Loperamide (Imodium)

Category:

• Miscellaneous

Description:

• Antidiarrheal

Indications:

• Diarrhea (acute non-specific)

• Chronic diarrhea (inflammatory bowel disease)

• Reduction of volume from ileostomy

• Traveler’s diarrhea

Contraindications:

• Acute diarrhea due to invasive organisms (enteroinvasive E. coli, Salmonella, Shigella) or pseudomembranous colitis

Precautions:

• Pregnancy category B: unknown if excreted in breast milk; compatible with breast feeding

• Liver disease, dehydration

• Severe ulcerative colitis (toxic megacolon)

• Children (greater variability in response)

Adverse Reactions (Side Effects):

• CNS: fatigue, fever, dizziness, drowsiness

• GI: abdominal pain, anorexia, constipation, dry mouth, nausea, toxic megacolon, vomiting

• RESP: respiratory depression

• SKIN: rash

Dosage:

Administered orally (capsule, liquid)

• Adult:   PO 4mg, then 2mg after each loose stool, max 16mg daily; maintenance for chronic diarrhea usually 4-8mg daily

• Child:   <2 years not recommended; 13-20 kg PO 2mg 2 times daily on day 1, then 0.1 mg/kg after each loose stool; >30 kg PO 2mg 3 times daily on day 1, then 0.1 mg/kg after each loose stool