GENERIC NAME: loperamide
BRAND NAMES: Imodium; Kaopectate II; Imodium A-D; Maalox Anti-Diarrheal Caplets; Pepto Diarrhea Control.
DRUG CLASS AND MECHANISM:
Loperamide is a medication that is used for the relief of acute diarrhea and the management of
chronic diarrhea in patients with inflammatory bowel disease (Crohn's disease and ulcerative colitis). The effectiveness of loperamide is comparable to
another anti-diarrheal, diphenoxylate (Lomotil). Loperamide
reduces
diarrhea by slowing the forward propulsion of intestinal
contents by the
intestinal muscles. Although loperamide is related chemically
to narcotics
such as morphine, it does not have any of the narcotics pain-
relieving
effects even at high doses. Loperamide was approved by the FDA
in 1976.
PRESCRIPTION: yes (Imodium). no (all other brand
names)
GENERIC AVAILABLE: yes
PREPARATIONS: capsules or tablets (2mg); liquid (1 mg
per
teaspoonsful).
STORAGE: Store at room temperature, 15-30°C (59-
86°F).
PRESCRIBED FOR: Loperamide is used for the relief of
acute or
chronic diarrhea.
DOSING: In adults and children 12 years of age and
older, the
usual dose is 4 mg (2 capsules) as a first dose, followed by 2
mg (1
capsule) after each unformed stool. The maximum dose is 16
mg/day. The
dose for children is: age 9 to 11 years, 2 mg three times the
first day;
age 6 to 8 years, 2 mg twice the first day; age 2 to 5 years, 1
mg times
three times the first day. After the first day, children less
than 12
years of age usually receive a dose of 0.1 mg/kg after an
unformed stool.
DRUG INTERACTIONS: Cholestyramine
(Questran) binds to
loperamide in the intestines and prevents its absorption,
thereby reducing
the effect of loperamide. Therefore, there should be at least a
two hour
interval between doses of loperamide and cholestyramine. Some
drugs which
are used to increase propulsion of intestinal contents
theoretically could
counteract loperamide. Such drugs include bethanechol (Urecholine),
cisapride (Propulsid), metoclopramide
(Reglan), and
erythromycin.
PREGNANCY: There are no adequate studies of loperamide
in
pregnant women. However, studies in animals receiving very high
doses of
loperamide suggest no important, detrimental effects on the
fetus.
Physicians may use loperamide during pregnancy if its benefits
are deemed
to outweigh the potential but unknown risks.
NURSING MOTHERS: It is not
known if loperamide is secreted in breast milk.
SIDE EFFECTS: Loperamide is generally well- tolerated.
The side
effects that have been reported during loperamide treatment
include
abdominal pain, constipation, drowsiness, dizziness, dry mouth,
fatigue,
nausea, and vomiting.
Last Editorial Review: 7/23/1998
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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