BACKGROUND: Loperamide is a synthetic piperidine derivative used for the treatment of both acute and chronic diarrhea. Little is known about its safety and risk in pregnancy. Human data are limited to one surveillance study of Michigan Medicaid patients, with 108 women exposed in the first trimester.
Full Answer
Is it safe to take loperamide during pregnancy?
Loperamide during pregnancy should not be consumed unless prescribed, it acts as a last resort against an extremely bad case of diarrhoea, the consumption should also only be considered based on the period of gestation.
Why is Lexapro in Pregnancy Category C?
Why is Lexapro in Pregnancy Category C? July 19, 2012 The Food and Drug Administration (FDA) placed Lexapro (escitalopram) in Category C because the federal health agency was concerned this common prescribed antidepressant medication might have the capacity to harm developing children.
What are "Pregnancy Category C" medications?
The U.S. FDA has issued the following definition for the pregnancy category C: For pregnant women, this means that any medication that has a Pregnancy Category C listed is not likely to be prescribed by your health care provider , as it may cause harm to your unborn baby.
What is a pregnancy class C drug?
Drug Treatment of Hypertension in Pregnancy. (3 days ago) According to FDA labetalol is a Class C drug. It may be associated with a risk of fetal bradycardia and neonatal hypoglycemia. According to either the World Health Organization and/or Thomson lactation ratings methyldopa is usually compatible with breast milk.
Is loperamide safe during pregnancy?
Loperamide, the active ingredient in the brand-name drug Imodium, is used to treat acute diarrhea and sometimes chronic diarrhea, and is considered safe for pregnant women. You can buy it at a pharmacy or drug store.
What pregnancy category is loperamide?
OTC Antidiarrheal Medications in PregnancyDrug nameFDA pregnancy risk classification by trimester (1st/2nd/3rd)Use in pregnancyLoperamide (Imodium)B/B/BProbably safe*Atropine/diphenoxylate (Lomotil)C/C/CNot recommended (adverse animal studies)2 more rows•Jun 15, 2003
Is it safe for pregnant to take Diatabs?
Can pregnant women and/or breastfeeding mothers take Diatabs®? Diatabs® is not advisable to be taken by those who are pregnant, or those who are breastfeeding.
Why is loperamide contraindicated?
Contraindications. Loperamide Hydrochloride Capsules is contraindicated in: pediatric patients less than 2 years of age due to the risks of respiratory depression and serious cardiac adverse reactions (see WARNINGS). patients with a known hypersensitivity to Loperamide hydrochloride or to any of the excipients.
What Antidiarrheals are safe during pregnancy?
The most recommended antidiarrheal for pregnant women is a kaolin-and-pectin-type medication (Kaopectate). Avoid antidiarrheals that contain bismuth subsalicylate (Pepto-Bismol) or atropine/diphenoxylate (Lomotil).
Is lomotil safe in pregnancy?
Safety During Pregnancy Lomotil should only be used during pregnancy if clearly needed. Notify the prescribing doctor if you become pregnant while taking Lomotil. It is not known if Lomotil passes into breast milk, but it is theorized that atropine does pass into breast milk.
Is Erceflora safe for pregnant?
This medicinal product may be used during pregnancy and breast-feeding.
Is Imodium safe in first trimester?
A doctor may also advise a pregnant patient to avoid Imodium, especially during the first trimester. The first trimester is when a baby is doing all of its major development, and the organs are developing. It's best to avoid all medicines during the first trimester.
Is hyoscine butylbromide safe in pregnancy?
No adverse effects during pregnancy or lactation have been proven; however, its use is recommended with caution under the first trimester. Side effects include: dry mouth, facial flushing, intermittent loss of accommodation reflexes, urinary retention and constipation.
Who should not take loperamide?
This medication should not be used by children younger than 2 years due to an increased risk of side effects (such as slow/shallow breathing, fast/irregular heartbeat). Warnings: Improper use of this medication (overuse or abuse) may cause serious harm, such as fast/irregular heartbeat or death.
Can I take omeprazole with loperamide?
Interactions between your drugs No interactions were found between Imodium and omeprazole.
When is Imodium contraindicated?
Contraindications. Imodium is contraindicated in patients with a known hypersensitivity to loperamide hydrochloride or to any of the excipients. Imodium is contraindicated in patients with abdominal pain in the absence of diarrhea. Imodium is not recommended in infants below 24 months of age.
Dosing & Uses
After each loose bowel movement: 2 tablets once initially, then 1 tab/dose with each subsequent loose stool up to 4 tab/day
Warnings
Hypersensitivity, bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis
Pregnancy & Lactation
Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs
Pharmacology
Slows intestinal motility by direct effects on circular & longitudinal muscle (loperamide); changes surface tension of gas bubbles, causing collapse of foam bubbles, thus allow easier passage (simethicone)
What is it?
Loperamide (Imodium®, Norimode®, Diah-limit®, Diocalm ultra®, Normaloe®, Diaquitte®, Diasorb®, Entrocalm loperamide®) is a medicine usually used to treat short episodes of diarrhoea.
Is it safe to take loperamide in pregnancy?
At present, there is information on only around 750 babies of women who were treated with loperamide during pregnancy (see below). More pregnancies need to be studied to be able to say whether or not use of loperamide in pregnancy is safe.
What if I have already taken loperamide during pregnancy?
If you have taken any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and to make sure that you are taking the lowest dose that works.
Can taking loperamide in pregnancy cause birth defects in my baby?
A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects. There is mixed scientific evidence about whether taking loperamide during the first trimester of pregnancy may increase the chance of having a baby with a birth defect.
Can taking loperamide in pregnancy cause miscarriage?
A very small study of 105 pregnant women taking loperamide showed no link with miscarriage. This result requires confirmation in much larger studies.
Can taking loperamide in pregnancy cause preterm birth, or my baby to be small at birth (low birth weight)?
Two studies of a total of around 750 pregnant women taking loperamide did not show that they had a higher chance of having a pre term birth (before 37 weeks), or a low birth weight baby (weighing less than 2,500g at birth). However, information from larger numbers of women is required before firm conclusions can be drawn.
Can taking loperamide in pregnancy cause stillbirth?
No studies have investigated the chance of stillbirth following use of loperamide in pregnancy.
What is the first line agent for pregnancy?
The recommended first-line agent is chlorpheniramine (Chlor-Trimeton), which is Category B. According to the Collaborative Perinatal Project, chlorpheniramine use during pregnancy was not associated with an increased risk of malformations. [ 7] .
What is the best treatment for a pregnant woman?
Pregnant women should be advised to first try nonpharmacologic treatments such as a saline nasal spray, the use of a humidifier, and increased hydration. [ 9, 10] The most commonly used cough, cold, and allergy products include antihistamines, decongestants, antitussives, and expectorants ( Table 2 ). [ 1]
Is oxymetazoline a cough medicine?
Inhaled decongestants such as oxymetazoline (Afrin) and phenylephrine (Neo-Synephrine) are both Category C and appear to be safe for use. The primary cough remedy used during pregnancy is dextromethorphan (Delsym).
Is dextromethorphan safe for pregnancy?
Many studies suggest that there is no association between dextromethorphan use and an increased risk of birth defects. [ 9, 10] However, many of the OTC products containing dextromethorphan also contain alcohol and should be avoided during pregnancy.
Is Guaifenesin safe for pregnancy?
Guaifenesin (Mucinex) is the expectorant typically found in most OTC cold medications. Its use appears to be safe during pregnancy, with the exception of the first trimester. [ 9]
Is pseudoephedrine a decongestant?
Pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) are the most common oral OTC decongestants used , with 25% of pregnant women using pseudoephedrine as their oral decongestant of choice. [ 11] . However, its use should be avoided during the first trimester due to associated risk of defects from vascular disruption known as gastroschisis.
What is the term for nausea and vomiting during pregnancy?
While nausea and vomiting are common indicators of early pregnancy, an extreme manifestation of the condition is termed hyperemesis gravidarum.
What are the symptoms of pregnancy?
The most common GI problems that occur during pregnancy include nausea, vomiting, acid reflux, diarrhea, and constipation. Drug therapy may be required when lifestyle modifications cannot provide adequate relief of symptoms. While nausea and vomiting are common indicators of early pregnancy, an extreme manifestation of the condition is termed ...
How common is acid reflux in pregnancy?
Acid reflux is another common problem estimated to occur in 30% to 50% of all pregnancies. [ 23] . Due to the pressure on the uterus, acid reflux during pregnancy is less likely to respond to lifestyle modifications such as elevation of the head when sleeping, eating small frequent meals, or avoiding eating within 3 hours of bedtime. [ 24] .
Does magnesium trisilicate cause fetal nephrolithiasis?
Long-term use of high-dose magnesium trisilicate has been associated with increased risk of fetal nephrolithiasis, hypotonia, and respiratory distress; sodium bicarbonate has been associated with metabolic acidosis and fluid overload. [ 23] .
How many women take OTC drugs while pregnant?
The prevalence of medication use during pregnancy is widespread and on the rise. More than 80% of pregnant women take OTC or prescription drugs during pregnancy, with only 60% of these patients consulting a health care professional when selecting a product. [ 1] .
How many pregnant women take OTC?
More than 80% of pregnant women take OTC or prescription drugs during pregnancy, with only 60% of these patients consulting a health care professional when selecting a product. Common pregnancy-associated conditions include cough, cold, allergies, gastrointestinal disorders, and pain.
Usual Adult Dose for Diarrhea - Acute
4 mg orally after the first loose stool, then 2 mg orally after each unformed stool Maximum dose: 16 mg per day Comments: -Clinical improvement is usually seen within 48 hours. Use (s): Control and symptomatic relief of acute nonspecific diarrhea
Usual Adult Dose for Diarrhea - Chronic
4 mg orally after the first loose stool, then 2 mg orally after each unformed stool until diarrhea is controlled Maximum dose: 16 mg per day Comments: -Clinical improvement is usually seen within 48 hours. -After diarrhea is controlled, reduce dose to meet individual requirements -When optimal daily dose has been established, this dose may be given as a single dose or in divided doses. -The average maintenance dose in clinical trials was 4 to 8 mg daily. -If no clinical improvement is seen with 16 mg per day after at least 10 days, symptoms are unlikely to be controlled by further administration. -Administration may be continued if diarrhea cannot be adequately controlled with diet or specific treatment. Use (s): Control and symptomatic relief of chronic diarrhea associated with inflammatory bowel disease..
Usual Pediatric Dose for Diarrhea - Acute
2 to 5 years (13 to 20 kg): First day dosage schedule: 1 mg orally 3 times a day (3 mg total daily dose) Subsequent daily dosage: 1 mg only after a loose stool, not to exceed 3 mg/day 6 to 8 years (20 to 30 kg): First day dosage schedule: 2 mg orally twice a day 2 (4 mg total daily dose) Subsequent daily dosage: 2 mg only after a loose stool, not to exceed 4 mg/day 9 to 12 years (over 30 kg): First day dosage schedule: 2 mg orally 3 times a day (6 mg total daily dose) Subsequent daily dosage: 2 mg only after a loose stool, not to exceed 6 mg/day 13 years and older: 4 mg orally after the first loose stool, then 2 mg orally after each unformed stool Maximum dose: 16 mg per day Comments: -Do not use in patients less than 2 years old due to the risks of respiratory depression and serious cardiac adverse reactions. -Clinical improvement is usually seen within 48 hours. Use (s): Control and symptomatic relief of acute nonspecific diarrhea.
Liver Dose Adjustments
Use with caution. -Systemic exposure may be increased due to reduced metabolism.
Precautions
US BOXED WARNING (S): -Cases of Torsades de Pointes, cardiac arrest, and death have been reported with use of higher than recommended doses. -Contraindicated in pediatric patients less than 2 years of age. -Avoid doses higher than recommended due to the risk of serious cardiac adverse reactions. Safety and efficacy have not been established in patients younger than 2 years. Consult WARNINGS section for additional precautions..
Other Comments
Administration advice: -Avoid doses higher than recommended due to the risk of serious cardiac reactions. -Use the non-prescription liquid formulation for patients 2 to 5 years old. -For patients 6 years and older, either the liquid formulation or tablets/capsules may be used. General: -Patients should receive fluid and electrolyte replacement as needed..
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.