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Loperamide: Brands, Price & Uses in Bangladesh
Loperamide is an antidiarrheal agent with the following evidence-based indications: Acute nonspecific diarrhea (FDA-approved) - for symptomatic relief in patients 2 years of age and older.
About Loperamide
Indications of Loperamide
Loperamide is an antidiarrheal agent with the following evidence-based indications:
- Acute nonspecific diarrhea (FDA-approved) - for symptomatic relief in patients 2 years of age and older.
- Chronic diarrhea associated with inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis in remission) (FDA-approved) - for use in adults under medical supervision.
- Reduction of ileostomy output (FDA-approved) - to decrease the volume of discharge from ileostomies.
- Traveler's diarrhea (guideline-supported, adjunct use) - commonly recommended as adjunct symptomatic therapy, often together with an appropriate antimicrobial when indicated, in adults without fever or bloody stools.
Loperamide is not indicated for conditions where inhibition of intestinal motility should be avoided (see Contraindications).
Dosage & Administration of Loperamide
Loperamide should be taken exactly as directed and not exceeded, due to the risk of serious cardiac events described in the Boxed Warning.
| Indication | Population | Dose |
|---|---|---|
| Acute diarrhea | Adults and children ≥13 years | Initial: 4 mg, then 2 mg after each unformed stool. Maximum 16 mg/day. |
| Children 2-12 years | Weight/age-based first-day dosing (see Pediatric Uses); do not exceed labeled maximums. | |
| Chronic diarrhea (IBD) | Adults | Initial: 4 mg, then 2 mg after each unformed stool until diarrhea is controlled, then reduce to the lowest effective maintenance dose (typically 4-8 mg/day). Maximum 16 mg/day. |
If there is no clinical improvement with Loperamide within 48 hours, treatment should be discontinued and the patient reassessed by a physician. Discontinue Loperamide immediately if constipation, abdominal distension, or ileus develops, and seek prompt medical attention if fever or blood in the stool occurs.
Side Effects of Loperamide
Side effects of Loperamide are generally uncommon at recommended doses but may include:
- Constipation, abdominal pain or cramping, nausea, vomiting, dry mouth
- Dizziness, drowsiness, fatigue, headache
- Flatulence, abdominal distension
- Skin rash and, rarely, hypersensitivity reactions including angioedema
Serious but rare adverse effects, generally associated with doses exceeding the recommended amount, include QT/QRS prolongation, Torsades de Pointes, other ventricular arrhythmias, syncope, cardiac arrest, and paralytic ileus (see Boxed Warning and Overdose Effects).
Contraindications of Loperamide
Loperamide is contraindicated in:
- Known hypersensitivity to Loperamide Hydrochloride or any component of the formulation.
- Patients with acute dysentery, which is characterized by blood in the stool and high fever.
- Acute ulcerative colitis.
- Bacterial enterocolitis caused by invasive organisms such as Salmonella, Shigella, and Campylobacter.
- Pseudomembranous colitis associated with the use of broad-spectrum antibiotics.
- Children under 2 years of age.
- Conditions where inhibition of peristalsis is to be avoided, e.g., in the presence of abdominal distension, or where ileus is present.
Frequently Asked Questions about Loperamide
What is Loperamide used for?
Loperamide is used for the symptomatic relief of acute nonspecific diarrhea in adults and children 2 years and older, chronic diarrhea associated with inflammatory bowel disease in adults, and to reduce the volume of discharge from ileostomies.
Can I take more than the recommended dose of Loperamide if my diarrhea is severe?
No. Taking more than the recommended dose of Loperamide can cause serious heart problems, including dangerous heart rhythm disturbances, cardiac arrest, and death. Never exceed the labeled or physician-prescribed dose of Loperamide, even if diarrhea seems severe. If diarrhea persists beyond 48 hours or worsens, stop taking Loperamide and see a doctor.
Is Loperamide safe during pregnancy?
Loperamide should be used during pregnancy only if the potential benefit clearly justifies the potential risk to the fetus, as adequate human safety data are limited. Always consult a physician before using Loperamide during pregnancy.
Can children take Loperamide?
Loperamide is contraindicated in children under 2 years of age due to the risk of serious, potentially fatal side effects. For children 2 years and older, dosing must follow weight/age-based guidelines and medical advice.
What should I do if I miss a dose of Loperamide?
Loperamide is typically taken after loose stools rather than on a fixed schedule, so a "missed dose" concept generally does not apply. Take the next dose of Loperamide only after your next unformed stool, without exceeding the maximum daily dose.
What should I do if I suspect an overdose of Loperamide?
An overdose of Loperamide can cause life-threatening heart rhythm problems. Seek immediate emergency medical attention or contact a poison control center right away; do not attempt to treat an overdose of Loperamide at home.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.