Loperamide from diarrhea in tablets and capsules: how to take

The purpose of the drug Loperamide is the inhibition of the motor activity of the intestine. Medpreparat reduces the motility of the gastrointestinal tract and slows the movement of the contents of the intestine. Loperamide is used in the period of diarrhea (diarrhea) for relief of symptoms. Diarrhea (diarrhea) is a frequent defecation (more than 2 times a day) with feces of a liquid consistency. Diarrheal syndrome is common even without the presence of infection. Diarrhea can be provoked by nonspecific inflammatory reactions in the stomach, intestines, liver, pancreas. Appears in endocrine diseases, diseases of the nervous system, oncology. Is a reaction to medicines:

• antibiotics;
• beta-blockers;
• NPS (non-steroidal anti-inflammatory drugs).

The drug is a derivative of piperidine and belongs to the group of opioid drugs. The production of Loperamide is carried out by many international pharmaceutical corporations and produces it under different brands:

• "Polfa" - Loperamide;
• Janssen Silag - Imodium;
• "Lekhim" - Loperamide;
• pilot plant SSCLS - Loperamide hydrochloride;
• FC "Akrihin" - Loperamid Acry;
• US Pharmacia - Stoperan.

The active ingredient in all of the above medications is the same - loperamide hydrochloride.

[1]

Indications of the loperamide from diarrhea

Medpreparat recommended for stopping rapid bowel emptying with the allocation of liquid feces, both acute and chronic, provoked by various causes. Among them:

• bowel diseases of an infectious nature (in combination with antibiotics);
• viral diseases accompanied by a loose stool;
• allergic manifestations;
• unstable psychoemotional states;
• use of other medicines;
• radiation sickness;
• the use of a large number of products that have a laxative effect;
• IBS or bear illness;
• diarrhea of tourists, which occurs when changing climatic conditions;
• Stabilization of the stool of patients with ileostomy;
• encopresis (incontinence, provoked by a violation of the tone of the rectal area);
• alcohol or chemical poisoning.

[2], [3], [4],

Release form

The pharmaceutical industry produces medicines in three forms:

• pills;
• capsules;
• syrup.

Chemical-pharmaceutical enterprises produce medications in original branded factory packages of cardboard containing a tablet or capsule drug in a variety of quantities.

A tablet or loperamide in the form of capsules is recommended to adults, as well as children from the age of six. Syrup is used for children, but in a number of countries it is banned.

Loperamide tablets against diarrhea

Tablets are flat-shaped with a risk in the middle, white with a slight shade of yellowness. The active ingredient - loperamide hydrochloride in the amount of 2 mg is included in the formulation. In addition to the active substance capable of arresting diarrheal syndrome, tablets contain: talc, silicon dioxide, calcium or magnesium stearate, lactose, starch. In the package - 90, 30, 20, 10 pieces of tablets.

[5], [6], [7]

Capsules for diarrhea Loperamide

Means in the form of oblong capsules filled with a powdery substance of white color, with a yellow shade, placed in a gelatinous wafer. Active ingredient in capsules and tablets loperamide hydrochloride in an amount of 2 mg. The package can accommodate - 24, 20, 12, 10 pieces of capsules in a blister pack.

[8]

Pharmacodynamics

Medpreparat for normalization of bowel movement. It has the ability to reduce the speed of undulating intestinal motions and slows the progress of chyme (food lump) through the digestive tract, having an antisecretory effect. The drug prolongs the time of absorption of liquid and electrolytes, because the active ingredient binds the opiate receptors of the intestinal walls and inhibits the synthesis of prostaglandins and acetylcholine. The drug activates the anal-rectal area, reducing the amount of urge to empty the intestine, and thereby contributes to retention of stool. It binds calmodulin (a special kind of protein), responsible for the transport of ions in the intestinal tract. Loperamide has no effect similar to morphine, which distinguishes this drug from other opioid drugs.

[9], [10], [11], [12]

Pharmacokinetics

When taken orally, it has a rapid absorption. After 60 minutes. (1 hour) after intake of more than 80% of the active substance is absorbed by the gastrointestinal tract, 5% by the liver. More than 96% of the drug is combined with plasma proteins. The greatest content in the bloodstream accumulates after 4 hours. The half-life is 17-40 hours. Loperamide from the body comes out with feces and bile. With stable liver function, the content of loperamide in the bloodstream and urine is low. With liver diseases there is an increase in the level of loperamide in blood plasma.

[13], [14], [15], [16], [17]

Dosing and administration

Among different age groups, manufacturers recommend using the individual dosage and duration of application that the therapist or pediatrician prescribes. Adults and adolescents in the acute period should take, according to the manufacturer's instructions, 4 mg of the drug (2 capsules or 2 tab.) Once. The maximum allowed amount of the drug per day is 16 mg, which corresponds to 8 tablets. Or 8 caps.

For therapeutic measures in the chronic form of diarrheal syndrome, adult patients are recommended to use 2 caps. Or 2 tab. Every day. The drug is taken until the number of acts of defecation is reduced to one two times a day.

For elderly patients, a dose is prescribed taking into account the existing diseases in the anamnesis and the severity of their course. Duration of treatment, dosage and the regimen is recommended by the attending physician.

Loperamide is discontinued after normalization of stool consistency or absence of stool for 12 hours. The standard treatment cycle takes from 1 to 2 days. If during the treatment with Loperamide there is flatulence, then stop taking the drug. During treatment there is a need to replenish the departed, as a result of frequent defecation, fluid and trace elements. It requires dietary nutrition and taking medications that normalize the water and electrolyte balance (for example, Regidron).

Patients with liver diseases take the drug with extreme caution, under close monitoring of the body. It is also necessary to observe the condition and pay attention to the clinical syndromes of intoxication of the nervous system.

During therapy with medication, it is required to exclude activities that require:

• concentration of attention;
• concentration;
• concentration;
• reaction rate.

Loperamide from diarrhea to a child

Admission Loperamida children, whose age is less than 6 years, is permitted in the form of drops or tablets. Producers of the drug are not recommended to prescribe Loperamide for children younger than 2 years of age. According to statistics, there were cases of death in children caused by paralysis of the smooth muscles of the intestine. All the incidents that occurred were related to the independent appointment by the parents of Loperamide, where the dosage of the drug was inadequately prescribed, and contraindications were not taken into account.

In many cases, paralytic intestinal obstruction developed during the use of Loperamide to treat diarrhea of infectious genesis. The result of uncontrolled use of the drug in a child's body is a violation of water-electrolyte equilibrium, which leads to a deterioration in the child's condition. During this period, it is necessary to saturate the body of the child with liquid and trace elements, because they are lost in large quantities with frequent evacuation of the intestine. All these measures were not carried out by parents. In view of the foregoing, WHO decided to exclude Loperamide from the list of diarrheal agents for children under the age of two.

Children 6-8 years of age may take 2 mg of the drug once (1 capsule or 1 table). If, after defecation, the stool has a liquid consistency, give the baby Loperamide at a dosage of 1 mg (1/2 table or 1/2 capsule). The maximum allowable daily dose is 3 tablets (6 mg). For the treatment of chronic diarrheal syndrome, 2 mg Loperamide per day is prescribed.

Children 9-12 years are allowed to use the drug 2 mg three times a day.

[24], [25], [26]

Loperamide does not help with diarrhea, what should I do?

If the normalization of the stool did not occur within 2 days, it is necessary to clarify the diagnosis. Most often this situation is possible if the patient has OCI (acute intestinal infection). The main symptoms of this disease are:

• weakness and lethargy;
• pallor of the skin;
• loss of appetite;
• Diarrhea (in severe cases with an admixture of blood and mucus);
• a feeling of chills;
• cramping in the abdomen;
• vomiting.

Any reaction of the body is physiologically necessary. When poisoning, vomiting and diarrhea remove toxins and infected contents from the digestive tract. Using Loperamide for diarrhea caused by infection, the patient can do themselves harm. The contents affected by toxins will not be evacuated and will begin to poison the body from the inside, sucking and spreading with blood flow throughout the body. If you solved the problem with diarrhea, but without improving your health and the temperature has started, you must stop taking Loperamide. The drug does not treat, but only relieves the symptoms of diarrhea.

Use of the loperamide from diarrhea during pregnancy

Theoretically, women during pregnancy are allowed to use Loperamide, but the use of this medication has its own characteristics. In the first trimester of pregnancy, it is strictly forbidden to take the medicine. Starting at week 13, gestation can be recommended for admission, but with caution and only if the benefit exceeds the risks from its use for the future mother and fetus. When diarrhea with severe complications of the pregnant should be recommended medication in a dosage with a minimal effect, which is set by the attending physician individually.

Can loperamid be fed to a lactating mother?

Loperamide in small doses has the ability to penetrate into breast milk. Therefore, during lactation it is necessary to abandon its use. If there is a need for the use of a medicine, then it is necessary to stop breastfeeding.

[18], [19], [20]

Contraindications

Loperamide is not recommended for use in the following conditions:

• nonspecific ulcerative colitis;
• diverticulosis of the intestine;
• diseases of the gastrointestinal tract of an infectious genesis (cholera, salmonellosis, dysentery, etc.);
• hypersensitivity to the components of the drug;
• hepatic insufficiency (take the drug under the control of the state of health);
• intestinal obstruction;
• early terms (1 trimester) of pregnancy;
• lactation period;
• children under the age of 2;
• flatulence;
• Obstipation.

[21], [22]

Side effects of the loperamide from diarrhea

Adverse events with Loperamide are as follows:

• immune reactions of type I hypersensitivity;
• vertigo;
• decrease in the volume of circulation of the extracellular fluid; xerostomia;
• negative change in water-electrolyte equilibrium;
• spasms of the intestine;
• pain in the epigastric region;
• constipation;
• nausea, attacks of vomiting;
• bloating;
• ishuria.

[23]

Overdose

The drug as a whole is well tolerated, but with non-competent dosing appear:

• sleep disorder;
• ataxia;
• decreased mental activity;
• increased muscle tone;
• miosis of the pupils;
• intestinal obstruction;
• violation of the act of breathing.

When these symptoms appear, you need to call an ambulance. After transporting the patient to the hospital, he is administered an antidote. In this case - Naloxone. Simultaneously with the antidote, the patient is washed with the stomach, and activated charcoal is given. If the symptoms appear repeatedly, Naloxone is given again to the patient. The patient spends two days in stationary conditions and when he is in a normal state, he is discharged home.

[27]

Interactions with other drugs

Synchronous use of loperamide and analgesic agents of the opioid series increases the risk of pathological constipation.

[28], [29]

Storage conditions

The medication is kept in a dry place, where sun rays do not reach and with a temperature regime of no more than + 25C. The location of the medicine should be protected from small children and animals.

[30], [31],

Shelf life

The date of manufacture and the end date of use are marked on a cardboard bundle and stamped on a blister. The total shelf life is 4 years. It is not recommended to apply the drug after the expiration date.

[32]