In the U.S.—

In Canada—

• Antidiarrheal

Loperamide ( loe-PER-a-mide) is a medicine used along with other measures to treat diarrhea. Loperamide helps stop diarrhea by slowing down the movements of the intestines.

In the U.S., loperamide capsules are available only with your doctor's prescription, while the liquid form and the tablet form are available without a prescription. In Canada, all the dosage forms are available without a prescription.

Loperamide is available in the following dosage forms:

Oral
• Capsules (U.S. and Canada)
• Oral solution (U.S. and Canada)
• Tablets (U.S. and Canada)

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For loperamide, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to loperamide. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in humans. However, studies in animals have not shown that loperamide causes cancer or birth defects or lessens the chances of becoming pregnant even when given in doses many times the human dose.

Breast-feeding—It is not known whether loperamide passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—This medicine should not be used in children under 6 years of age unless directed by a doctor. Children, especially very young children, are very sensitive to the effects of loperamide. This may increase the chance of side effects during treatment. Also, the fluid loss caused by diarrhea may result in a serious health problem (dehydration). Loperamide may hide the symptoms of dehydration. For these reasons, do not give medicine for diarrhea to children without first checking with their doctor. If you have any questions about this, check with your health care professional.

Older adults—The fluid loss caused by diarrhea may result in a serious health problem (dehydration). Loperamide may hide the symptoms of dehydration. For this reason, elderly persons with diarrhea, in addition to using medicine for diarrhea, must receive a sufficient amount of liquids to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking loperamide, it is especially important that your health care professional know if you are taking any of the following:

• Antibiotics such as cephalosporins (e.g., Ceftin, Keflex), clindamycin (e.g., Cleocin), erythromycins (e.g., E.E.S., PCE), tetracyclines (e.g., Achromycin, Doryx)—These antibiotics may cause diarrhea; loperamide may make the diarrhea caused by antibiotics worse or make it last longer

• Narcotic pain medicine—There is a greater chance that severe constipation may occur if loperamide is used together with narcotic pain medicine

• Colitis (severe)—A more serious problem of the colon may develop if you use loperamide

• Dysentery—This condition may get worse; a different kind of treatment may be needed

• Liver disease—The chance of severe central nervous system (CNS) side effects may be greater in patients with liver disease

Do not use loperamide to treat your diarrhea if you have a fever or if there is blood or mucus in your stools. Contact your doctor.

For safe and effective use of this medicine:

• Follow your doctor's instructions if this medicine was prescribed.
• Follow the manufacturer's package directions if you are treating yourself.

Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

Importance of diet and fluid intake while treating diarrhea:

• In addition to using medicine for diarrhea, it is very important that you replace the fluid lost by the body and follow a proper diet. For the first 24 hours, you should eat gelatin, and drink plenty of caffeine-free clear liquids, such as ginger ale, decaffeinated cola, decaffeinated tea, and broth. During the next 24 hours you may eat bland foods, such as cooked cereals, bread, crackers, and applesauce. Fruits, vegetables, fried or spicy foods, bran, candy, caffeine, and alcoholic beverages may make the condition worse.
• If too much fluid has been lost by the body due to the diarrhea, a serious condition (dehydration) may develop. Check with your doctor as soon as possible if any of the following signs or symptoms of too much fluid loss occur:
  • Decreased urination
  • Dizziness and lightheadedness
  • Dryness of mouth
  • Increased thirst
  • Wrinkled skin

Dosing—

The dose of loperamide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of loperamide. If your dose is different, do not change it unless your doctor tells you to do so.

• For diarrhea:
  • For oral dosage form (capsules):
    • Adults and teenagers—The usual dose is 4 milligrams (mg) (2 capsules) after the first loose bowel movement, and 2 mg (1 capsule) after each loose bowel movement after the first dose has been taken. No more than 16 mg (8 capsules) should be taken in any twenty-four-hour period.
    • Children 8 to 12 years of age—The usual dose is 2 mg (1 capsule) three times a day.
    • Children 6 to 8 years of age—The usual dose is 2 mg (1 capsule) two times a day.
    • Children up to 6 years of age—Use is not recommended unless directed by your doctor.
  • For oral dosage form (oral solution):
    • Adults and teenagers—The usual dose is 4 teaspoonfuls (4 mg) after the first loose bowel movement, and 2 teaspoonfuls (2 mg) after each loose bowel movement after the first dose has been taken. No more than 8 teaspoonfuls (8 mg) should be taken in any twenty-four-hour period.
    • Children 9 to 11 years of age—The usual dose is 2 teaspoonfuls (2 mg) after the first loose bowel movement, and 1 teaspoonful (1 mg) after each loose bowel movement after the first dose has been taken. No more than 6 teaspoonfuls (6 mg) should be taken in any twenty-four-hour period.
    • Children 6 to 8 years of age—The usual dose is 2 teaspoonfuls (2 mg) after the first loose bowel movement, and 1 teaspoonful (1 mg) after each loose bowel movement after the first dose has been taken. No more than 4 teaspoonfuls (4 mg) should be taken in any twenty-four-hour period.
    • Children up to 6 years of age—Use is not recommended unless directed by your doctor.
  • For oral dosage form (tablets):
    • Adults and teenagers—The usual dose is 4 mg (2 tablets) after the first loose bowel movement, and 2 mg (1 tablet) after each loose bowel movement after the first dose has been taken. No more than 8 mg (4 tablets) should be taken in any twenty-four-hour period.
    • Children 9 to 11 years of age—The usual dose is 2 mg (1 tablet) after the first loose bowel movement, and 1 mg (½ tablet) after each loose bowel movement after the first dose has been taken. No more than 6 mg (3 tablets) should be taken in any twenty-four-hour period.
    • Children 6 to 8 years of age—The usual dose is 2 mg (1 tablet) after the first loose bowel movement, and 1 mg (½ tablet) after each loose bowel movement after the first dose has been taken. No more than 4 mg (2 tablets) should be taken in any twenty-four-hour period.
    • Children up to 6 years of age—Use is not recommended unless directed by your doctor.

Missed dose—

If you must take this medicine regularly and you miss a dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children
• Store away from heat and direct light.
• Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Loperamide should not be used for more than 2 days, unless directed by your doctor. If you will be taking this medicine regularly for a long time, your doctor should check your progress at regular visits.

Check with your doctor if your diarrhea does not stop after two days or if you develop a fever.

Along with its needed effects, a medicine may cause some unwanted effects. When this medicine is used for short periods of time at low doses, side effects usually are rare .

However, check with your doctor immediately if any of the following side effects are severe and occur suddenly since they may be signs of a more severe and dangerous problem with your bowels:

• Rare
  • Bloating;  constipation;  loss of appetite;  stomach pain (severe) with nausea and vomiting 
  
  

Also, check with your doctor as soon as possible if the following side effect occurs:

• Rare
  • Skin rash 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Rare
  • Dizziness or drowsiness;  dryness of mouth 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.