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Loperamide

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Loperamide, Imodium

  • See Also
  1. Loperamide Toxicity
  2. Traveler's Diarrhea
  • Indications
  1. See Loperamide Misuse
  2. Traveler's Diarrhea
  • Contraindications
  1. Clostridioides difficile
  2. Dysentery (toxigenic Diarrhea)
  3. Child under age 2 years
  • Mechanism
  1. Peripherally acting Opioid
  1. Adult
    1. Initial: 4 mg orally for single first dose
    2. Titrate: 2 mg PO after each loose stool
    3. Maximum: 16 mg/day
  2. Child Age 9 to 12 year old (weight >30 kg)
    1. Give 2 mg orally three times daily
    2. Then 0.1 mg/kg orally after each loose stool
    3. Maximum: 6 mg/day in divided doses
  3. Child Age 6 to 8 years old (weight 21 to 30 kg)
    1. Give 2 mg orally twice daily
    2. Then 0.1 mg/kg orally after each loose stool
    3. Maximum: 4 mg/day in divided doses
  4. Child Age 2 to 5 years old (weight 13 to 20 kg)
    1. Give 1 mg orally three times daily on day 1
    2. Then 0.1 mg/kg orally after each loose stool
    3. Maximum: 3 mg/day in divided doses
  1. Adults
    1. Start 4 mg
    2. Then 2 mg after each loose stool until Diarrhea is controlled
    3. Then taper to maintenance 4 to 8 mg/day in divided doses (or as single dose)
    4. Maximum: 16 mg/day
  2. Child (over age 2 years)
    1. Start 0.08 to 0.24 mg/kg/day orally divided 2 to 3 times daily
    2. Maximum: 2 mg/dose and 16 mg/day
  • Safety
  1. Pregnancy Category C
  2. Safe in Lactation
  • Adverse Effects
  1. See Loperamide Toxicity
  • Resources
  1. Loperamide (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=72a7ae47-cdf3-4949-b9f8-f29b153f787f
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 96