PRESCRIPTION: Yes, but also OTC
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules or tablets: 1 or 2 mg; liquid: 1 mg per teaspoonful (5 ml).
STORAGE: Loperamide should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
DOSING: In adults and children 12 years of age and older, the usual dose is 4 mg initially, followed by 2 mg after each loose stool. The maximum dose is 16 mg/day (8 mg if self medicating).
For chronic diarrhea 4-8 mg per day may be administered after control is achieved.
The dose for acute diarrhea in children is: age 8 to 12 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 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 a loose stool.
Chronic diarrhea in children is treated with 0.08-0.24 mg/kg/d divided into two doses, one dose given every 12 hours. For traveler's diarrhea children 6-12 years old receive 2 mg after the first lose stool then 1 mg after each subsequent stool. Children older than 12 receive 4 mg initially then 1 mg after each loose stool.
The maximum daily dose for traveler's diarrhea is 4 mg (6-8 years old), 6 mg (6-12 years old), and 8 mg (>12 years old).
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.
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