LOPERAMIDE TABLET USE
Loperamide should not be used when inhibition of peristalsis is to be avoided due to the possible risk of significant sequelae including ileus, megacolon and toxic megacolon. Loperamide must be discontinued promptly when constipation, abdominal distension or ileus develop.
Common questions about ImodiumHere are answers to some frequently asked questions about Imodium.What should I not take with Imodium?Because of possible drug interactions, you should avoid taking certain other medications with Imodium. However, there aren’t any foods, vitamins, herbs, or supplements known to interact with Imodium.Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.To see a list of drugs that may interact with Imodium, see the “Imodium interactions” section below.Can Imodium make you feel ‘high’?No, taking Imodium at the recommended dosage to treat diarrhea won’t make you feel “high.” At this dosage, Imodium doesn’t affect your brain. Instead, it only works inside your intestine.However, Imodium’s chemical structure is similar to that of opioids, such as morphine and heroin. If it’s misused and taken in extremely large doses, Imodium can affect your brain. And if it enters your brain, it may make you feel high.Some people misuse Imodium in this way to make themselves feel high. But you shouldn’t misuse Imodium, because doing so can have serious effects on your heart. (See the following question for more details).If you have questions about how Imodium may affect you, talk with your doctor or pharmacist.Is misusing Imodium dangerous?Yes, misusing Imodium can be very dangerous. (Misuse is also sometimes called abuse.)In fact, misusing Imodium can cause serious heart problems, such as an irregular heartbeat or heart attack. It can also cause loss of consciousness and slow, weak breathing. And it can sometimes even lead to death.Because of these risks, you should never take more Imodium than the dosage that’s recommended on the product labeling or by your doctor. If you have questions about the correct dosage for you, ask your doctor or pharmacist.What should I do if I’m still having diarrhea after taking Imodium?If you’re still having diarrhea after your first dose of Imodium, take another dose after each loose stool that follows. But only take doses up to the maximum daily dose. For more information about this, see the “Imodium dosage” section above.If you still have diarrhea after using Imodium for 2 days (48 hours), see your doctor. Your doctor may order certain tests to see what’s causing your diarrhea. And they may recommend a treatment other than Imodium, depending on the results of those tests.Will I be able to poop after I take Imodium?Yes, you should be able to. Imodium slows down the contractions in your intestine so that you pass firmer stools less often. But usually, the drug doesn’t completely stop you from having bowel movements.According to Imodium’s manufacturer, in clinical studies constipation occurred in less than 3% of people who took the drug. To read more about constipation with Imodium, see the “Imodium side effects” section below.If you’re concerned about not having bowel movements while you’re taking Imodium, talk with your doctor or pharmacist.Is Imodium safe to use?Yes, Imodium is generally considered to be a very safe drug when it’s taken correctly. (This means it’s taken according to the instructions on its product label or as instructed by your doctor.)To read about the possible side effects of Imodium, see the “Imodium side effects” section below.Is Imodium gluten free?It’s not known for sure. The manufacturer of Imodium hasn’t specified whether the drug is gluten free.Imodium is available in four different products:Imodium A-D oral solution, which is a liquidImodium A-D caplets, which are capsule-shaped tabletsImodium A-D softgels, which are liquid-filled capsulesImodium Multi-Symptom relief caplets, which are capsule-shaped tabletsGluten isn’t listed as an inactive ingredient for any forms of Imodium. (Inactive ingredients are ingredients in a medication that don’t affect how it works. Examples include ingredients added for coloring or flavoring.)However, it’s possible that Imodium is made in a facility that also makes products that contain gluten. In this case, the manufacturer can’t guarantee that Imodium products aren’t contaminated with gluten.If you have celiac disease or another condition that makes your body sensitive to gluten, talk with your doctor or pharmacist. They can advise if Imodium is safe for you to take. They may also recommend a gluten-free product for your condition
.If I have diarrhea from other drugs, such as metformin, can I take Imodium?Yes, it’s possible. If your doctor says it’s safe, you may be able to take Imodium for diarrhea that’s caused by other drugs. This includes metformin (Fortamet, Glumetza, Riomet), which is used to treat diabetes.However, before taking Imodium for this purpose, talk with your doctor.
This is because, in certain situations, it’s not appropriate to self-treat diarrhea with Imodium.Your doctor may suggest different ways to treat diarrhea that’s caused by other drugs. For example, for metformin, it’s recommended that you take it with food to lessen diarrhea. Your doctor may also adjust your metformin dosage
.Before taking Imodium with other drugs, talk with your doctor or pharmacist. They can advise if it’s safe for you to take Imodium. Or they may suggest alternative treatments.
Because of possible drug interactions, you should avoid taking certain other medications with Imodium. However, there aren’t any foods, vitamins, herbs, or supplements known to interact with Imodium.
Frequently asked questions for LoperamideLoperamideQ. Is Loperamide safe?Loperamide is relatively safe if used as recommended.
In case of any side effects, consult your doctor.Q. What is Loperamide used for?Loperamide is used for treating short-term or long-term diarrhea, with or without any associated disease.Q. Can Loperamide be used for IBS?Loperamide may be used in few cases of IBS but please consult your doctor before its use.Q. Can I take Loperamide with antibiotics, paracetamol, ibuprofen, omeprazole, ciprofloxacin, desmopressin, ritonavir, quinidine or cotrimoxazole?Loperamide may be taken simultaneously with antibiotics, paracetamol, ibuprofen, omiprazole or ciprofloxacin. Loperamide might interact with desmopressin, ritonavir, quinidine or cotrimoxazole. Please consult your doctor before useQ. Does Loperamide help in opiate withdrawal?Loperamide is used in higher doses as a part of opiate withdrawal process. However, do consult your doctor regarding the same.Q. Is Loperamide addictive?No, Loperamide is a safe and non-addictive anti-diarrheal drug.Q. Can Loperamide be used for stomach cramps, nausea, stomach flu, rota virus diarrhea and gas?Loperamide may benefit few cases of stomach cramps or nausea associated with diarrhea.
It is sometimes used for stomach flu, rota virus diarrhea. It is not used for gas. Please consult your doctor before taking the drug.Q. Can I take Loperamide with cimetidine?Cimetidine can decrease the metabolism of Loperamide, increase its blood levels and hence, increase its effects and side effects. Your dose of Loperamide may needs to be decreased. Consult your doctor prior to taking both the drugs together.
The 13 included trials studied 1,788 children younger than 12 y: 975 children assigned to loperamide and 813 assigned to placebo. Of the 13 studies, six studies used loperamide doses ≤0.25 mg/kg/d, four studies used doses >0.25 mg/kg/d, and three studies used unclear maximum doses (Table 1).
Loperamide is approved to help control symptoms of diarrhea, including Travelers’ Diarrhea. The maximum approved daily dose for adults is 8 mg per day for OTC use and 16 mg per day for prescription use. It is sold under the OTC brand name Imodium A-D, as store brands, and as generics.
Non-clinical data have shown that loperamide is a P-glycoprotein substrate. Concomitant administration of loperamide (16 mg single dose) with quinidine, or ritonavir, which are both P-glycoprotein inhibitors, resulted in a 2 to 3-fold increase in loperamide plasma levels. The clinical relevance of this pharmacokinetic interaction with P-glycoprotein inhibitors, when loperamide is given at recommended dosages, is unknown. The concomitant administration of loperamide (4 mg single dose) and itraconazole, an inhibitor of CYP3A4 and P-glycoprotein, resulted in a 3 to 4-fold increase in loperamide plasma concentrations. In the same study a CYP2C8 inhibitor,
gemfibrozil, increased loperamide by approximately 2-fold. The combination of itraconazole and gemfibrozil resulted in a 4-fold increase in peak plasma levels of loperamide and a 13-fold increase in total plasma exposure. These increases were not associated with central nervous system (CNS) effects as measured by psychomotor tests (i.e. subjective drowsiness and the Digit Symbol Substitution Test). The concomitant administration of loperamide (16 mg single dose) and ketoconazole, an inhibitor of CYP3A4 and P-glycoprotein, resulted in a 5-fold increase in loperamide plasma concentrations.
This increase was not associated with increased pharmacodynamic effects as measured by pupillometry. Concomitant treatment with oral desmopressin resulted in a 3-fold increase of desmopressin plasma concentrations, presumably due to slower gastrointestinal motility. It is expected that drugs with similar pharmacological properties may potentiate loperamide's effect and that drugs that accelerate gastrointestinal transit may decrease its effect.