Loperamide / Simethicone Dosage

Applies to the following strengths: 2 mg-125 mg

Usual Adult Dose for Diarrhea - Acute

Loperamide 4 mg-simethicone 250 mg orally once after the first loose stool, followed by loperamide 2 mg-simethicone 125 mg orally once after each subsequent loose stool

Maximum dose: Loperamide 8 mg-simethicone 500 mg/24 hours
Duration of therapy: Up to 2 days

Comments:

Doses should be taken on an empty stomach (e.g., approximately 2 hours after a meal or 1 hour before a meal).
Patients should take each dose with a full glass of water.

Use: Relief of symptoms related to diarrhea and gas (bloating, cramps, pressure)

Usual Pediatric Dose for Diarrhea - Acute

Age-based dosing:
Under 2 years: Not recommended.

2 to 5 years: Patients should consult with their healthcare provider.

6 to 8 years: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool

Maximum dose: Loperamide 4 mg-simethicone 250 mg/24 hours
Duration of therapy: Up to 2 days

9 to 11 years: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool

Maximum dose: Loperamide 6 mg-simethicone 375 mg/24 hours
Duration of therapy: Up to 2 days

12 years and older: Loperamide 4 mg-simethicone 250 mg orally once after the first loose stool, followed by loperamide 2 mg-simethicone 125 mg orally once after each subsequent loose stool

Maximum dose: Loperamide 8 mg-simethicone 500 mg/24 hours
Duration of therapy: Up to 2 days

Weight-based dosing:
Up to 15 kg: Not recommended.

15.5 to 21.4 kg: Patients should consult with their healthcare provider.

21.8 to 26.8 kg: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool

Maximum dose: Loperamide 4 mg-simethicone 250 mg/24 hours
Duration of therapy: Up to 2 days

27.3 to 43.2 kg: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool

Maximum dose: Loperamide 6 mg-simethicone 375 mg/24 hours
Duration of therapy: Up to 2 days

Comments:

Weight-based dosing is preferred; however, this drug may be dosed based on age.
Doses should be taken on an empty stomach (e.g., approximately 2 hours after a meal or 1 hour before a meal).
Patients should take each dose with a full glass of water.

Use: Relief of symptoms related to diarrhea and gas (bloating, cramps, pressure)

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Use with caution.

Dose Adjustments

Clinical improvement not observed or within 2 days OR worsening of symptoms during treatment: Discontinue administration. Patients should contact their healthcare provider.

Patients who develop abdominal swelling or bulging: Patients should promptly discontinue treatment and contact their healthcare provider.

Patients who have difficulty swallowing the caplet: Patients should stop treatment and consult with their healthcare provider.

Precautions

CONTRAINDICATIONS:

Hypersensitivity, including rashes, to the active components or any of the ingredients
Patients with bloody or black stools
Patients with difficulty swallowing

Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

Patients should take each dose with a full glass of water.

Storage requirements:

Protect from light.

General:

Patients should receive fluid and electrolyte replacement therapy as needed.

Patient advice:

Inform patients that diarrheal syndromes may cause dizziness, drowsiness, tiredness, and they should avoid driving or operating machinery if these side effects occur.
Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
Patients should be instructed to avoid exceeding the recommended dose and/or the duration of treatment.