Drug Detail:Loperamide (Loperamide [ loe-per-a-mide ])
Drug Class: Antidiarrheals
Usual Adult Dose for Diarrhea - Acute
4 mg orally after the first loose stool, then 2 mg orally after each unformed stool
Maximum dose: 16 mg per day
Comments:
- Clinical improvement is usually seen within 48 hours.
Use(s): Control and symptomatic relief of acute nonspecific diarrhea
Usual Adult Dose for Diarrhea - Chronic
4 mg orally after the first loose stool, then 2 mg orally after each unformed stool until diarrhea is controlled
Maximum dose: 16 mg per day
Comments:
- Clinical improvement is usually seen within 48 hours.
- After diarrhea is controlled, reduce dose to meet individual requirements
- When optimal daily dose has been established, this dose may be given as a single dose or in divided doses.
- The average maintenance dose in clinical trials was 4 to 8 mg daily.
- If no clinical improvement is seen with 16 mg per day after at least 10 days, symptoms are unlikely to be controlled by further administration.
- Administration may be continued if diarrhea cannot be adequately controlled with diet or specific treatment.
Use(s): Control and symptomatic relief of chronic diarrhea associated with inflammatory bowel disease.
Usual Pediatric Dose for Diarrhea - Acute
2 to 5 years (13 to 20 kg):
First day dosage schedule: 1 mg orally 3 times a day (3 mg total daily dose)
Subsequent daily dosage: 1 mg only after a loose stool, not to exceed 3 mg/day
6 to 8 years (20 to 30 kg):
First day dosage schedule: 2 mg orally twice a day 2 (4 mg total daily dose)
Subsequent daily dosage: 2 mg only after a loose stool, not to exceed 4 mg/day
9 to 12 years (over 30 kg):
First day dosage schedule: 2 mg orally 3 times a day (6 mg total daily dose)
Subsequent daily dosage: 2 mg only after a loose stool, not to exceed 6 mg/day
13 years and older:
4 mg orally after the first loose stool, then 2 mg orally after each unformed stool
Maximum dose: 16 mg per day
Comments:
- Do not use in patients less than 2 years old due to the risks of respiratory depression and serious cardiac adverse reactions.
- Clinical improvement is usually seen within 48 hours.
Use(s): Control and symptomatic relief of acute nonspecific diarrhea
Renal Dose Adjustments
No adjustment recommended.
Liver Dose Adjustments
Use with caution.
- Systemic exposure may be increased due to reduced metabolism.
Precautions
US BOXED WARNING(S):
- Cases of Torsades de Pointes, cardiac arrest, and death have been reported with use of higher than recommended doses.
- Contraindicated in pediatric patients less than 2 years of age.
- Avoid doses higher than recommended due to the risk of serious cardiac adverse reactions.
Safety and efficacy have not been established in patients younger than 2 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Avoid doses higher than recommended due to the risk of serious cardiac reactions.
- Use the non-prescription liquid formulation for patients 2 to 5 years old.
- For patients 6 years and older, either the liquid formulation or tablets/capsules may be used.
General:
- Patients should receive fluid and electrolyte replacement as needed.
Frequently asked questions
- How long does Imodium stop diarrhea for?
