loperamide (OTC)

Brand and Other Names:Imodium, K-Pek II, more...NeoDiaral, Diaraid
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

liquid

  • 1mg/5mL
  • 1mg/7.5mL

suspension

  • 1mg/7.5mL

tablet

  • 2mg

capsule

  • 2mg

tablet chewable

  • 2mg

Acute Diarrhea

4 mg initially, then 2 mg after each loose stool; not to exceed 16 mg/day (8 mg/day for self-medication); discontinue if no improvement seen within 48 hours

Chronic Diarrhea

4 mg initially, then 2 mg after each loose stool until controlled, and then 4-8 mg/day in divided doses

Traveler's Diarrhea

4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day

Dosage Forms & Strengths

liquid

  • 1mg/5mL
  • 1mg/7.5mL

suspension

  • 1mg7.5mL

tablet

  • 2mg

capsule

  • 2mg

tablet chewable

  • 2mg

Acute Diarrhea

First Day of Treatment

  • 2-6 years (13-20 kg): 1 mg q8hr PO
  • 6-8 years: (20-30 kg): 2 mg q12hr PO
  • 8-12 years (>30 kg): 2 mg q8hr PO

Second & Subsequent Doses

  • 0.1 mg/kg PO after each loose stool; not to exceed dose recommended for first 24 hours  

Chronic Diarrhea

0.08-0.24 mg/kg/day PO divided q12hr  

Traveler's Diarrhea

<6 years: Safety and efficacy not established

6-8 years: 2 mg after first loose stool, then 1 mg after each subsequent stool; not to exceed 4 mg/day

8-12 years: 2 mg after first loose stool, then 1 mg after each subsequent stool; not to exceed 6 mg/day

>12 years: 4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day

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Interactions

Interaction Checker

and loperamide

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              Serious - Use Alternative (21)

              • artemether

                artemether and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • artemether/lumefantrine

                artemether/lumefantrine and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • bedaquiline

                bedaquiline and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • ceritinib

                ceritinib and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • chloroquine

                chloroquine and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • citalopram

                citalopram and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • clarithromycin

                clarithromycin and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • clozapine

                clozapine and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • crizotinib

                crizotinib and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • eluxadoline

                loperamide, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions. Loperamide may be used occasionally for acute management of severe diarrhea but avoid chronic use. Discontinue loperamide immediately if constipation occurs.

              • erdafitinib

                erdafitinib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.

              • fentanyl

                fentanyl, loperamide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl intranasal

                fentanyl intranasal, loperamide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl transdermal

                fentanyl transdermal, loperamide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl transmucosal

                fentanyl transmucosal, loperamide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fexinidazole

                fexinidazole and loperamide both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

                fexinidazole will increase the level or effect of loperamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

              • lasmiditan

                lasmiditan increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

              • lefamulin

                lefamulin and loperamide both increase QTc interval. Avoid or Use Alternate Drug.

              • quinidine

                quinidine will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

              • sotorasib

                sotorasib will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.

              • tepotinib

                tepotinib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.

              Monitor Closely (61)

              • albuterol

                albuterol and loperamide both increase QTc interval. Use Caution/Monitor.

              • alfuzosin

                alfuzosin and loperamide both increase QTc interval. Use Caution/Monitor.

              • amiodarone

                amiodarone will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • apomorphine

                apomorphine and loperamide both increase QTc interval. Use Caution/Monitor.

              • arformoterol

                arformoterol and loperamide both increase QTc interval. Use Caution/Monitor.

              • aripiprazole

                aripiprazole and loperamide both increase QTc interval. Use Caution/Monitor.

              • atomoxetine

                atomoxetine and loperamide both increase QTc interval. Use Caution/Monitor.

              • atorvastatin

                atorvastatin will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • berotralstat

                berotralstat will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.

              • bosutinib

                bosutinib increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • clarithromycin

                clarithromycin will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • clotrimazole

                clotrimazole will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • crizotinib

                crizotinib increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • cyclosporine

                cyclosporine will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • dasatinib

                dasatinib and loperamide both increase QTc interval. Use Caution/Monitor.

              • degarelix

                degarelix and loperamide both increase QTc interval. Use Caution/Monitor.

              • dronedarone

                dronedarone will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • elagolix

                elagolix will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • eliglustat

                eliglustat increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.

              • erythromycin base

                erythromycin base will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • felodipine

                felodipine will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • fostamatinib

                fostamatinib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp substrates. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib.

              • fostemsavir

                loperamide and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

              • glecaprevir/pibrentasvir

                glecaprevir/pibrentasvir will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • indinavir

                indinavir will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • istradefylline

                istradefylline will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.

              • ivacaftor

                ivacaftor increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.

              • ketoconazole

                ketoconazole will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lapatinib

                lapatinib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lomitapide

                lomitapide increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing dose when used concomitantly with lomitapide.

              • lonafarnib

                lonafarnib will increase the level or effect of loperamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Loperamide is contraindicated in patients aged <2 years; when lonafarnib is coadministered with loperamide, do not exceed loperamide 1 mg qDay when first coadministered; slowly increase loperamide dosage with caution in accordance with its approved product labeling.

                lonafarnib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Lonafarnib is a weak P-gp inhibitor. Monitor for adverse reactions if coadministered with P-gp substrates where minimal concentration changes may lead to serious or life-threatening toxicities. Reduce P-gp substrate dose if needed.

              • loratadine

                loratadine will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lovastatin

                lovastatin will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • metoclopramide intranasal

                loperamide will decrease the level or effect of metoclopramide intranasal by Other (see comment). Use Caution/Monitor. Coadministration of metoclopramide intranasal with drugs that impair GI motility may decrease systemic absorption of metoclopramide. Monitor for reduced therapeutic effect.

              • nefazodone

                nefazodone will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nicardipine

                nicardipine will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nifedipine

                nifedipine will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nilotinib

                nilotinib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • osilodrostat

                osilodrostat and loperamide both increase QTc interval. Use Caution/Monitor.

              • phenobarbital

                phenobarbital will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • phenytoin

                phenytoin will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ponatinib

                ponatinib increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • quercetin

                quercetin will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ranolazine

                ranolazine will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • rifampin

                rifampin will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ritonavir

                ritonavir will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • sarecycline

                sarecycline will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.

              • simvastatin

                simvastatin will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • sirolimus

                sirolimus will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • St John's Wort

                St John's Wort will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • stiripentol

                stiripentol will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.

              • tacrolimus

                tacrolimus will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • tolvaptan

                tolvaptan will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • trazodone

                trazodone will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • tucatinib

                tucatinib will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.

              • vemurafenib

                vemurafenib increases levels of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • verapamil

                verapamil will increase the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              Minor (2)

              • gemfibrozil

                gemfibrozil will increase the level or effect of loperamide by decreasing metabolism. Minor/Significance Unknown.

              • itraconazole

                itraconazole will increase the level or effect of loperamide by Other (see comment). Minor/Significance Unknown. Monitor ECG when itraconazole is coadministered with loperamide (dose >16mg/day).

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              Adverse Effects

              Frequency Not Defined

              Dizziness

              Fatigue

              Abdominal pain

              Constipation

              Nausea

              Dry mouth

              Angioedema

              Bullous eruptions

              Flatulence

              Rash

              Postmarketing Reports

              Pancreatitis

              QT/QTc interval prolongation, Torsades de Pointes, other ventricular arrhythmias, cardiac arrest, syncope, and death

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              Warnings

              Black Box Warnings

              Torsades de Pointes and sudden death

              • Cases of Torsades de Pointes, cardiac arrest, and death reported with use of higher than recommended dosages
              • Contraindicated in patients < 2 years
              • Avoid dosages higher than recommended in adults and pediatric patients 2 years of age and older due to risk of serious cardiac adverse reactions

              Contraindications

              Hypersensitivity, bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis

              Patients in whom constipation must be avoided

              Abdominal pain without diarrhea

              Avoid use as primary therapy with acute dysentery (bloody stools and high fever, acute ulcerative colitis, bacterial enterocolitis [caused by Salmonella, Shigella, and Campylobacter), pseudomembranous colitis associated with antibiotic use)

              Age <2 years

              Cautions

              May cause drowsiness or dizziness, which may impair physical abilities to operate heavy machinery or tasks requiring mental alertness

              Hypersensitivity reactions reported, including anaphylaxis, rash, urticaria, and rare cases of Steven’s Johnson syndrome or toxic epidermal necrolysis

              Discontinue if no improvement seen within 48 hours in patients with acute diarrhea, symptoms worsen, or abdominal swelling or bulging develops

              Discontinue promptly if constipation, abdominal pain or distention, blood in stool, or ileus develops; do not use when peristalsis inhibition should be avoided (ie, due to potential for ileus, megacolon, or toxic megacolon)

              Discontinue therapy if symptoms of abdominal distention occur in patients with AIDS; cases of toxic megacolon reported with infectious colitis, resulting from viral or bacterial pathogens

              Use with caution in patients with hepatic impairment due to reduced first pass metabolism; monitor for signs of CNS toxicity

              Use of higher than recommended doses or abuse of loperamide can result in serious cardiac adverse events, including QT interval prolongation, Torsades de Pointes, or other ventricular arrhythmias, syncope, and cardiac arrest; in cases of abuse, individuals often use other drugs together with loperamide in attempts to increase its absorption and penetration across the blood-brain barrier, inhibit loperamide metabolism, and enhance its euphoric effects

              Dehydration, particularly in pediatric patients less than 6 years of age, may further influence variability of response to loperamide

              Avoid loperamide in combination with drugs or herbal products known to prolong QT interval, including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmics, antipsychotics (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone), antibiotics (e.g., moxifloxacin), or any other drug known to prolong the QT interval (e.g., pentamidine, methadone)

              Avoid administering therapy to patients with risk factors for QT prolongation, including patients with congenital long QT syndrome, with a history of cardiac arrhythmias or other cardiac conditions, elderly patients and those with electrolyte abnormalities

              Patients with a history of abnormal heart rhythm or liver disease, should ask their healthcare provider before using the product; taking more than directed can cause serious heart problems or death

              Potential toxic dose in patients <6 years: 0.4 mg/kg  

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              Pregnancy & Lactation

              Pregnancy category: B

              Lactation: Not known if distributed in breast milk; use caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Slows intestinal motility through opioid receptor; has direct effects on circular and longitudinal muscle; reduces fecal volume; increases viscosity

              Absorption

              Bioavailability: 0.3%

              Onset: 1-3 hr

              Duration: 41 hr

              Peak plasma time: 5 hr (capsule); 2.5 hr (liquid)

              Distribution

              Poor penetration through blood-brain barrier

              Metabolism

              Significant first-pass metabolism, resulting in very low plasma level of drug

              Metabolites: Glucuronide (inactive)

              Elimination

              Elimination half-life: 7-14 hr

              Excretion: Feces (30-40%), urine (1%)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Anti-Diarrheal (loperamide) oral
              -
              2 mg tablet
              Anti-Diarrheal (loperamide) oral
              -
              2 mg tablet
              Anti-Diarrheal (loperamide) oral
              -
              1 mg/7.5 mL liquid
              Anti-Diarrheal (loperamide) oral
              -
              2 mg capsule
              Anti-Diarrheal (loperamide) oral
              -
              2 mg capsule
              Anti-Diarrheal (loperamide) oral
              -
              2 mg tablet
              loperamide oral
              -
              2 mg capsule
              loperamide oral
              -
              2 mg capsule
              loperamide oral
              -
              2 mg capsule
              loperamide oral
              -
              2 mg capsule
              loperamide oral
              -
              1 mg/5 mL liquid
              loperamide oral
              -
              1 mg/7.5 mL liquid
              loperamide oral
              -
              1 mg/7.5 mL liquid
              Diamode oral
              -
              2 mg tablet
              Imodium A-D oral
              -
              2 mg capsule
              Imodium A-D oral
              -
              1 mg/7.5 mL liquid
              Imodium A-D oral
              -
              1 mg/7.5 mL liquid

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              loperamide oral

              LOPERAMIDE LIQUID - ORAL

              (low-PAIR-uh-mide)

              COMMON BRAND NAME(S): Imodium, Imodium A-D

              WARNING: Improper use of this medication (overuse or abuse) may cause serious harm, such as fast/irregular heartbeat or death. Do not increase your dose, take it more often, or take it for longer than directed. Taking loperamide with certain other medications may also cause harm. See also Precautions, Drug Interactions, and Overdose sections.This medication should not be used by children younger than 2 years due to an increased risk of side effects (such as slow/shallow breathing, fast/irregular heartbeat).

              USES: See also Warning section.This medication is used to treat sudden diarrhea (including traveler's diarrhea). It works by slowing down the movement of the gut. This decreases the number of bowel movements and makes the stool less watery. Loperamide is also used to reduce the amount of discharge in patients who have had an ileostomy. It is also used to treat ongoing diarrhea in people with inflammatory bowel disease.Loperamide treats only the symptoms, not the cause of the diarrhea (e.g., infection). Treatment of other symptoms and the cause of the diarrhea should be determined by your doctor.

              HOW TO USE: See also Warning section.If you are using the over-the-counter product to self-treat, read all the directions on the product package before taking this medication. If your doctor has prescribed this medication, follow your doctor's directions and the directions on your prescription label.Take this medication by mouth, usually after each loose stool or as directed by your doctor. Shake the bottle well before each use. Measure each dose carefully using the attached measuring cup. Do not use a household spoon since you may not get the correct dose.The dosage is based on your condition and response to treatment. In children, dosage is also based on age and weight. Adults should not use more than 8 milligrams in 24 hours if self-treating, or 16 milligrams in 24 hours if under a doctor's direction.Diarrhea can cause dehydration. Drink plenty of fluids and minerals (electrolytes) to replace what is lost. Tell your doctor right away if you develop signs of dehydration (e.g., extreme thirst, decreased urination, muscle cramps, weakness, fainting). You may also need to change to a bland diet during this time to reduce irritation to your stomach/intestines. Consult your doctor or pharmacist for more information.Tell your doctor if your diarrhea does not improve after 2 days, if your condition worsens, or if you develop new symptoms. If you develop blood in the stool, fever, or an uncomfortable fullness/swelling of the stomach/abdomen, or if you think you may have a serious medical problem, seek immediate medical attention.If you are taking this medication under your doctor's direction for ongoing diarrhea, tell your doctor if your diarrhea continues after 10 days of treatment.

              SIDE EFFECTS: Dizziness, drowsiness, tiredness, or constipation may occur. If any of these effects persist or worsen, contact your doctor promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Stop taking this medication and get medical help right away if you have any very serious side effects, including: severe constipation/nausea/vomiting, stomach/abdominal pain, uncomfortable fullness of the stomach/abdomen, fast/irregular heartbeat, severe dizziness, fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking loperamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: stomach/abdominal pain without diarrhea, bowel obstruction (e.g., ileus, megacolon, abdominal distention).Antibiotics may rarely cause a severe intestinal condition due to a bacteria called C. difficile. Symptoms include: diarrhea that doesn't stop, abdominal or stomach pain/cramping, or blood/mucus in your stool. This condition may occur during treatment or weeks to months after treatment has stopped. This medication may make this condition worse. Do not use this anti-diarrhea product, especially after recent antibiotic use, if you have the above symptoms without talking with your doctor first.This medication should not be used without seeing your doctor first if you have certain medical conditions. These symptoms/conditions may require other treatment before you can use this medication safely. Before using this medication, tell your doctor or pharmacist your medical history, especially of: black/tarry stool, blood/mucus in your stool, high fever, HIV infection/AIDS, liver problems, certain stomach/intestinal infections (e.g., Salmonella, Shigella), certain type of bowel disease (acute ulcerative colitis).Loperamide may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using loperamide, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using loperamide safely.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Liquid forms of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).Children may be more sensitive to the effects of this drug, especially drowsiness. Children are also at a higher risk for dehydration. See also Warning and How to Use sections.During pregnancy, this medication should be used only if clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk but is unlikely to have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: pramlintide, recent/current antibiotic use, drugs that can cause constipation (including anticholinergics such as belladonna/scopolamine, antispasmodics such as glycopyrrolate/oxybutynin, potent opioid pain medicines such as morphine, certain antihistamines such as diphenhydramine, tricyclic antidepressants such as amitriptyline), cholestyramine, ritonavir, saquinavir.Many drugs besides loperamide may affect the heart rhythm (QT prolongation), including amiodarone, chlorpromazine, haloperidol, methadone, moxifloxacin, pentamidine, procainamide, quinidine, sotalol, thioridazine, ziprasidone, among others.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: difficult urination, slowed breathing, deep sleep, fast/irregular heartbeat, severe dizziness, fainting.

              NOTES: If your doctor has prescribed this medication for you, do not share it with others.

              MISSED DOSE: If you are taking this drug on a regular schedule (not "as needed") and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Refer to storage information printed on the package. Store at room temperature between 59-77 degrees F (15-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.