Loperamide may be used to treat diarrhea or to reduce the amount of stool (poop) in people who have an ileostomy (which is when a surgeon re-routes your bowel through a small opening in your torso).

Loperamide works by acting on mu-opioid receptors in the gut to slow down the movement of the gut, which in turn, slows down contractions in the intestines. This allows more time for fluids and nutrients to be absorbed back into the body, which makes the stool less watery and decreases the number of times you go to the toilet.

Loperamide was FDA approved in 1976 and is available on prescription and over the counter.

You should not use loperamide if you have ulcerative colitis, bloody or tarry stools, diarrhea with a high fever, or diarrhea caused by antibiotic medication.

Loperamide is safe when used as directed. TAKING TOO MUCH LOPERAMIDE CAN CAUSE SERIOUS HEART PROBLEMS OR DEATH.

Serious heart problems may also happen if you take loperamide with other medicines. Ask a doctor or pharmacist about safely using medications together.

Do not give loperamide to a child younger than 2 years old.

Before taking this medicine

You should not use loperamide if you are allergic to it, or if you have:

• stomach pain without diarrhea;

• diarrhea with a high fever;

• ulcerative colitis;

• diarrhea that is caused by a bacterial infection; or

• stools that are bloody, black, or tarry.

Ask your doctor before using loperamide to treat diarrhea caused by taking an antibiotic (Clostridium difficile).

Do not give loperamide to a child younger than 2 years old. Do not give loperamide to an older child or teenager without a doctor's advice.

Ask a doctor or pharmacist if it is safe for you to take loperamide if you have:

• a fever;

• mucus in your stools;

• liver disease; or

• a heart rhythm disorder.

Ask a doctor before using this medicine if you are pregnant.

You should not breast-feed while you are using loperamide.

Loperamide comes as a tablet, capsule, and as a suspension or solution (liquid) to take by mouth. Nonprescription (over-the-counter) loperamide usually is taken immediately after each loose bowel movement but not more than the 24-hour maximum amount described on the label. Prescription loperamide is sometimes taken on a schedule (one or more times a day). Follow the directions on the package or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take loperamide exactly as directed.

If you are giving loperamide to your child, read the package label carefully to make sure that it is the right product for the age of the child. Loperamide should not be given to a child younger than 2 years of age. Check the package label to find out how much medication the child needs. If you know how much your child weighs, give the dose that matches that weight on the chart. If you don't know your child's weight, give the dose that matches your child's age. Ask your child's doctor if you don't know how much medication to give your child.

If you are taking loperamide liquid, do not use a household spoon to measure your dose. Use the measuring cup that came with the medication or use a spoon made especially for measuring liquid medication.

If you are taking loperamide for acute diarrhea and your symptoms get worse or if your diarrhea lasts longer than 48 hours, stop taking this medication and call your doctor.

Use loperamide exactly as directed on the label, or as prescribed by your doctor.

Loperamide is safe when used as directed. TAKING TOO MUCH LOPERAMIDE CAN CAUSE SERIOUS HEART PROBLEMS OR DEATH.

The usual adult dosage of loperamide for both acute and chronic diarrhea is 4 mg orally after the first loose stool, then 2 mg orally after each unformed stool. You should not take more than 16mg (8 capsules) per day.

Clinical improvement is usually seen within 48 hours.

The usual dosage of loperamide for a child varies depending on their age and weight. Always follow the directions on the label when giving loperamide to a child. A safe dose of loperamide is different for an adult than for a child.

Take loperamide with a full glass of water. Diarrhea can cause your body to lose fluids and electrolytes. Drink plenty of liquids to keep from getting dehydrated.

The loperamide chewable tablet must be chewed before swallowing.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Not all liquid forms of loperamide are the same strengths. Carefully follow all dosing instructions for the medicine you are using.

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

Stop taking loperamide and call your doctor if you still have diarrhea after 2 days of treatment, or if you also have stomach bloating.

You should not use loperamide if you are allergic to it, or if you have:

• stomach pain without diarrhea;

• diarrhea with a high fever;

• ulcerative colitis;

• diarrhea that is caused by a bacterial infection; or

• stools that are bloody, black, or tarry.

Ask your doctor before using loperamide to treat diarrhea caused by taking an antibiotic (Clostridium difficile).

Do not give loperamide to a child younger than 2 years old. Do not give loperamide to an older child or teenager without a doctor's advice.

Ask a doctor or pharmacist if it is safe for you to take loperamide if you have:

• a fever;

• mucus in your stools;

• liver disease; or

• a heart rhythm disorder.

Ask a doctor before using this medicine if you are pregnant.

You should not breast-feed while you are using loperamide.

Most people just take loperamide on an "as needed" basis and do not have a daily dosing schedule. If you miss a dose, you don't need to do anything.

If you are taking loperamide to reduce your frequency of bowel motions after an ileostomy, you may have a dosing schedule. Take the missed dose as soon as you remember but if it is almost time for the next dose, just skip that dose. Do not take two doses at once.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of loperamide can be fatal.

Overdose symptoms may include fast or irregular heartbeats, or fainting. A person caring for you should seek emergency medical attention if you pass out and are hard to wake up.

Never exceed the recommended dose for loperamide. The maximum dosage of loperamide in adults and children over the age of 13 years is 16mg (eight capsules) per day (24 hours).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Drink plenty of water or other clear fluids to replace fluids lost while having diarrhea.

Avoid drinking tonic water. It can interact with loperamide and may cause serious heart problems.

Avoid becoming dehydrated by drinking plenty of fluids. Avoid vigorous exercise or exposure to hot weather if you are dehydrated.

Avoid driving or hazardous activity until you know how loperamide will affect you. Your reactions could be impaired.

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Stop taking loperamide and call your doctor at once if you have:

• diarrhea that is watery or bloody;

• stomach pain or bloating;

• ongoing or worsening diarrhea; or

• fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out).

Common side effects of loperamide may include:

• constipation;

• dizziness, drowsiness;

• nausea; or

• stomach cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take. Ask a doctor or pharmacist about safely using medications together.

Loperamide can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, heart problems, depression, mental illness, cancer, malaria, or HIV.

Many drugs can affect loperamide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Ask your pharmacist any questions you have about taking this medicine.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Imodium® Multi-Symptom Relief (containing Loperamide, Simethicone)