. 2013 Jul; 73(10):1121-9. </em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=31643647" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=31643647" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c8dec4a68b6b5afc6b86e1">Crofelemer - LiverTox</a><div class="ralinkpop offscreen_noflow">Crofelemer - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c8dec3ab82281a80331020">Crizotinib - LiverTox</a><div class="ralinkpop offscreen_noflow">Crizotinib - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c8dec2ab82281a80330c75">Crizanlizumab - LiverTox</a><div class="ralinkpop offscreen_noflow">Crizanlizumab - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c8dec1ab82281a803308a9">Cranberry - LiverTox</a><div class="ralinkpop offscreen_noflow">Cranberry - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c8dec0ab82281a803303b8">Covid-19 Vaccines - LiverTox</a><div class="ralinkpop offscreen_noflow">Covid-19 Vaccines - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
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stroke: #FFFFFF;
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stroke-width: 8;
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<path class="st10" d="M159,99.1h-24V88.4c0-5,3.3-6.2,5.7-6.2h16.8V60l-24.4-0.1c-22.1,0-26.2,16.5-26.2,27.1v12.1H90v22.5h16.9 v67.5H135v-67.5h21.7L159,99.1z"></path>
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<title>Youtube</title>
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<path class="st5" d="M88.4,1037.4c-10.4,0-18.7,8.3-18.7,18.7v40.1c0,10.4,8.3,18.7,18.7,18.7h72.1c10.4,0,18.7-8.3,18.7-18.7 v-40.1c0-10.4-8.3-18.7-18.7-18.7H88.4z M115.2,1058.8l29.4,17.4l-29.4,17.4V1058.8z"></path>
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<p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br />
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<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br />
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<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p>
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<p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br />
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<a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br />
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