Detailed Drug Information:

DRUG CLASS AND MECHANISM: 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 toanother anti-diarrheal, diphenoxylate (Lomotil). Loperamide reducesdiarrhea by slowing the forward propulsion of intestinal contents by theintestinal muscles. Although loperamide is related chemically to narcoticssuch as morphine, it does not have any of the narcotics pain- relievingeffects even at high doses. Loperamide was approved by the FDA in 1976.

PRESCRIPTION: yes (Imodium). no (all other brand names)

PREPARATIONS: capsules or tablets (2mg); liquid (1 mg perteaspoonsful).

STORAGE: Store at room temperature, 15-30°C (59- 86°F).

PRESCRIBED FOR: Loperamide is used for the relief of acute orchronic diarrhea.

DOSING: In adults and children 12 years of age and older, theusual dose is 4 mg (2 capsules) as a first dose, followed by 2 mg (1capsule) after each unformed stool. The maximum dose is 16 mg/day. Thedose for children is: age 9 to 11 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 timesthree times the first day. After the first day, children less than 12years of age usually receive a dose of 0.1 mg/kg after an unformed stool.

DRUG INTERACTIONS: Cholestyramine (Questran) binds toloperamide in the intestines and prevents its absorption, thereby reducingthe effect of loperamide. Therefore, there should be at least a two hourinterval between doses of loperamide and cholestyramine. Some drugs whichare used to increase propulsion of intestinal contents theoretically couldcounteract loperamide. Such drugs include bethanechol (Urecholine),cisapride (Propulsid), metoclopramide (Reglan), and erythromycin.

PREGNANCY: There are no adequate studies of loperamide inpregnant women. However, studies in animals receiving very high doses ofloperamide suggest no important, detrimental effects on the fetus.Physicians may use loperamide during pregnancy if its benefits are deemedto outweigh the potential but unknown risks.

NURSING MOTHERS: It is not known if loperamide is secreted in breast milk.

SIDE EFFECTS: Loperamide is generally well- tolerated. The sideeffects that have been reported during loperamide treatment includeabdominal pain, constipation, drowsiness, dizziness, dry mouth, fatigue,nausea, and vomiting.