Loperamide is a drug that has been produced in Ukraine for more than 40 years and is an emergency medicine for acute and chronic disorders of a non-infectious nature.
The drug is a piperidine derivative and interacts with opioid receptors in the intestinal wall by inhibiting the flow of prostaglandin and acetylcholine. As a result, contractile function decreases and the time of movement of intestinal contents increases. The anal sphincter begins to hold feces longer, the urge to defecate decreases, and the excretion of water and electrolytes in feces is reduced.
Overdose and side effects of loperamide
Loperamide is not recommended for use in cases of ulcerative colitis, bloody or tarry stools, diarrhea caused by antibiotics, or diarrhea that is accompanied by a high fever.
The maximum daily dose of loperamide for an adult is 12 mg.
The drug is available in the following forms:
- pills;
- capsules;
- dispersible tablets.
Be careful!
Loperamide is safe when used as directed and at the recommended dosage. An overdose of loperamide can cause heart problems and cause serious harm to health.
Loperamide cannot be combined with all medications; if combined incorrectly, side effects may occur. Before taking loperamide, consult your doctor.
#7 Interaction
Medicines that interact with loperamide can reduce its effectiveness, change its duration of action, and increase side effects. An interaction between two medications does not always mean that you should stop taking one of the medications, but sometimes it is necessary to do so. Talk to your doctor about which medications can and cannot be combined with loperamide.
Medicines that may have a moderate interaction with loperamide:
- lumacaftor and other P-glycoprotein substrates;
- sincalide;
- haloperidol;
- quinidine;
- ilamiodarone;
- ondansetron;
- opioids;
- Ramosetron.
Please note that this list is not comprehensive and only includes common medications that may interact with loperamide. For more detailed advice about the interaction of loperamide with other drugs that you take, contact your doctor and carefully read the instructions for the drug.
Using loperamide: what you need to know before you start taking it
Loperamide should not be taken if you are allergic or hypersensitive to loperamide hydrochloride or any part of the drug.
Loperamide should not be used if you have the following conditions:
- abdominal pain without diarrhea;
- ulcerative colitis or pseudomembranous colitis caused by the use of broad-spectrum antibiotics;
- bacterial enterocolitis caused by microorganisms of the Salmonella, Shigella and Campylobacter families;
- diarrhea accompanied by high fever;
- diarrhea caused by a bacterial infection;
- bloody, black, tarry stools.
Before taking loperamide to treat diarrhea caused by antibiotics, consult your doctor.
This drug should not be taken by children under 2 years of age. For older children, loperamide should be prescribed by a doctor.
Check with your doctor to see if it is safe for you to take loperamide if you have these conditions:
- fever;
- mucus in stool;
- liver diseases;
- heart rhythm disturbances.
It is unknown whether loperamide can harm the fetus during pregnancy. Therefore, pregnant women should inform their doctor about their condition and follow his recommendations for using the drug.
During lactation (breastfeeding), do not take loperamide or stop feeding while using the drug.
Can I take Loperamide during pregnancy?
Diarrhea that occurs during pregnancy should not become a reason to decide on self-medication. First of all, it is necessary to examine a pregnant woman for the presence of an intestinal infection. Then it is important to evaluate her diet in order to draw conclusions about the need to adjust the menu. If diarrhea is not the result of serious gastrointestinal disorders, Loperamide may be approved for use provided that the pregnancy is not in the first trimester.
How to take loperamide?
You should take loperamide according to the instructions or individual doctor's prescription.
You should not take a dose of the drug more than recommended in the instructions. Overdose can cause serious heart problems and other negative effects.
Pay attention to the difference in dosages for adults and children. Doses for children of different ages are different, so read the instructions carefully.
Loperamide in tablet and capsule form should be taken with a full glass of water.
Diarrhea causes fluid loss that needs to be replaced, so if you have this condition, you should drink plenty of water to avoid dehydration.
The rules for using loperamide depend on the form of the drug, for example, a chewable tablet must be chewed before swallowing. Loperamide in the form of an oral suspension (liquid) should be shaken before administration and the dose indicated in the instructions should be taken. It must be measured only using a special device for measuring the dose of medicine, which is included with the package, and not with a kitchen spoon.
The drug must be stored at room temperature, avoiding moisture and sunlight. Loperamide in liquid and suspension form should not be frozen.
Be careful!
Stop using the drug and call your doctor if, after 2 days of using loperamide, your diarrhea does not go away or you experience bloating.
Contraindications
In the process of taking the medicine, painful and other conditions were identified that were negatively affected by the medicine. In such conditions, you should immediately stop taking the drug. Before taking Loperamide, you should familiarize yourself with the list of contraindications and make sure that there are no such conditions.
Contraindications include:
- intestinal obstruction;
- individual increased susceptibility to the constituent components;
- acute ulcerative colitis;
- lactation period;
- 1st trimester of pregnancy;
- constipation;
- children under the age of 4-8 years (depending on the manufacturer).
Consequences of an overdose of loperamide
Get emergency medical help if you think you have taken too much loperamide.
Symptoms of overdose are as follows:
- cardiopalmus;
- irregular heartbeat;
- fainting.
Be careful!
If you have these symptoms, call your doctor or seek emergency medical help immediately. If you become unconscious, the person near you should immediately seek emergency medical attention.
Pharmacodynamics and pharmacokinetics
Loperamide Hydrochloride is an antidiarrheal drug that is effective in inhibiting intestinal motility. The effect of the drug is manifested due to the binding of its active ingredient to opioid receptors located in the intestinal walls, resulting in suppression of the release of prostaglandin E2α and acetylcholine . As a result of this effect, the movement of intestinal contents and its peristalsis , and the absorption time of electrolytes and water . In addition to this, the drug has an antisecretory effect, reduces the urge to defecate , increases the tone of the anal sphincter and helps to contain feces.
T1/2 of a drug is on average 11 (from 9 to 14) hours. The connection with plasma proteins (mainly with albumin ) is at the level of 95%. Elimination is carried out due to oxidative N-demethylation, which is the main pathway of metabolic transformations of the drug. It is excreted from the human body mainly with feces.
What should you not do while taking loperamide?
Loperamide should not be taken with tonic water; the interaction between the two may cause heart problems.
Stay hydrated and drink plenty of fluids. If you are dehydrated, do not engage in intense exercise or be outside in hot weather.
Study the effect of the drug on you before driving a car or operating complex machinery. The speed of your reactions may be impaired. If the medicine causes drowsiness and slower reactions, do not drive or operate complex machinery after using it.
Popular questions about Loperamide
How to take Loperamide?
Loperamide stomach upset tablets should be swallowed with water.
Adults and children over 12 years of age need to take 2 tablets orally at once, then reduce the dose to 1 tablet and drink after each loose bowel movement. You should not take more than 6 tablets per day.
How quickly does loperamide work?
The medicine acts three to six hours after ingestion.
How often can you take loperamide?
The drug is taken as early as possible, from the first symptoms of the disorder until the cessation of loose bowel movements.
The patient should not take more than 6 tablets per day. If the condition does not improve within two days, stop taking the medication.
Should I take loperamide before or after meals?
Eating does not affect the pharmacological properties and absorption of the drug.
What are the side effects of loperamide?
Get emergency medical help right away if you have signs of any of the following reactions to loperamide:
- hives;
- labored breathing;
- swelling of the face or throat;
- fever;
- burning in the eyes;
- a red or purple skin rash that spreads throughout the body and causes pimples and flaking.
Be careful!
Stop using loperamide and call your doctor immediately if you experience these side effects:
- watery or bloody diarrhea;
- stomach pain or bloating;
- continued or worsening diarrhea;
- fast or racing heartbeat;
- shortness of breath and sudden dizziness.
Common side effects may include:
- constipation;
- dizziness, drowsiness;
- nausea;
- stomach cramps.
This is not a complete list of side effects of loperamide. Check with your doctor about all side effects of this drug and if any of them occur, stop using it and seek emergency medical help.
Loperamide instructions: from what
The prescription of the drug is not always associated with the onset of diarrhea, although it is the main indication. If stool disorder occurs due to a reaction to taking medications, you should take Loperamide, which will stop the rapid movement of food through the intestines, and along with it, the medication taken.
This will allow the active substances not to be evacuated through the anus, but to remain in the intestine in order to have time to be absorbed into the blood and provide the expected therapeutic assistance. Diarrhea is often caused by taking antibiotics. If the patient takes antibacterial drugs, and they, along with frequent loose stools, immediately leave the body, no treatment will work. Therefore, diarrhea caused by taking medications is the first indication for prescribing Loperamide.
In addition, the drug is indicated for use in case of metabolic disorders. In this case, the patient, no matter how much he eats, does not gain weight, does not receive enough nutrients, as a result of which the body is rapidly depleted. Loperamide allows food to stay in the intestines, and vitamins and minerals to be absorbed through its walls.
If the patient has had surgery to remove the end of the intestine through an opening in the abdominal cavity, Loperamide may be prescribed to reduce the frequency of bowel movements and also allow food to remain in the lumen, which is especially important for those patients whose intestinal length has been significantly reduced as a result of the operation .
Method of administration and dosage of loperamide
Application and dosage of loperamide for children:
- from 2 to 5 years (child weight 13 - 20 kg);
On the first day: 1 mg orally 3 times a day (total daily dose 3 mg).
Subsequent daily dose: 1 mg only after loose stools, not more than 3 mg per day
- from 6 to 8 years (child weight 20 - 30 kg);
On the first day: 2 mg orally 2 times a day (total daily dose 4 mg).
Subsequent daily dose: 2 mg only after loose stools, not more than 4 mg per day.
- from 9 to 12 years (child weight more than 30 kg);
On the first day: 2 mg orally 3 times a day (total daily dose 6 mg).
Subsequent daily dose: 2 mg only after loose stools, not more than 6 mg per day
- from 12 to 18 years (child weight over 30 kg);
On the first day: 4 mg orally after each loose stool.
Subsequent daily dose: 2 mg only after each unformed stool.
Application and dosage of loperamide for acute diarrhea in adults:
- initial dose - 4 mg orally, then 2 mg after each subsequent loose stool or as prescribed by the doctor;
- the maximum daily dose is 12 mg per day.
Application and dosage of loperamide for chronic diarrhea in adults:
- initial dose - 4 mg orally after each loose stool, then 2 mg until diarrhea stops;
- the maximum dose is 12 mg per day.
Once diarrhea has resolved, reduce the dose according to individual needs.
Clinical improvement should be observed within 48 hours. If no change occurs, stop using the drug and consult a doctor.
Adverse reactions
The following negative effects may occur:
- allergy;
- bloating;
- weakness;
- gagging;
- difficult emptying;
- feeling of dry mouth;
- dizziness;
- discomfort and pain in the abdominal area.
In rare cases, there may be urinary retention.
What you need to know about loperamide
Keep loperamide and all other medicines out of the reach of children, never share your medicine with other people, and use it only as directed.
Before using loperamide, be sure to consult your doctor.
Sources
Loperamide / Drugs.com
Loperamide/National register of medicinal products (ukr.)
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How much does Loperamide Akrikhin cost?
There are many manufacturers producing Loperamide under different names. The addition “Akrikhin” indicates that the drug belongs to a specific company. The manufacturer Akrikhin KhFK JSC is not a representative of companies selling drugs at high prices, therefore, if the pharmacy does not have just Loperamide, and the pharmacist offers an analogue with the postscript “Akrikhin”, do not be alarmed. The price for a package of 20 tablets will cost about 59 rubles, and a box with a dozen tablets will cost only 30 rubles.
Reviews
When looking through reviews of loperamide hydrochloride, you should remember that this drug is mainly intended for the symptomatic treatment of diarrhea for a short period of time. In the case of bacterial , exudative , invasive , etc. origin, the drug will be at least ineffective, and in some cases may lead to masking of the symptoms of the pathological process and, as a result, to the progression of the disease.
Indications for use
The use of Loperamide Hydrochloride is indicated for the symptomatic treatment of chronic and acute diarrhea.
The drug can be used for prevention against traveler's diarrhea . In this case, therapy should continue for at least 48 hours. blood is detected in the stool should the drug intake be interrupted until the exact cause of this phenomenon is determined.
special instructions
It is worth remembering that the use of loperamide hydrochloride for the treatment of diarrhea is symptomatic. In the case when the cause of diarrhea is accurately diagnosed, it is better to carry out targeted therapy using medications indicated specifically for this painful condition.
Purely against the background of diarrhea , especially in children, an imbalance of electrolytes and dehydration . When observing these phenomena, first of all, measures should be taken to replenish electrolytes and fluids in the body.
When taking loperamide hydrochloride to treat diarrhea in patients with immunodeficiency , if the first symptoms of abdominal bloating , therapy should be stopped immediately. Also, in patients with AIDS , isolated cases of the formation of toxic megacolon with parallel infectious colitis both bacterial and viral etiology .
Despite the absence of deviations in the pharmacokinetic parameters of loperamide hydrochloride in the treatment of patients with liver pathologies , this group of patients should prescribe the drug with caution, due to the slowdown in first-pass metabolic transformations. For timely detection of possible symptoms of toxic damage to the central nervous system, such patients should be under constant observation.
Due to the presence of lactose , its use is prohibited for patients with sugar intolerance .
In case of formation of bloating , constipation , partial intestinal obstruction , as well as megacolon , diverticulosis , enterocolitis associated with exposure to Salmonella bacteria , therapy should be stopped immediately.
During pregnancy and lactation
data on the embryotoxic and teratogenic effects of loperamide hydrochloride . Despite this, during pregnancy , especially in the first trimester, prescribing the drug is permissible only if the positive effect for the mother significantly exceeds the possible risk for the fetus/child.
A certain amount of the drug is found in the milk of a nursing mother, and therefore breastfeeding .
