Loperamide (Imodium)

Category:

  • Miscellaneous

Description:

  • Antidiarrheal

Indications:

  • Diarrhea (acute non-specific)

  • Chronic diarrhea (inflammatory bowel disease)

  • Reduction of volume from ileostomy

  • Travelerís diarrhea

Contraindications:

  • Acute diarrhea due to invasive organisms (enteroinvasive E. coli, Salmonella, Shigella) or pseudomembranous colitis

Precautions:

  • Pregnancy category B: unknown if excreted in breast milk; compatible with breast feeding

  • Liver disease, dehydration

  • Severe ulcerative colitis (toxic megacolon)

  • Children (greater variability in response)

Adverse Reactions (Side Effects):

  • CNS: fatigue, fever, dizziness, drowsiness

  • GI: abdominal pain, anorexia, constipation, dry mouth, nausea, toxic megacolon, vomiting

  • RESP: respiratory depression

  • SKIN: rash

 

Dosage:

Administered orally (capsule, liquid)

  • Adult:   PO 4mg, then 2mg after each loose stool, max 16mg daily; maintenance for chronic diarrhea usually 4-8mg daily

  • Child:   <2 years not recommended; 13-20 kg PO 2mg 2 times daily on day 1, then 0.1 mg/kg after each loose stool; >30 kg PO 2mg 3 times daily on day 1, then 0.1 mg/kg after each loose stool

 

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