- Inflammatory Bowel Disease Slideshow
- Take the Tummy Trouble Quiz
- Ulcerative Colitis Slideshow Pictures
- What is loperamide (Imodium)? How does it work (mechanism of action)?
- What are the uses for loperamide?
- What are the side effects of loperamide?
- What is the dosage for loperamide?
- Which drugs or supplements interact with loperamide?
- Is loperamide safe to take if I'm pregnant or breastfeeding?
- What else should I know about loperamide?
What is loperamide (Imodium)? How does it work (mechanism of action)?
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 narcotics' pain- relieving effects even at high doses.
Loperamide was approved by the FDA in 1976.
What are the uses for loperamide?
Loperamide is used for the relief of acute or chronic diarrhea and traveler's diarrhea.
What are the side effects of loperamide?
Loperamide is generally well- tolerated. The side effects that have been reported during loperamide treatment include:
Loperamide is generally safe at approved doses, but when large doses are taken, or if it is taken in conjunction with other drugs of abuse it can lead to severe heart rhythm problems (arrhythmia, slow or fast rhythms), fainting (syncope), low blood pressure, and death.
Quick GuideInflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment
What is the dosage for loperamide?
- 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).
- Chronic diarrhea: 4-8 mg per day may be administered after control is achieved.
Dosage for children
- Acute diarrhea in children: 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: 0.08-0.24 mg/kg/d divided into two doses, one dose given every 12 hours.
- Traveler's diarrhea in 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).
According to guidelines from the U.S. Food and Drug Administration (FDA), if you are using OTC loperamide and your diarrhea lasts more than 2 days, stop taking the drug and contact your doctor.
Which drugs or supplements interact with loperamide?
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.
Theoretically, some drugs that are used to increase propulsion of intestinal contents could counteract loperamide. Such drugs include bethanechol (Urecholine), cisapride (Propulsid), metoclopramide (Reglan), and erythromycin.
Is loperamide safe to take if I'm pregnant or breastfeeding?
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. Doctors may prescribe loperamide during pregnancy if its benefits outweigh the potential but unknown risks.
What else should I know about loperamide?
- Is available as capsules or tablets: 1 or 2 mg; liquid: 1 mg per teaspoonful (5 ml)
- Should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
- Is available in generic form, over the counter (OTC), and by prescription.
The FDA released a drug safety communication regarding loperamide in 2018. The FDA received reports of serious heart problems and deaths associated with taking much higher than the recommended doses of loperamide, primarily among people who are intentionally misusing or abusing the product. The FDA is attempting to work with manufacturers to limit the number of doses available in a package to promote its safe use. Loperamide is a safe drug when used as directed.
Loperamide (Imodium) is a medication for the treatment and relief of acute, chronic, or travler's diarrhea. Imodium usually cures diarrhea in a couple of days. Common side effects of Imodium are fatigue, dizziness, abdominal pain, and constipation. If diarrhea lasts longer, contact your doctor. Imodium also has the potential to be abused by substance abuse addicts.
Multimedia: Slideshows, Images & Quizzes
Irritable Bowel Syndrome (IBS) Quiz: Test Your Medical IQ
What are symptoms of irritable bowel syndrome (IBS)? Take this quiz and get quick facts on causes and treatment options for this...
IBS - Irritable Bowel Syndrome: Symptoms, Diet, Treatment
What is irritable bowel syndrome (IBS)? Learn about symptoms, causes, and foods that trigger IBS. Get lifestyle tips for managing...
Inflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment
What is inflammatory bowel disease? IBD can include Crohn's disease and ulcerative colitis. Learn more about testing, treatments,...
What's Causing Your Abdominal Pain?
Get the facts on the most common causes of abdominal pain. Learn the difference between a stomachache and more serious causes of...
Worst Foods for Digestion
Discover which foods to avoid in order to prevent diarrhea and digestive problems. Find out which foods can trigger diarrhea and...
Related Disease Conditions
Irritable Bowel Syndrome (IBS) Symptoms, Diet, Treatment, and Test
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms of: Abdominal...
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary...
Diarrhea (Causes, Medicine, Remedies, Treatment)
Diarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal...
Microscopic Colitis (Lymphocytic Colitis and Collagenous Colitis)
Microscopic colitis (lymphocytic colitis and collagenous colitis) is a disease of inflammation of the colon. Microscopic colitis...
Food Poisoning (Symptoms, Remedies, Treatment, Cure)
Food poisoning is common, but can also be life threatening. The symptoms for food poisoning are fever, abdominal pain, headache,...
Travelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary...
Bowel or fecal incontinence refers to the loss of voluntary control of stool, or bowel movements. The condition can include...
SIBO (Small Intestinal Bacterial Overgrowth)
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least...
Salmonella infection (salmonellosis) is typically caused by the consumption of contaminated foods. Symptoms of salmonellosis...
Irritable Bowel Syndrome in Children (IBS)
Irritable bowel syndrome (IBS) in children is a functional gastrointestinal disorder with signs and symptoms of: Abdominal...
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps, and fever are common symptoms. Mild...
IBS-D (Irritable Bowel Syndrome with Diarrhea)
IBS-D or irritable bowel syndrome with diarrhea refers to IBS with diarrhea. Symptoms of IBS-D include intestinal gas...
Stomach Flu vs. Food Poisoning
The stomach flu (viral gastroenteritis) and food poisoning are not the same infections. However, they do have a few similar...
Treatment & Diagnosis
- Irritable Bowel Syndrome IBS FAQs
- Medication Disposal
- Dangers of Mixing Medications
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Travel Medicine Kit
- E. coli Infection Facts
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Prevention & Wellness
Daily Health News
Subscribe to MedicineNet's General Health Newsletter
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.
Top loperamide Related Articles
Abdominal Pain PicturesGet the facts on the most common causes of abdominal pain. Learn the difference between a stomachache and more serious causes of abdominal pain. Diagnosis of abdominal pain is based on symptoms and the location of pain, like sharp pain in the lower abdomen.
DiarrheaDiarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.
Worst Foods for DigestionDiscover which foods to avoid in order to prevent diarrhea and digestive problems. Find out which foods can trigger diarrhea and other digestive problems such as gas, bloating, indigestion, heartburn and more.
Fecal IncontinenceBowel or fecal incontinence refers to the loss of voluntary control of stool, or bowel movements. The condition can include partial incontinence, in which a person loses only a small amount of liquid waste, to complete incontinence, in which the entire bowel movement cannot be controlled. Diet changes and elimination of certain medications can help patients to regain bowel control. Treatment involves a combination of medication, biofeedback, and exercise.
Food PoisoningFood poisoning is common, but can also be life threatening. The symptoms for food poisoning are fever, abdominal pain, headache, diarrhea, nausea and vomiting. Food poisoning has many causes, for example, chemicals (from toxic fish or plants) and bacteria (Staphylococcus aureus or Salmonella). Treatment of food poisoning depends upon the cause.
IBS SlideshowWhat is irritable bowel syndrome (IBS)? Learn about symptoms, causes, and foods that trigger IBS. Get lifestyle tips for managing IBS through diet and with IBS medications.
IBD SlideshowWhat is inflammatory bowel disease? IBD can include Crohn's disease and ulcerative colitis. Learn more about testing, treatments, and the home care needed to manage inflammatory bowel disease.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms of:
- Abdominal pain
- Increased gas (flatulence)
- Abdominal cramping
- Food intolerance
Two new tests are now available that may help diagnose irritable bowel syndrome with diarrhea and constipation (IBS-M) and irritable bowel syndrome with diarrhea (IBS-D). Treatment for IBS includes diet changes, medications, and other lifestyle changes to manage symptoms.
IBS QuizWhat are symptoms of irritable bowel syndrome (IBS)? Take this quiz and get quick facts on causes and treatment options for this common and uncomfortable digestive disorder.
Irritable Bowel Syndrome in Children
Irritable bowel syndrome (IBS) in children is a functional gastrointestinal disorder with signs and symptoms of:
- Abdominal pain
The cause of IBS is unknown, however, certain foods, stress, anxiety, and depression may contribute to the symptoms of IBS. There is no cure for IBS in children; however, medications, dietary changes, and stress management may relieve symptoms.
Lymphocytic ColitisMicroscopic colitis (lymphocytic colitis and collagenous colitis) is a disease of inflammation of the colon. Microscopic colitis is only visible when the colon's lining is examined under a microscope. The cause of microscopic colitis is not known. Symptoms of microscopic colitis are chronic watery diarrhea and abdominal pain or cramps. Microscopic colitis is diagnosed through biopsies of several areas of the colon. There is no standardized treatment for microscopic colitis; however, eliminating NSAIDs, and treatment medications such as Imodium, Lomotil, Petpo-Bismol, Entocort EC, and mesalamine (Asacol) have been helpful in some individuals.
Salmonella Food Poisoning (Salmonellosis)Salmonella infection (salmonellosis) is typically caused by the consumption of contaminated foods. Symptoms of salmonellosis include fever, vomiting, diarrhea, and abdominal pain. Salmonellosis typically resolves on its own in four to seven days. It's important to increase one's fluid intake to compensate for the fluid lost by vomiting and/or diarrhea.
Small Intestinal Bacterial Overgrowth (SIBO)
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine, but they are more like the bacteria that are found in the colon. There are many conditions associated with SIBO, including:
- Crohn's disease
- Irritable bowel syndrome (IBS)
It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome.
Symptoms of SIBO include:
- Excess gas
- Abdominal bloating
- Abdominal pain
Treatment for SIBO can include:
- Low FODMAP Diet
Travel MedicineTravelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include:
- meningococcal meningitis,
- yellow fever,
- hepatitis A,
- typhoid fever,
- polio, and
Traveler's DiarrheaTravelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of travelers' diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of travelers' diarrhea. There are five unique classes of E. coli that causes gastroenteritis. Other bacteria responsible for travelers' diarrhea include Campylobacter, jejuni, shigella, and salmonella. Viruses such as rotavirus and Norwalk virus (norovirus) and giardia lamblia a parasite may cause travelers' diarrhea. Prevention is careful eating and drinking of water.