Loperamide Hydrochloride(loe per’ a mide)
Prescription: Apo-Loperamide (CAN), Imodium
OTC: Diar-Aid Caplets, Imodium A-D, K-Pek Il, Neo-Diaral, Pepto Diarrhea Control
PREGNANCY CATEGORY B
Drug class
Antidiarrheal
Therapeutic Actions
Slows intestinal motility and affects water and electrolyte movement through the bowel by inhibiting peristalsis through direct effects on the circular and longitudinal muscles of the intestinal wall.
Indications
Control and symptomatic relief of acute nonspecific diarrhea and chronic diarrhea associated with inflammatory bowel disease
Reduction of volume of discharge from ileostomies
OTC use: Control of diarrhea, including traveler’s diarrhea
Contraindications and Cautions
Contraindicated with allergy to loperamide, patients who must avoid constipation, diarrhea associated with organisms that penetrate the intestinal mucosa (Escherichia coli, Salmonella, Shigella, Clostridium difficile).
Use cautiously with hepatic impairment, acute ulcerative colitis, pregnancy, and lactation.
Available Forms
Tablets—2 mg; capsules—2 mg; liquid—1 mg/5 mL; 1 mg/7.5 mL
Dosages
Adults
Acute diarrhea: Initial dose of 4 mg PO followed by 2 mg after each unformed stool. Do not exceed 16 mg/day unless directed by a physician. Clinical improvement is usually seen within 48 hr.
Chronic diarrhea: Initial dose of 4 mg PO followed by 2 mg after each unformed stool until diarrhea is controlled. Individualize dose based on patient response. Average daily maintenance dose is 4–8 mg. If no clinical improvement is seen with dosage of 16 mg/day for 10 days, further treatment will probably not be effective.
Traveler’s diarrhea (OTC): 4 mg PO after first loose stool, followed by 2 mg after each subsequent stool; do not exceed 16 mg/day.
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