II. Indications
III. Contraindications
- Clostridioides difficile
- Dysentery (toxigenic Diarrhea)
- Child under age 2 years
IV. Mechanism
- Peripherally acting Opioid
V. Dosing: Acute Diarrhea
- Adult
- Initial: 4 mg orally for single first dose
- Titrate: 2 mg PO after each loose stool
- Maximum: 16 mg/day
- Child Age 9 to 12 year old (weight >30 kg)
- Give 2 mg orally three times daily
- Then 0.1 mg/kg orally after each loose stool
- Maximum: 6 mg/day in divided doses
- Child Age 6 to 8 years old (weight 21 to 30 kg)
- Give 2 mg orally twice daily
- Then 0.1 mg/kg orally after each loose stool
- Maximum: 4 mg/day in divided doses
- Child Age 2 to 5 years old (weight 13 to 20 kg)
- Give 1 mg orally three times daily on day 1
- Then 0.1 mg/kg orally after each loose stool
- Maximum: 3 mg/day in divided doses
VI. Dosing: Chronic Diarrhea or High Ileostomy Output
- Adults
- Start 4 mg
- Then 2 mg after each loose stool until Diarrhea is controlled
- Then taper to maintenance 4 to 8 mg/day in divided doses (or as single dose)
- Maximum: 16 mg/day
- Child (over age 2 years)
- Start 0.08 to 0.24 mg/kg/day orally divided 2 to 3 times daily
- Maximum: 2 mg/dose and 16 mg/day
VII. Safety
- Pregnancy Category C
- Safe in Lactation
VIII. Adverse Effects
IX. Resources
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 96
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Related Studies
| loperamide (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LOPERAMIDE 1 MG/7.5 ML SOLN | Generic OTC | $0.03 per ml |
| LOPERAMIDE 2 MG CAPSULE | Generic | $0.26 each |
| LOPERAMIDE-SIMETH 2-125 MG TAB | Generic OTC | $0.30 each |
Ontology: Loperamide (C0023992)
| Definition (NCI) | A synthetic agent chemically related to the opiates with anti-diarrheal properties. Loperamide decreases gastro-intestinal motility by effects on the circular and longitudinal muscles of the intestine. Part of its anti-diarrheal effect may be due to a reduction of gastro-intestinal secretion produced by opioid receptor binding in the intestinal mucosa. (NCI04) |
| Definition (MSH) | One of the long-acting synthetic ANTIDIARRHEALS; it is not significantly absorbed from the gut, and has no effect on the adrenergic system or central nervous system, but may antagonize histamine and interfere with acetylcholine release locally. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D008139 |
| SnomedCT | 116726003, 387040009 |
| LNC | LP18991-7, MTHU007262 |
| English | Loperamide, 1-Piperidinebutanamide, 4-(4-chlorophenyl)-4-hydroxy-N,N-dimethyl-alpha,alpha-diphenyl-, loperamide, Loperamide [Chemical/Ingredient], LOPERAMIDE, Loperamide (product), Loperamide (substance) |
| Swedish | Loperamid |
| Czech | loperamid |
| Finnish | Loperamidi |
| Russian | LOPERAMID, LOPERAMIDGIDROKHLORID, ЛОПЕРАМИД, ЛОПЕРАМИДГИДРОХЛОРИД |
| Japanese | カグダリン, ロペナ, ロンバニン, ベルテッサ, ロスポリア, ロペミン, ロペラニール, ロペラン, ミロピン, クラレット, ロペカルド, タイペミン, ロペミック, ロペラミド, 塩酸ロペラミド, ロペジャスト, ロペラミド塩酸塩 |
| Polish | Loperamid |
| Spanish | loperamida (producto), loperamida (sustancia), loperamida, Loperamida |
| French | Lopéramide |
| German | Loperamid |
| Italian | Loperamide |
| Portuguese | Loperamida |
Ontology: Imodium (C0591635)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D008139 |
| English | imodium, Imodium |
