Loperamide, 2 mg capsules 20 pcs

Pharmacotherapeutic group: Antidiarrheal agent

Pharmacological action

Antidiarrheal agent. It decreases tone and motility of intestinal smooth muscle, apparently at the expense of binding to opioid receptors in the intestinal wall. It inhibits release of acetylcholine and prostaglandins, reducing peristalsis and increasing time of passage of contents through the intestine.

Enhances the tone of the anal sphincter. The action comes quickly and lasts for 4-6 hours.

Indications

• Symptomatic treatment of acute and chronic diarrhea (genesis: allergic, emotional, medicinal, radiation; when changing diet and quality composition of food, in violation of metabolism and absorption). As adjuvant in diarrhea of infectious genesis.
• Stool regulation in patients with ileostoma.

.

Active ingredient

Loperamide

Composition

Ingredients for 1 capsule:

Active ingredient: loperamide hydrochloride – 2.0 mg.

How to take, the dosage

Adults and children over 6 years old: The initial dose is 2 capsules (4 mg) for adults and 1 capsule (2 mg) for children; further 1 capsule (2 mg) after each defecation in case of loose stools.

Chronic diarrhea: the initial dose is 2 capsules (4 mg) per day for adults and 1 capsule (2 mg) for children; further the initial dose should be adjusted so that the frequency of normal stools is 1-2 times per day, which is usually achieved with a maintenance dose of 1 to 6 capsules (2-12 mg) per day.

Maximal daily dose in acute and chronic diarrhea in adults is 8 capsules (16 mg); maximal daily dose in children is calculated depending on body weight (3 capsules per 20 kg body weight of the child), but should not exceed 8 capsules (16 mg).

In case of normal stools or in case of absence of stools more than 12 hours the drug is discontinued.

Interaction

It is believed that concomitant use of colestyramine may decrease the efficacy of loperamide.

Concomitant use with co-trimoxazole, ritonavir increases bioavailability of loperamide due to inhibition of its metabolism during “first passage” through the liver.

In case of loperamide overdose, naloxone is used as an antidote.

Special Instructions

With caution, use in hepatic insufficiency.

Do not use in clinical situations where suppression of intestinal peristalsis is required.

If there is no effect after 2 days of using loperamide, the diagnosis should be clarified and the infectious genesis of the diarrhea should be excluded.

With caution, use in patients with hepatic impairment.

In case of loperamide overdose, naloxone is used as an antidote.

Contraindications

• High sensitivity to the drug,
• lactose intolerance,
• lactase deficiency or glucose-galactose malabsorption,
• lactose deficiency or glucose-galactose malabsorption
• diverticulosis,
• intestinal obstruction,
• acute ulcerative colitis,
diarrhea against acute pseudomembranous enterocolitis,
• as monotherapy – dysentery and other gastrointestinal tract infections;
• pregnancy (first trimester),
• lactation period,
• loperamide capsules are not prescribed in children under 6 years.

With caution: hepatic impairment.

Side effects

Digestive system disorders: abdominal pain, bloating, nausea, constipation, dry mouth.

CNS disorders: increased fatigue, drowsiness, dizziness.

Allergic reactions: skin rash.

Overdose

Symptoms: central nervous system depression (stupor, coordination disorders, drowsiness, miosis, muscle hypertonia, respiratory depression), intestinal obstruction.

Treatment: antidote – naloxone; given that the duration of action of loperamide is longer than that of naloxone, the latter may be reintroduced.

Symptomatic treatment: activated charcoal, gastric lavage, artificial lung ventilation. Medical observation for at least 48 hours is necessary.

Pregnancy use

It is contraindicated in the first trimester of pregnancy. In II and III trimesters of pregnancy, loperamide may be prescribed in cases when the expected benefit of therapy for the mother exceeds the potential risk to the fetus.

Because a small amount of loperamide is found in breast milk, administration during breastfeeding is not recommended.

Similarities

Lopedium, Loperamide-Acri, Imodium, Diara, Loperamide