loperamide

Generic Name: loperamide (oral) (loe PER a mide)Brand names: Diamode, Imodium A-D, Imodium A-D EZ Chews, Imodium A-D New Formula, Kao-Paverin, Kaopectate Caplet, Maalox Anti-Diarrheal, Imodium, Pepto Diarrhea Control, Imotil, Kaopectate 1-D, Diar-Aid

What is loperamide?

Loperamide slows the rhythm of digestion so that the small intestines have more time to absorb fluid and nutrients from the foods you eat.

Loperamide is used to treat diarrhea. Loperamide is also used to reduce the amount of stool in people who have an ileostomy (re-routing of the bowel through a surgical opening in the stomach).

Loperamide may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about loperamide?

You should not use this medication if you are allergic to loperamide, or if you have stools that are bloody, black, or tarry, or if you have diarrhea that is caused by taking an antibiotic.

Before taking loperamide, tell your doctor if you are allergic to any drugs, or if you have a fever, mucus in your stools, a history of liver disease, or if you are taking an antibiotic.

Drink extra water while you are taking this medication to keep from getting dehydrated. It may take up to 48 hours of taking loperamide before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 10 days of treatment. Loperamide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking loperamide?

Do not use this medication if you are allergic to loperamide, or if you have:

• stools that are bloody, black, or tarry; or

• if you have diarrhea that is caused by taking an antibiotic.

Before taking loperamide, tell your doctor if you are allergic to any drugs, or if you have:

• a fever;

• mucus in your stools;

• a history of liver disease; or

• if you are taking an antibiotic.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take loperamide.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether loperamide passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 2 years old without the advice of a doctor.

How should I take loperamide?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended.

Take loperamide with a full glass of water. Drink extra water while you are taking this medication to keep from getting dehydrated.

Loperamide is usually taken at the first sign of diarrhea, and again if diarrhea comes back. The first dose of loperamide is usually twice as much as the following doses. Do not take this medication more than 3 times in 24 hours without your doctor's advice.

The loperamide chewable tablet should be chewed before swallowing.

Shake the liquid form of this medicine well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Immodium A-D Liquid and New Immodium A-D Liquid contain two different strengths of loperamide. If you switch from using one brand to using the other, follow the dosing instructions carefully. Immodium A-D Liquid also contains a small amount of alcohol, but New Immodium A-D Liquid does not.

It may take up to 48 hours of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 10 days of treatment. Store loperamide at room temperature away from moisture and heat. Do not allow the liquid form of this medicine to freeze.

See also: Loperamide dosage in more detail

What happens if I miss a dose?

Since loperamide is usually taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include dizziness, drowsiness, urinating less than usual, severe stomach cramps or bloating, and vomiting.

What should I avoid while taking loperamide?

Loperamide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use loperamide to stop the diarrhea unless your doctor has told you to.

Loperamide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• stomach pain or bloating;

• ongoing or worsening diarrhea;

• diarrhea that is watery or bloody; or

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

Less serious side effects may include:

• dizziness;

• drowsiness, tired feeling;

• constipation;

• mild stomach pain; or

• mild skin rash or itching.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Loperamide Dosing Information

Usual Adult Dose for Diarrhea -- Acute:

Tablets, capsules, and liquid:Initial: 4 mg orally after the first loose stool, thenMaintenance: 2 mg after each loose stool, not to exceed 16 mg in any 24-hour period. Clinical improvement is usually observed within 48 hours.Chewable tablets:Initial: 4 mg after the first loose stool, thenMaintenance: 2 mg after each subsequent loose stool, but not exceeding 8 mg in 24 hours.

Usual Adult Dose for Diarrhea -- Chronic:

Tablets, capsules, and liquid:Initial: 4 mg orally once followed by 2 mg orally after each loose stool, not to exceed 16 mg in any 24-hour period.Maintenance: The average daily maintenance dosage is 4 to 8 mg. Clinical improvement is usually observed within 10 days. If clinical improvement is not observed at a maximum dosage of 16 mg for duration of 10 days, symptoms are unlikely to be controlled by further administration.

Usual Pediatric Dose for Diarrhea -- Acute:

2 to 6 years (13 to 20 kg):Liquid formulation only to be used in this age group.Initial: 1 mg orally 3 times a day for the first day, thenMaintenance: 0.1 mg/kg/dose after each loose stool, but not exceeding initial dose.6 to 8 years (20 to 30 kg):Tablets, capsules, and liquid:Initial: 2 mg orally twice a day for the first day, thenMaintenance: 0.1 mg/kg/dose after each loose stool, but not exceeding initial dose.Chewable tablets:Initial: 2 mg orally after the first loose stool, thenMaintenance: 1 mg orally after each subsequent loose stool, but not exceeding 4 mg in 24 hours.8 to 12 years (greater than 30 kg):Tablets, capsules, and liquid:Initial: 2 mg orally 3 times a day for the first day, thenMaintenance: 0.1 mg/kg/dose after each loose stool, but not exceeding initial dose.Chewable tablets:Initial: 2 mg orally after the first loose stool, thenMaintenance: 1 mg orally after each subsequent loose stool, but not exceeding 6 mg in 24 hours.12 to 18 years:Tablets, chewable tablets, capsules, and liquid:Initial: 4 mg after the first loose stool, thenMaintenance: 2 mg after each subsequent loose stool, but not exceeding 8 mg in 24 hours.

Usual Pediatric Dose for Diarrhea -- Chronic:

less than 2 years:Therapeutic dose for the treatment of chronic diarrhea has not been established for this patient population.

What other drugs will affect loperamide?

Before taking loperamide, tell your doctor if you are also taking saquinavir (Invirase).

There may be other drugs that can interact with loperamide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about loperamide.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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Copyright 1996-2006 Cerner Multum, Inc. Version: 2.09. Revision Date: 4/12/2009 4:39:00 PM.