Precautions and warnings

People with infectious diarrhea, liver problems, infants, and those who are pregnant or breastfeeding should receive specific additional treatments at the same time.

Drug Interactions

Certain medicines like co-trimoxazole, ritonavir, and saquinavir can increase how much of this drug is absorbed by the body. Taking it with quinidine may cause breathing problems. Loperamide can make the body absorb more desmopressin from the gut, but it can lower the amount of saquinavir available in the body.

Contraindications

Do not use when stopping peristalsis is not recommended, such as in cases of ileus or megacolon. Also, avoid use in antibiotic-induced colitis, active inflammatory bowel disease, or if the patient develops abdominal swelling while taking the medication. Do not use if there is abdominal pain without diarrhea.

Mode of actions

Loperamide works by slowing down the movement of the intestines. It does this by acting directly on the muscles in the intestinal wall, which helps to reduce peristalsis (the wavelike movements that push food through the gut) and make food take longer to pass through. As a result, it decreases the amount of stool, makes the stool thicker, and reduces the loss of fluids and electrolytes. Loperamide achieves these effects by acting on opioid receptors in the gut and affecting both the circular and longitudinal muscles of the intestine.

Dosage & Administration

Adult:
Acute Diarrhea
4 mg initially, then 2 mg after each loose stool; not to exceed 16 mg/day (8 mg/day for self-medication); discontinue if no improvement seen within 48 hours.

Chronic Diarrhea
4 mg initially, then 2 mg after each loose stool until controlled, and then 4-8 mg/day in divided doses
Traveler's Diarrhea.

4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day

Children:
Acute Diarrhea
First Day of Treatment

2-6 years (13-20 kg): 1 mg q8hr PO
6-8 years: (20-30 kg): 2 mg q12hr PO
8-12 years (>30 kg): 2 mg q8hr PO

Second & Subsequent Doses

0.1 mg/kg PO after each loose stool; not to exceed dose recommended for first 24 hours

Chronic Diarrhea
0.08-0.24 mg/kg/day PO divided q12hr

Traveler's Diarrhea
12 years: 4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect even sometimes unable to demonstrate the risk on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required.

Discuss with your doctors and tell them feedback about this medicine.

There is no specific information about whether this medicine is passed on to the baby through breast milk. Discuss with your doctor before breastfeeding.

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