Loperamide

Loperamide is an antidiarrheal drug.

Release form and composition

Loperamide dosage forms - tablets (10, 20, 30, 40, 50, 60, 70, 80 or 100 pieces per pack) and oral capsules (7, 10, 14, 28 or 30 pieces per pack) .

The active ingredient of the drug is loperamide hydrochloride. In 1 tablet and 1 capsule it contains 2 mg.

Auxiliary components:

• Tablets: potato starch, worn-70, calcium stearate;
• Capsules: magnesium stearate, milk sugar, aerosil, corn starch, talc.

Indications for use

Loperamide is intended for the symptomatic treatment of acute and chronic diarrhea of ​​various origins, including medicinal, emotional, radiation and allergic origin; infectious genesis (as an aid); developed as a result of impaired absorption and metabolism, changes in the diet or the qualitative composition of food.

Also, the drug is prescribed to patients with ileostomy for the regulation of stool (reducing its frequency and volume, imparting a density of its consistency).

Contraindications

• Glucose-galactose malabsorption, lactase deficiency or lactose intolerance;
• Acute dysentery (especially accompanied by increased body temperature and the presence of blood in the stool);
• Diarrhea accompanying acute pseudomembranous enterocolitis caused by the use of broad-spectrum antibiotics;
• Ulcerative colitis in the acute stage;
• Intestinal obstruction;
• Diverticulosis;
• Other conditions in which the suppression of intestinal peristalsis is unacceptable;
• Dysentery and other infectious diseases of the gastrointestinal tract - in the form of monotherapy;
• I trimester of pregnancy;
• Lactation;
• Children's age up to 6 years;
• Hypersensitivity to the drug.

Loperamide should be used with caution in patients with hepatic insufficiency, as well as children under the age of 12 years.

Dosing and Administration

Both dosage forms of the drug are intended for oral administration.

Recommended doses for acute diarrhea:

• Adult patients: the initial dose is 4 mg (2 capsules or 2 tablets), then 2 mg (1 capsule or tablet) after each defecation with liquid stools;
• Children from 6 years: 2 mg after each act of defecation with liquid stools.

Recommended doses for chronic diarrhea:

• Adults: the initial dose of 4 mg, then 2 mg from 1 to 6 times per day;
• Children from 6 years: 2 mg 1 to 5 times a day.

The duration of treatment is determined by the normalization of the chair or its absence for at least 12 hours.

Side effects

• Gastrointestinal: dry mouth, pain or discomfort in the abdomen, constipation and / or bloating, nausea, vomiting, intestinal colic; very rarely - intestinal obstruction;
• Nervous system: drowsiness, fatigue, dizziness;
• Allergic reactions: urticaria and skin rash; in individual cases - anaphylactic shock and bullous rash;
• Other: rarely - urinary retention.

Overdose symptoms: depression of the central nervous system (muscle hypertonia, incoordination, miosis, drowsiness, stupor, respiratory depression) and intestinal obstruction. If necessary, prescribe an antidote - naloxone (its duration of action is less than that of loperamide, therefore repeated administration is possible). Treatment involves gastric lavage, taking activated charcoal, symptomatic therapy and, if required, mechanical ventilation. The patient must be under the supervision of a physician for at least 1 day.

special instructions

In chronic diarrhea, loperamide can only be taken as prescribed by a doctor.

If there is no clinical improvement in acute diarrhea within 48 hours, or abdominal distention, constipation or partial intestinal obstruction develops, the drug should be discontinued.

Younger children are more sensitive to the opiate-like effects of loperamide (effects on the central nervous system), so they should use Loperamide with extreme caution.

Caution should also be observed in elderly patients, since in old age, variability of loperamide reaction and masking of dehydration symptoms are possible.

When treating diarrhea, especially in children, it is necessary to compensate for the loss of fluid and electrolytes.

Patients with impaired liver function should carefully monitor the signs of toxic damage to the central nervous system.

In travelers' diarrhea, loperamide can lead to a prolonged rise in temperature, which is caused by the slowing down of the removal of microorganisms (Salmonella, Shigella, some strains of Escherichia coli, etc.) and their penetration into the intestinal mucosa.

The entire period of treatment is recommended to use caution when driving and engaging in other potentially hazardous activities that require quick reactions and high concentration of attention.

Drug interaction

With the simultaneous use of opioid analgesics increases the risk of developing severe constipation.

Terms and conditions of storage

Store in a place protected from light and moisture at a temperature up to 25 ºС.

Shelf life - 2 years.