Thursday, July 12, 2012

loperamide



Generic Name: loperamide (loe PER a mide)

Brand names: Diamode, Imodium A-D, Imodium A-D EZ Chews, Imodium A-D New Formula, Kao-Paverin, Kaopectate 1-D, Maalox Anti-Diarrheal, Imodium, Pepto Diarrhea Control, Imotil, Diar-Aid


What is loperamide?

Loperamide slows the rhythm of digestion so that the small intestines have more time to absorb fluid and nutrients from the foods you eat.


Loperamide is used to treat diarrhea. Loperamide is also used to reduce the amount of stool in people who have an ileostomy (re-routing of the bowel through a surgical opening in the stomach).


Loperamide may also be used for purposes not listed in this medication guide.


What is the most important information I should know about loperamide?


You should not use this medication if you are allergic to loperamide, or if you have stools that are bloody, black, or tarry, or if you have diarrhea that is caused by taking an antibiotic.

Before taking loperamide, tell your doctor if you have a fever, mucus in your stools, a history of liver disease, or if you are taking an antibiotic.


Drink plenty of liquids while you are taking loperamide. It may take up to 48 hours before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 10 days of treatment. Loperamide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What should I discuss with my healthcare provider before taking loperamide?


You should not use this medication if you are allergic to loperamide, or if you have:

  • stools that are bloody, black, or tarry; or




  • if you have diarrhea that is caused by taking an antibiotic.



Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:



  • a fever;




  • mucus in your stools;



  • a history of liver disease; or


  • if you are taking an antibiotic.




FDA pregnancy category C. It is not known whether loperamide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Loperamide can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using loperamide. Do not give this medicine to a child without medical advice.

How should I take loperamide?


Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.


Take loperamide with a full glass of water. Drink extra water while you are taking this medication to keep from getting dehydrated.

Loperamide is usually taken at the first sign of diarrhea, and again if diarrhea comes back. The first dose of loperamide is usually twice as much as the following doses. Do not take this medication more than 3 times in 24 hours without your doctor's advice.


The loperamide chewable tablet must be chewed before swallowing.


Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one.

Immodium A-D Liquid and New Immodium A-D Liquid contain two different strengths of loperamide. If you switch from using one brand to using the other, follow the dosing instructions carefully. Immodium A-D Liquid also contains a small amount of alcohol, but New Immodium A-D Liquid does not.


It may take up to 48 hours before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 10 days of treatment. Store at room temperature away from moisture and heat. Do not freeze liquid loperamide.

See also: Loperamide dosage (in more detail)

What happens if I miss a dose?


Since loperamide is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include dizziness, drowsiness, urinating less than usual, severe stomach cramps or bloating, and vomiting.


What should I avoid while taking loperamide?


Loperamide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink.


Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you are taking an antibiotic and you have diarrhea that is watery or has blood in it, call your doctor. Do not use loperamide to stop the diarrhea unless your doctor has told you to.


Loperamide side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking loperamide and call your doctor at once if you have a serious side effect such as:

  • stomach pain or bloating;




  • ongoing or worsening diarrhea;




  • diarrhea that is watery or bloody; or




  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.



Less serious side effects may include:



  • dizziness;




  • drowsiness, tired feeling;




  • constipation;




  • mild stomach pain; or




  • mild skin rash or itching.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Loperamide Dosing Information


Usual Adult Dose for Diarrhea -- Acute:

Tablets, capsules, and liquid:
Initial: 4 mg orally after the first loose stool, then
Maintenance: 2 mg after each loose stool, not to exceed 16 mg in any 24-hour period. Clinical improvement is usually observed within 48 hours.
Chewable tablets:
Initial: 4 mg after the first loose stool, then
Maintenance: 2 mg after each subsequent loose stool, but not exceeding 8 mg in 24 hours.

Usual Adult Dose for Diarrhea -- Chronic:

Tablets, capsules, and liquid:
Initial: 4 mg orally once followed by 2 mg orally after each loose stool, not to exceed 16 mg in any 24-hour period.
Maintenance: The average daily maintenance dosage is 4 to 8 mg. Clinical improvement is usually observed within 10 days. If clinical improvement is not observed at a maximum dosage of 16 mg for duration of 10 days, symptoms are unlikely to be controlled by further administration.

Usual Pediatric Dose for Diarrhea -- Acute:

2 to 6 years (13 to 20 kg):
Liquid formulation only to be used in this age group.
Initial: 1 mg orally 3 times a day for the first day, then
Maintenance: 0.1 mg/kg/dose after each loose stool, but not exceeding initial dose.

6 to 8 years (20 to 30 kg):
Tablets, capsules, and liquid:
Initial: 2 mg orally twice a day for the first day, then
Maintenance: 0.1 mg/kg/dose after each loose stool, but not exceeding initial dose.
Chewable tablets:
Initial: 2 mg orally after the first loose stool, then
Maintenance: 1 mg orally after each subsequent loose stool, but not exceeding 4 mg in 24 hours.

8 to 12 years (greater than 30 kg):
Tablets, capsules, and liquid:
Initial: 2 mg orally 3 times a day for the first day, then
Maintenance: 0.1 mg/kg/dose after each loose stool, but not exceeding initial dose.
Chewable tablets:
Initial: 2 mg orally after the first loose stool, then
Maintenance: 1 mg orally after each subsequent loose stool, but not exceeding 6 mg in 24 hours.

12 to 18 years:
Tablets, chewable tablets, capsules, and liquid:
Initial: 4 mg after the first loose stool, then
Maintenance: 2 mg after each subsequent loose stool, but not exceeding 8 mg in 24 hours.

Usual Pediatric Dose for Diarrhea -- Chronic:

less than 2 years:
Therapeutic dose for the treatment of chronic diarrhea has not been established for this patient population.


What other drugs will affect loperamide?


Tell your doctor about all other medicines you use, especially saquinavir (Invirase).


This list is not complete and other drugs may interact with loperamide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More loperamide resources


  • Loperamide Side Effects (in more detail)
  • Loperamide Dosage
  • Loperamide Use in Pregnancy & Breastfeeding
  • Drug Images
  • Loperamide Drug Interactions
  • Loperamide Support Group
  • 8 Reviews for Loperamide - Add your own review/rating


  • loperamide Advanced Consumer (Micromedex) - Includes Dosage Information

  • Loperamide Prescribing Information (FDA)

  • Loperamide MedFacts Consumer Leaflet (Wolters Kluwer)

  • Imodium Prescribing Information (FDA)

  • Imodium Consumer Overview

  • Imodium MedFacts Consumer Leaflet (Wolters Kluwer)

  • Loperamide Hydrochloride Monograph (AHFS DI)



Compare loperamide with other medications


  • Diarrhea
  • Diarrhea, Acute
  • Diarrhea, Chronic
  • Lymphocytic Colitis
  • Traveler's Diarrhea


Where can I get more information?


  • Your pharmacist can provide more information about loperamide.

See also: loperamide side effects (in more detail)


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