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Loperamide (Oral)

Generic Name: loperamide (loe-PER-a-mide)

Oral route(Capsule)

Cases of Torsades de Pointes, cardiac arrest, and death have been reported with the use of a higher than recommended dosages of loperamide hydrochloride. Loperamide hydrochloride is contraindicated in pediatric patients less than 2 years of age. Avoid loperamide hydrochloride dosages higher than recommended in adults and pediatric patients 2 years of age and older due to the risk of serious cardiac adverse reactions .

Medically reviewed by Drugs.com. Last updated on Sep 25, 2020.

Commonly used brand name(s)

In the U.S.

  • Diamode
  • Imodium
  • Imodium A-D
  • Imogen
  • Imotil
  • Imperim
  • Kaodene A-D
  • Kao-Paverin Caps

Available Dosage Forms:

  • Capsule, Liquid Filled
  • Solution
  • Tablet
  • Capsule
  • Suspension
  • Liquid

Therapeutic Class: Antidiarrheal

Uses for loperamide

Loperamide is used to control and relieve the symptoms of acute diarrhea. It is also used to treat chronic diarrhea in patients with inflammatory bowel disease. Loperamide helps stop diarrhea by slowing down the movements of the intestines.

Loperamide is also used to decrease the amount of drainage in patients who have ileostomies.

Loperamide capsules are available only with your doctor's prescription.

Before using loperamide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For loperamide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to loperamide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of loperamide in the pediatric population. Safety and efficacy have not been established. Loperamide should not be used in children younger than 2 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of loperamide in the elderly. However, elderly patients are more likely to have heart rhythm problems, which may require caution in patients receiving loperamide.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking loperamide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using loperamide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Capmatinib
  • Lasmiditan
  • Saquinavir
  • Simeprevir
  • Venetoclax

Using loperamide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Gemfibrozil

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of loperamide. Make sure you tell your doctor if you have any other medical problems, especially:

  • Heart rhythm problems, history of—Use with caution. May make this condition worse.
  • HIV or AIDS—Use with caution. May cause side effects to become worse.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Stomach or bowel problems (eg, dysentery, enterocolitis caused by bacteria, pseudomembranous colitis, stomach pain without diarrhea, ulcerative colitis)—Should not be used in patients with these conditions.

Proper use of loperamide

Take loperamide exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Swallow the capsule whole. Do not crush, break, or chew it.

Drink plenty of water while using loperamide.

Dosing

The dose of loperamide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of loperamide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For acute diarrhea:
    • For oral dosage form (capsules):
      • Adults and children 13 years of age and older—At first, 4 milligrams (mg) (2 capsules) after the first loose bowel movement, then 2 mg (1 capsule) after each loose bowel movement after the first dose has been taken. However, dose is usually not more than 16 mg (8 capsules).
      • Children 8 to 12 years of age weighing more than 30 kilograms (kg)—2 mg (1 capsule) 3 times a day.
      • Children 6 to 8 years of age weighing 20 to 30 kg—2 mg (1 capsule) 2 times a day.
      • Children 2 to 5 years of age weighing 20 kg or less—Use the oral solution.
      • Children younger than 2 years of age—Use is not recommended.
    • For oral dosage form (oral solution):
      • Children 8 to 12 years of age weighing more than 30 kilograms (kg)—2 teaspoonfuls (2 mg) 3 times a day.
      • Children 6 to 8 years of age weighing 20 to 30 kg—2 teaspoonfuls (2 mg) 3 times a day.
      • Children 2 to 5 years of age weighing 13 to 20 kg—1 teaspoonful (1 mg) 3 times a day.
      • Children younger than 2 years of age—Use is not recommended.
    • For oral dosage form (tablets):
      • Adults and teenagers—The usual dose is 4 mg (2 tablets) after the first loose bowel movement, and 2 mg (1 tablet) after each loose bowel movement after the first dose has been taken. No more than 8 mg (4 tablets) should be taken in any 24-hour period.
      • Children 9 to 11 years of age—The usual dose is 2 mg (1 tablet) after the first loose bowel movement, and 1 mg (½ tablet) after each loose bowel movement after the first dose has been taken. No more than 6 mg (3 tablets) should be taken in any 24-hour period.
      • Children 6 to 8 years of age—The usual dose is 2 mg (1 tablet) after the first loose bowel movement, and 1 mg (½ tablet) after each loose bowel movement after the first dose has been taken. No more than 4 mg (2 tablets) should be taken in any 24-hour period.
      • Children up to 6 years of age—Use is not recommended unless directed by your doctor.
  • For chronic diarrhea:
    • For oral dosage form (capsules):
      • Adults—At first, 4 milligrams (mg) (2 capsules) after the first loose bowel movement, then 2 mg (1 capsule) after each loose bowel movement after the first dose has been taken. Your doctor may adjust your dose as needed. However, dose is usually not more than 16 mg (8 capsules) per day.
      • Children 2 years of age and older—Use and dose must be determined by your doctor.
      • Children younger than 2 years of age—Use is not recommended.

Missed dose

If you miss a dose of loperamide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using loperamide

If you will be taking loperamide for chronic diarrhea, it is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by loperamide. If you will be taking loperamide for acute diarrhea, you should not use it for more than 2 days, unless directed by your doctor.

Check with your doctor if your diarrhea does not stop after two days or if you develop a fever.

Loperamide may cause heart rhythm problems (eg, torsades de pointes, ventricular arrhythmias). Check with your doctor right away if you or your child have chest pain or discomfort, fast, slow, or irregular heartbeat, fainting, or trouble breathing.

Loperamide may increase your risk for stomach or bowel problems. Check with your doctor right away if you have bloating, blood in the stools, constipation, fever, loss of appetite, nausea or vomiting, or stomach pain.

Loperamide may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Check with your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using loperamide.

Loperamide may cause some people to become dizzy, or drowsy, or tired. Make sure you know how you react to loperamide before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Loperamide side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

  • Bloating
  • constipation
  • loss of appetite
  • nausea
  • stomach pain
  • vomiting

Incidence not known

  • Blistering, peeling, loosening of skin
  • chest pain or discomfort
  • chills
  • cough
  • decrease in urine volume
  • decrease in frequency of urination
  • difficulty in passing urine
  • diarrhea
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • hives or welts, itching, rash
  • irregular or slow heartbeat
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
  • no blood pressure or pulse
  • painful urination
  • palpitations
  • red irritated eyes
  • redness of the skin
  • red skin lesions, often with a purple center
  • sores, ulcers, or white spots in the mouth or on the lips
  • sore throat
  • stopping of heart
  • unconsciousness
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

  • Acid or sour stomach
  • belching
  • dizziness
  • drowsiness
  • dryness of mouth
  • excess air or gas in the stomach or bowels
  • full feeling
  • heartburn
  • indigestion
  • passing gas
  • stomach upset

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.