What is loperamide and why is it used?

Loperamide is an antidiarrheal agent. It is also used to reduce the amount of stool in people with a post-operative stoma – an artificial opening in the torso through which the end of the small intestine is exposed to the skin.

In the “ Yod ” telegram channel we tell you how to take care of your health based on evidence-based medicine.

In pharmacies the drug can be found under several trade names: “Loperamide”, “Diara”, “Imodium”, “Superilol”. The medicine is usually dispensed without a doctor’s prescription. But this does not mean that the product can be taken without consulting a specialist. Only he can calculate a safe and effective dose and understand whether the patient has contraindications.

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Is diarrhea dangerous during pregnancy?

Who invented loperamide and when?

Loperamide was first synthesized in 1969 by the Belgian pharmaceutical company Janssen Pharmaceutica. In 1974, the drug was approved for use in the United States under the trade name Imodium.

How loperamide works

Loperamide acts on μ receptors and slows intestinal contraction. As a result, absorption improves and the body receives more nutrients from food and liquid. The stool becomes less liquid, the person begins to go to the toilet less often.

The effectiveness of loperamide for diarrhea has been proven in numerous clinical studies.

What you need to know about loperamide before you start taking it

Most importantly, loperamide should not be given to children under two years of age. The drug may cause respiratory depression and serious heart problems. Therefore, if diarrhea begins in a child, it is important to show him to the pediatrician and find out how to cope with the problem in other ways.

Adults and children over two years of age should definitely refuse the drug if they were ever allergic to it. Also, you should not take loperamide:

• for abdominal painwithout diarrhea;
• diarrhea with high fever;
• ulcerative colitis;
• black or tarry stools.

If diarrhea appears after antibiotics, you should definitely consult a doctor before taking loperamide.

The active substance may cause dizziness and drowsiness . Therefore, immediately after taking it, you should not drive a car or even a bicycle. It is better to observe your well-being for several hours.

What drugs and substances should you not mix loperamide with?

Loperamide may interact with medications you are already taking. This can lead to serious heart problems. Therefore, you should not combine it with the following drugs:

• clozapine,used to treat mental disorders;
• ritonaviris a medicine for HIV infection;
• quinidinefor abnormal heartbeat or malaria ;
• itraconazolefor fungal infections;
• gemfibrozilis a cholesterol-lowering medicine;
• metmorphinefor diabetes;
• desmopressin,prescribed for bedwetting or excessive urination.

Loperamide can also be dangerous if taken with other medications for diarrhea, constipation, or stomach and intestinal problems.

While taking loperamide, you should avoid alcohol. Drinking alcohol will increase the chances that a person will experience side effects from the drug. And if you drink tonic drinks along with the medicine , this can lead to heart problems.

In what dosages is loperamide usually used?

Remember that only a doctor can prescribe the drug and calculate the exact dosage. And it is better to consult with him before taking the product.

For adults with acute and chronic diarrhea, doctors usually recommend drinking 4 mg of loperamide immediately after the onset of diarrhea, then taking 2 mg after each loose stool. The maximum dose is 16 mg per day.

With children over two years old and teenagers, it becomes more difficult and stricter. They should not be given loperamide without a doctor’s prescription. The exact dosage depends on the age and weight of the child.

• From 2 to 5 years with a weight of 13–20 kg:on the first day of diarrhea, 1 mg three times. The next day, 1 mg only after loose stools, but not more than 3 mg per day.
• From 6 to 8 years old with a weight of 20–30 kg:on the first day 2 mg twice, and the next day 2 mg only after loose stools , but not more than 4 mg per day.
• From 9 to 12 years with a weight of more than 30 kg:on the first day 2 mg three times. The next day, 2 mg only after loose stools, no more than 6 mg per day.
• After 13 years:4 mg after the first loose stool, then 2 mg after each unformed stool. The maximum dose is 16 mg per day.

Typically, improvement is observed within 48 hours after starting treatment. If this does not happen, you should stop taking loperamide and consult your doctor for further advice.

What are the side effects of loperamide?

Call 103 or 112 and call an ambulance if hives , swelling of the face or throat, difficulty breathing, burning in the eyes, or a red or purple rash appear after taking loperamide.

You should immediately stop taking the medication and consult a physician if you notice at least one of the following signs:

• bloody diarrhea,
• stomach pain or bloating
• worsening diarrhea,
• cardiopalmus,
• shortness of breath,
• sudden dizziness.

Common and relatively safe side effects of loperamide are:

• constipation,
• dizziness,
• drowsiness,
• nausea,
• crampsin the stomach.

How is loperamide used during pregnancy and lactation?

Pregnant women should definitely consult a doctor before taking the medicine. Animal studies have not shown any harm to the fetus, but there is still not much data.

The drug should not be taken during lactation. There is only one exception – when the benefits outweigh the risks. But this decision must be made by the doctor and the patient together, having discussed the details.

What happens if I miss a dose of loperamide

If you miss a dose of loperamide, do not take a double dose. Just take the next one on schedule.

What happens if I drink more than the allowed dose?

An overdose of loperamide can lead to serious consequences. Call an ambulance if you accidentally take more than the recommended dose and your heartbeat becomes rapid or uneven.