Missed Dose
Loperamide is beneficial because it acts as a mu opioid-agonist on the myenteric plexus of the large intestine. This is just a fancy way of saying loperamide has the same effects that opioids do on your stomach. Loperamide is a synthetic opioid, though it does not get you high.
Overdose
The maximum daily dose for loperamide varies depending on the age of the patient. For adults and adolescents 12 years of age and older, the maximum dose is 16 mg. per day, in divided doses. Typically, this will be four mg. following the first bout of diarrhea and two mg. doses after each additional bout of diarrhea.
How to use?
How often is it safe to take Imodium? Loperamide is a very safe drug which is not addictive. It can be taken in doses of up to 8 capsules (16 milligrams) per day over long periods of time. Do not take more than 16 milligrams per day without medical advice. Is it better to stop diarrhea or let it go?
Why is loperamide considered an opioid?
- Fainting
- Rapid heartbeat or irregular heart rhythm
- Unresponsiveness, meaning that you can’t wake the person up or the person doesn’t answer or react normally
What is the maximum daily dosage for loperamide?
How often to take loperamide?
What are the risks of taking loperamide?
See more
How many mg of a sulfate can you take a day?
However, dose is usually not more than 16 mg (8 capsules) per day. Children 2 years of age and older—Use and dose must be determined by your doctor. Children younger than 2 years of age—Use is not recommended.
How to store a med?
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use.
Can you take IBM Micromedex more often?
Proper Use. Drug information provided by: IBM Micromedex. Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. Swallow the capsule whole.
Usual Adult Dose for Diarrhea - Acute
Loperamide 4 mg-simethicone 250 mg orally once after the first loose stool, followed by loperamide 2 mg-simethicone 125 mg orally once after each subsequent loose stool -Maximum dose: Loperamide 8 mg-simethicone 500 mg/24 hours -Duration of therapy: Up to 2 days Comments: -Doses should be taken on an empty stomach (e.g., approximately 2 hours after a meal or 1 hour before a meal). -Patients should take each dose with a full glass of water. Use: Relief of symptoms related to diarrhea and gas (bloating, cramps, pressure).
Usual Pediatric Dose for Diarrhea - Acute
Age-based dosing: Under 2 years: Not recommended. 2 to 5 years: Patients should consult with their healthcare provider. 6 to 8 years: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool -Maximum dose: Loperamide 4 mg-simethicone 250 mg/24 hours -Duration of therapy: Up to 2 days 9 to 11 years: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool -Maximum dose: Loperamide 6 mg-simethicone 375 mg/24 hours -Duration of therapy: Up to 2 days 12 years and older: Loperamide 4 mg-simethicone 250 mg orally once after the first loose stool, followed by loperamide 2 mg-simethicone 125 mg orally once after each subsequent loose stool -Maximum dose: Loperamide 8 mg-simethicone 500 mg/24 hours -Duration of therapy: Up to 2 days Weight-based dosing: Up to 15 kg: Not recommended. 15.5 to 21.4 kg: Patients should consult with their healthcare provider. 21.8 to 26.8 kg: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool -Maximum dose: Loperamide 4 mg-simethicone 250 mg/24 hours -Duration of therapy: Up to 2 days 27.3 to 43.2 kg: Loperamide 2 mg-simethicone 125 mg orally once after the first loose stool, followed by loperamide 1 mg-simethicone 62.5 mg orally once after each subsequent loose stool -Maximum dose: Loperamide 6 mg-simethicone 375 mg/24 hours -Duration of therapy: Up to 2 days Comments: -Weight-based dosing is preferred; however, this drug may be dosed based on age. -Doses should be taken on an empty stomach (e.g., approximately 2 hours after a meal or 1 hour before a meal). -Patients should take each dose with a full glass of water. Use: Relief of symptoms related to diarrhea and gas (bloating, cramps, pressure).
Dose Adjustments
Clinical improvement not observed or within 2 days OR worsening of symptoms during treatment: Discontinue administration.
Precautions
CONTRAINDICATIONS: -Hypersensitivity, including rashes, to the active components or any of the ingredients -Patients with bloody or black stools -Patients with difficulty swallowing Safety and efficacy have not been established in patients younger than 2 years. Consult WARNINGS section for additional precautions.
Other Comments
Administration advice: -Patients should take each dose with a full glass of water. Storage requirements: -Protect from light. General: -Patients should receive fluid and electrolyte replacement therapy as needed. Patient advice: -Inform patients that diarrheal syndromes may cause dizziness, drowsiness, tiredness, and they should avoid driving or operating machinery if these side effects occur. -Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding. -Patients should be instructed to avoid exceeding the recommended dose and/or the duration of treatment..
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
How much loperamide is in a loperamide capsule?
Capsules - each capsule contains 2 mg of loperamide hydrochloride. The capsules have a light green body and a dark green cap with "JANSSEN" imprinted on one segment and "IMODIUM" on the other segment. IMODIUM® capsules are supplied in bottles of 100.
What is IMODIUM used for?
IMODIUM® (loperamide hydrochloride) is indicated for the control and symptomatic relief of acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease. IMODIUM® is also indicated for reducing the volume of discharge from ileostomies.
Why is IMODIUM used with caution?
Although no pharmacokinetic data are available in patients with hepatic impairment, IMODIUM should be used with caution in such patients because of reduced first pass metabolism. (see Precautions).
What is the hypersensitivity to loperamide?
Hypersensitivity to loperamide or any component of the formulation; abdominal pain without diarrhea; children <2 years; acute dysentery; acute ulcerative colitis; bacterial enterocolitis (caused by Salmonella, Shigella, and Campylobacter ); pseudomembranous colitis associated with broad-spectrum antibiotic use.
How much titration for diarrhea?
Chronic diarrhea: Oral: Initial: 4 mg, followed by 2 mg after each loose stool (maximum: 16 mg/day); maintenance dose should be slowly titrated downward to minimum required to control symptoms (usual: 4 to 8 mg/day as a single dose or in divided doses; maximum: 16 mg/day).
What is the best treatment for traveler's diarrhea?
The American College of Gastroenterology recommends adjunctive loperamide therapy in patients receiving antibiotics for Traveler’s diarrhea to decrease duration of diarrhea and increase chance for a cure Riddle 2016.
Is loperamide used for cancer?
Data from clinical trials, clinical practice guidelines, and reviews support the use of loperamide in the management of cancer treatment-induced diarrhea, including irinotecan-induced diarrhea Andreyev 2014, Benson 2004, Morturano 2012, Park 2016, Rothenberg 1996, Sharma 2005, Swain 2017.
Can loperamide cause torsades de pointes?
Cases of torsades de pointes, cardiac arrest, and death have been reported with the use of a higher than recommended dosage of loperamide.
Is loperamide safe for diarrhea?
Acute diarrhea : Note: Loperamide is not recommended for management of infectious diarrhea in pediatr ic patients (IDSA [Shane 2017]). For patients who are small for chronological age, consider dosing according to weight range and not by age group. Use lowest effective dose for shortest duration.
How many caps of imodium should I take for diarrhea?
The recommended dosage for adults and children ages 12 years and older is as follows: Take two caplets after your first loose stool. Then take one caplet after each loose stool that follows.
What is the difference between imodium and lomotil?
Imodium Multi-Symptom Relief is used to treat diarrhea along with gas, bloating, and cramps. Lomotil is used as an add-on treatment for diarrhea that’s not controlled with other medications. Imodium is used in adults and children ages 2 years and older.
How long does it take for Imodium to work?
Imodium typically starts to control diarrhea within 1 hour after you’ve taken the first dose.
What should I not take with Imodium?
However, there aren’t any foods, vitamins, herbs, or supplements known to interact with Imodium.
Is misusing Imodium dangerous?
Yes, misusing Imodium can be very dangerous. (Misuse is also sometimes called abuse.)
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.
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.
How much loperamide is in a loperamide capsule?
Capsules - each capsule contains 2 mg of loperamide hydrochloride. The capsules have a light green body and a dark green cap with "JANSSEN" imprinted on one segment and "IMODIUM" on the other segment. IMODIUM® (loperamide hcl) capsules are supplied in bottles of 100.
How many mg of imidium is needed for diarrhea?
The average daily maintenance dosage in clinical trials was 4 to 8 mg (two to four capsules). A dosage of 16 mg (eight capsules) was rarely exceeded. If clinical improvement is not observed after treatment with 16 mg per day for at least 10 days, symptoms are unlikely to be controlled by further administration. IMODIUM® (loperamide hcl) administration may be continued if diarrhea cannot be adequately controlled with diet or specific treatment.
What is imodium used for?
Imodium (loperamide hydrochloride) is an antidiarrheal used to treat diarrhea. Imodium is also used to reduce the amount of stool in people who have an ileostomy (re-routing of the bowel through a surgical opening in the stomach). Imodium is available in generic form and over-the-counter ( OTC ).
What is imodium hydrochloride?
IMODIUM® (loperamide hydrochloride) is indicated for the control and symptomatic relief of acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease. IMODIUM® (loperamide hcl) is also indicated for reducing the volume of discharge from ileostomies.
When should Imodium be discontinued?
IMODIUM (loperamide hcl) must be discontinued promptly when constipation, abdominal distention or ileus develop.
Why is IMODIUM used in children?
IMODIUM® (loperamide hcl) should be used with special caution in young children because of the greater variability of response in this age group. Dehydration, particularly in younger children, may further influence the variability of response to IMODIUM® (loperamide hcl) .
How to report side effects of prescription drugs?
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Why is it important for emergency physicians to be aware of loperamide overdoses?
It is necessary for emergency physicians to be aware of loperamide overdoses because cases have been increasing over the past several years and the cardiac complications can be life-threatening. Keywords: loperamide overdose, imodium® overdose, opioid, long qt syndrome, torsades. Introduction.
Is loperamide an over the counter drug?
Loperamide (Imodium®) is an over-the-counter anti-diarrheal medication abused by some patients to either achieve opioid-like euphoria or self-medicate the symptoms of opioid withdrawal [1]. The use of this drug of abuse is on the rise with the number of cases of reported overdose increasing each year [2]. Unfortunately, patients must use doses much higher than recommended to achieve systemic opioid effects with loperamide. These overdoses result in cardiac arrhythmias and electrolyte disturbances that can be fatal [1,3-4]. Due to the increasingly problematic opioid epidemic, the emergency physician needs to be aware of loperamide overdose as a possible cause for arrhythmia in the toxicology patient. In this case, we present a 35-year-old male with a loperamide overdose, leading to multiple shocks from his automated implantable cardioverter-defibrillator (AICD) because of the resulting arrhythmias.
Can loperamide cause cardiac arrhythmias?
These overdoses result in cardiac arrhythmias and electrolyte disturbances that can be fatal [1,3-4]. Due to the increasingly problematic opioid epidemic, the emergency physician needs to be aware of loperamide overdose as a possible cause for arrhythmia in the toxicology patient.
Is loperamide a cardiac overdose?
In light of the opioid epidemic, cardiac complications following a loperamide overdose are a growing concern for patients presenting to the emergency department (ED). Here, we present the case of a 35-year-old male with long QT syndrome who presented following a loperamide overdose and was receiving multiple shocks because of the resulting arrhythmias and electrolyte disturbances. It is necessary for emergency physicians to be aware of loperamide overdoses because cases have been increasing over the past several years and the cardiac complications can be life-threatening.
Is loperamide a drug?
Loperamide overdose is becoming a growing concern in the field of emergency medicine, secondary to the opioid epidemic. The over-the-counter anti-diarrheal medication is intended to only utilize mu-opioid receptors in the myenteric plexus of the gastrointestinal (GI) tract to slow intestinal motility. Unfortunately, in an overdose, specificity for the gastrointestinal tract is overwhelmed and the drug, including its opioid effects, becomes systemic [5]. Patients use high-dose loperamide for symptoms of opioid withdrawal and even attempt to recreationally overdose on this medication with doses of the medication over 100 times the recommended 16 mg daily maximum. Patients with a predisposition to arrhythmia, such as long QT syndrome in this case, are especially at risk due to the action of loperamide on potassium channels, resulting in QT prolongation, and on sodium channels, resulting in QRS prolongation [4]. Unfortunately, the number of cases of loperamide overdose continues to rise by as high as 91% from 2010-2015 [6], highlighting the increasing trend of the overdose on this medication [2,7-8]. Many cases have been reported showing arrhythmia in patients who overdose on loperamide to the point where the Food and Drug Administration (FDA) issued a warning in June 2016 about the potential cardiotoxic side effects of loperamide in an attempt to dissuade potential abusers [3]. Although acute overdose to achieve euphoria is common, patients also suffer from chronic overdoses because they use daily high-doses to control opioid withdrawal symptoms in place of drugs like methadone [9]. The overdose of loperamide can also be seen in individuals with chronic diarrhea who take doses that are much too high [10].
Where to report side effects of loperamide?
We urge patients, consumers, and health care professionals to report side effects involving loperamide or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.
Why do people take loperamide?
Some individuals are taking high doses of loperamide to treat symptoms of opioid withdrawal.
How many mg of loperamide in a carton?
These changes limit each carton to no more than 48 mg of loperamide and require the tablets and capsules to be packaged in individual doses. FDA continues to work with manufacturers, including those of generic and liquid OTC loperamide products to institute appropriate package sizes and types that support the safe use of these medicines.
Can you take loperamide more than prescribed?
Patients and consumers should only take the dose of loperamide directed by your health care professionals or according to the OTC Drug Facts label, as taking more than prescribed or listed on the label can cause severe heart rhythm problems or death.
Does loperamide slow down bowel movements?
Loperamide acts on opioid receptors in the gut to slow the movement in the intestines and decrease the number of bowel movements. It is safe at approved doses, but when much higher than recommended doses are taken, it can lead to serious problems, including severe heart rhythm problems and death.
Is loperamide OTC?
[1-30-2018] To foster safe use of the over-the counter (OTC) anti-diarrhea drug loperamide, the U.S. Food and Drug Administration (FDA) is working with manufacturers to use blister packs or other single dose packaging and to limit the number of doses in a package. We continue to receive reports of serious heart problems and deaths with much higher than the recommended doses of loperamide, primarily among people who are intentionally misusing or abusing the product, despite the addition of a warning to the medicine label and a previous communication. Loperamide is a safe drug when used as directed.
Can you take loperamide with OTC?
Also counsel patients to take loperamide only as prescribed or according to the OTC Drug Facts label and advise patients that drug interactions with commonly used medicines may increase the risk of serious cardiac events.