Diarrhea
May be taken with or without food.
Acute Diarrhea 4 mg initially, then 2 mg after each loose stool; not to exceed 16 mg/day (8 mg/day for self-medication); discontinue if no improvement seen within 48 hours Chronic Diarrhea 4 mg initially, then 2 mg after each loose stool until controlled, and then 4-8 mg/day in divided doses Traveler's Diarrhea 4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day
Acute Diarrhea First Day of Treatment 2-6 years (13-20 kg): 1 mg q8hr PO 6-8 years: (20-30 kg): 2 mg q12hr PO 8-12 years (>30 kg): 2 mg q8hr PO Second & Subsequent Doses 0.1 mg/kg PO after each loose stool; not to exceed dose recommended for first 24 hours Chronic Diarrhea 0.08-0.24 mg/kg/day PO divided q12hr Traveler's Diarrhea <6 years: Safety and efficacy not established 6-8 years: 2 mg after first loose stool, then 1 mg after each subsequent stool; not to exceed 4 mg/day 8-12 years: 2 mg after first loose stool, then 1 mg after each subsequent stool; not to exceed 6 mg/day >12 years: 4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day
Conditions when inhibition of peristalsis is undesirable (e.g. ileus or megacolon); antibiotic induced colitis; active inflammatory bowel disease; if abdominal distention develops during use; abdominal pain in the absence of diarrhoea.
Loperamide inhibits peristalsis and prolongs transit time by acting directly on intestinal wall muscles. It also reduces faecal volume, increases viscosity and decreases fluid and electrolyte loss.. Slows intestinal motility through opioid receptor; has direct effects on circular and longitudinal muscle;.
Concomitant specific therapy must be given in those with infectious diarrhoea; hepatic dysfunction; infants; pregnancy, lactation. Lactation: Not known if distributed in breast milk; use caution
Abdominal pain, distention, and discomfort; paralytic ileus; constipation, dry mouth, drowsiness, dizziness, fatigue, rash. Potentially Fatal: Toxic megacolon.
Bioavailability increased by co-trimoxazole, ritonavir, saquinavir. Respiratory depression reported when administered with quinidine. Loperamide increases GI absorption of desmopressin and decreases exposure to saquinavir.