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Loperamide Dosage

Medically reviewed on February 15, 2018.

Applies to the following strengths: 2 mg; 1 mg/5 mL; 1 mg/7.5 mL

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Diarrhea - Acute

4 mg orally after the first loose stool, then 2 mg orally after each unformed stool
Maximum dose: 16 mg per day

Comments:
-Clinical improvement is usually seen within 48 hours.

Use(s): Control and symptomatic relief of acute nonspecific diarrhea

Usual Adult Dose for Diarrhea - Chronic

4 mg orally after the first loose stool, then 2 mg orally after each unformed stool until diarrhea is controlled
Maximum dose: 16 mg per day

Comments:
-Clinical improvement is usually seen within 48 hours.
-After diarrhea is controlled, reduce dose to meet individual requirements
-When optimal daily dose has been established, this dose may be given as a single dose or in divided doses.
-The average maintenance dose in clinical trials was 4 to 8 mg daily.
-If no clinical improvement is seen with 16 mg per day after at least 10 days, symptoms are unlikely to be controlled by further administration.
-Administration may be continued if diarrhea cannot be adequately controlled with diet or specific treatment.

Use(s): Control and symptomatic relief of chronic diarrhea associated with inflammatory bowel disease.

Usual Pediatric Dose for Diarrhea - Acute

2 to 5 years (13 to 20 kg):
First day dosage schedule: 1 mg orally 3 times a day (3 mg total daily dose)
Subsequent daily dosage: 1 mg only after a loose stool, not to exceed 3 mg/day

6 to 8 years (20 to 30 kg):
First day dosage schedule: 2 mg orally twice a day 2 (4 mg total daily dose)
Subsequent daily dosage: 2 mg only after a loose stool, not to exceed 4 mg/day

9 to 12 years (over 30 kg):
First day dosage schedule: 2 mg orally 3 times a day (6 mg total daily dose)
Subsequent daily dosage: 2 mg only after a loose stool, not to exceed 6 mg/day

13 years and older:
4 mg orally after the first loose stool, then 2 mg orally after each unformed stool
Maximum dose: 16 mg per day

Comments:
-Do not use in patients less than 2 years old due to the risks of respiratory depression and serious cardiac adverse reactions.
-Clinical improvement is usually seen within 48 hours.

Use(s): Control and symptomatic relief of acute nonspecific diarrhea

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Use with caution.
-Systemic exposure may be increased due to reduced metabolism.

Precautions

US BOXED WARNING(S):
-Cases of Torsades de Pointes, cardiac arrest, and death have been reported with use of higher than recommended doses.
-Contraindicated in pediatric patients less than 2 years of age.
-Avoid doses higher than recommended due to the risk of serious cardiac adverse reactions.

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:
-Avoid doses higher than recommended due to the risk of serious cardiac reactions.
-Use the non-prescription liquid formulation for patients 2 to 5 years old.
-For patients 6 years and older, either the liquid formulation or tablets/capsules may be used.

General:
-Patients should receive fluid and electrolyte replacement as needed.

Further information

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

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