Loperamide for diarrhea in tablets and capsules: how to take

The purpose of the drug Loperamide is to inhibit intestinal motility. The drug reduces gastrointestinal motility and slows down the movement of intestinal contents. Loperamide is used during diarrhea to relieve symptoms. Diarrhea is frequent bowel movements (more than 2 times a day) with liquid stool. Diarrhea syndrome is common even without the presence of infection. Diarrhea can be provoked by non-specific inflammatory reactions in the stomach, intestines, liver, pancreas. It appears with endocrine diseases, diseases of the nervous system, oncology. It is a reaction to drugs:

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

The drug is a derivative of piperidine and belongs to the group of opioid drugs. Loperamide is produced by many international pharmaceutical corporations and is released under various trade marks:

• "Polfa" - Loperamide;
• Janssen Silag - Imodium;
• "Lekhim" - Loperamide;
• pilot plant of the State Scientific Center of Medicines - Loperamide Hydrochloride;
• FC "Akrikhin" - Loperamide Akri;
• YUS Pharmacy - Stoperan.

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

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Indications Loperamide for diarrhea

The drug is recommended for stopping frequent bowel movements with the release of liquid feces of both acute and chronic nature, provoked by various reasons. Among them:

• infectious intestinal diseases (in combination with antibiotics);
• viral diseases accompanied by loose stools;
• allergic reactions;
• unstable psycho-emotional states;
• use of other medications;
• radiation sickness;
• consumption of large quantities of foods that have a laxative effect;
• IBS or bear disease;
• traveler's diarrhea, which occurs when climate conditions change;
• stabilization of stool in patients with ileostomy;
• encopresis (fecal incontinence caused by a disturbance in the tone of the rectal area);
• alcohol or chemical poisoning.

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Release form

The pharmaceutical industry produces medicine in three forms:

• pills;
• capsules;
• syrup.

Chemical and pharmaceutical companies produce the drug in original branded factory cardboard packaging containing tablets or encapsulated drugs in varying quantities.

The tablet preparation or Loperamide in capsule form is recommended for adults and children from the age of six. Syrup is used for children, but it is prohibited in a number of countries.

Loperamide tablets for diarrhea

Flat tablets with a score line in the middle, white with a slight yellowish tint. The composition of the drug includes the active ingredient - loperamide hydrochloride in the amount of 2 mg. In addition to the active substance capable of stopping diarrhea syndrome, the tablets contain: talc, silicon dioxide, calcium or magnesium stearate, lactose, starch. The package contains 90, 30, 20, 10 tablets.

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Loperamide capsules for diarrhea

The product is in the form of oblong capsules filled with a white powder-like substance with a yellow tint, placed in a gelatinous wafer. The active ingredient in capsules and tablets is loperamide hydrochloride in the amount of 2 mg. The package may contain 24, 20, 12, 10 capsules in a blister.

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Pharmacodynamics

A medicine for normalizing bowel movements. It has the ability to reduce the speed of wave-like movements of the intestine and slows down the movement of chyme (food bolus) through the gastrointestinal tract, exerting an antisecretory effect. The medicine prolongs the time of absorption of fluid and electrolytes, due to the fact that the active ingredient binds opiate receptors of the intestinal walls and inhibits the synthesis of prostaglandins and acetylcholine. The medicine activates the anal-rectal area, reducing the number of urges to empty the intestines, and thereby promotes fecal retention. It binds calmodulin (a special type of protein), which is responsible for the transport of ions in the intestinal tract. Loperamide does not have an effect similar to morphine, which distinguishes this medicine from other opioid drugs.

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Pharmacokinetics

When taken orally, it is rapidly absorbed. 60 minutes (1 hour) after administration, 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 highest content in the bloodstream accumulates after 4 hours. The half-life is 17-40 hours. Loperamide is excreted from the body with feces and bile. With stable liver function, the content of loperamide in the bloodstream and urine is low. In liver diseases, an increase in the level of loperamide in the blood plasma is noted.

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Dosing and administration

Among different age groups, manufacturers recommend using an individual dosage and duration of use, which are prescribed by a therapist or pediatrician. Adults and adolescents in the acute period should take, according to the manufacturer's instructions, 4 mg of the drug (2 capsules or 2 tablets) once. The maximum permitted amount of the drug per day is 16 mg, which corresponds to 8 tablets or 8 capsules.

For therapeutic measures in chronic diarrheal syndrome, adult patients are recommended to use 2 capsules or 2 tablets daily. The drug is taken until the number of bowel movements is reduced to one or two times a day.

For elderly patients, the dose is prescribed taking into account the history of diseases and the severity of their course. The duration of treatment, dosage and administration regimen are recommended by the attending physician.

Loperamide is stopped after the stool consistency has normalized or there have been no bowel movements for 12 hours. The standard treatment cycle lasts from 1 to 2 days. If flatulence occurs during Loperamide treatment, the drug is stopped. During treatment, there is a need to replenish the fluids and microelements lost as a result of frequent bowel movements. Dietary nutrition and medications that normalize water and electrolyte balance (for example, Regidron) are required.

Patients with liver diseases take the drug with extreme caution, under close control of the organ's function. It is also necessary to monitor the condition and pay attention to clinical syndromes of nervous system intoxication.

During therapy with the drug, it is necessary to exclude activities that require:

• concentration of attention;
• concentration;
• composure;
• reaction speed.

Loperamide for diarrhea in children

Taking Loperamide by children under 6 years of age is permitted in the form of drops or tablets. Manufacturers of the drug do not recommend prescribing Loperamide to children under 2 years of age. According to statistics, there have been cases of death among children caused by paralysis of the smooth muscles of the intestine. All incidents that occurred were associated with self-prescription of Loperamide by parents, where the dosage of the drug was inadequately prescribed, and contraindications were not taken into account.

In many cases, paralytic ileus developed during the use of Loperamide for the treatment of diarrhea of infectious genesis. The result of uncontrolled use of the drug in a child's body is a violation of the water-electrolyte balance, which leads to a deterioration in the child's condition. During this period, it is necessary to saturate the child's body with liquid and microelements, because they are lost in large quantities with frequent bowel movements. All of these measures were not carried out by the parents. Given the above, WHO decided to exclude Loperamide from the list of drugs for the treatment of diarrhea syndrome in children under two years of age.

Children aged 6-8 years can take 2 mg of the medicine (1 capsule or 1 tablet) once. If the stool is liquid after defecation, the child should be given Loperamide at a dosage of 1 mg (1⁄2 tablet or 1⁄2 capsule). The maximum permissible daily dose is 3 tablets (6 mg). For the treatment of chronic diarrheal syndrome, 2 mg of Loperamide per day is prescribed.

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

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

If the stool has not returned to normal within 2 days, then the diagnosis needs to be clarified. Most often, this situation is possible if the patient has acute intestinal infection (AII). The main symptoms of this disease are:

• weakness and lethargy;
• paleness of the skin;
• loss of appetite;
• diarrhea (in severe cases with blood and mucus);
• feeling of chills;
• cramping pain in the abdomen;
• vomit.

Any reaction of the body is physiologically necessary. In case of poisoning, vomiting and diarrhea remove toxins and infected contents from the gastrointestinal tract. Using Loperamide for diarrhea caused by infection, the patient can harm himself. The contents affected by toxins will not be evacuated and will begin to poison the body from the inside, being absorbed and spreading with the bloodstream throughout the body. If the diarrhea issue has been resolved, but there is no improvement in well-being and the temperature has begun to rise, it is necessary to stop taking Loperamide. The drug does not cure, but only relieves the symptoms of diarrhea.

Use Loperamide for diarrhea during pregnancy

Theoretically, women are allowed to use Loperamide during pregnancy, but the use of this drug has its own characteristics. In the first trimester of pregnancy, it is strictly forbidden to take the drug. Starting from the 13th week of gestation, it can be recommended for use, but with caution and only if the benefits outweigh the risks of its use for the expectant mother and fetus. In case of diarrhea with severe complications, the pregnant woman should be recommended the drug in a dosage with a minimal effect, which is determined by the attending physician individually.

Can a nursing mother take Loperamide for diarrhea?

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

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Contraindications

Loperamide is not recommended for use in the following conditions:

• nonspecific ulcerative colitis;
• intestinal diverticulosis;
• gastrointestinal diseases of infectious origin (cholera, salmonellosis, dysentery, etc.);
• hypersensitivity to the components of the drug;
• liver failure (take the drug under health control);
• intestinal obstruction;
• early stages (1st trimester) of pregnancy;
• lactation period;
• children under 2 years of age;
• flatulence;
• constipation.

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Side effects Loperamide for diarrhea

Side effects of Loperamide include:

• immune hypersensitivity reactions type I;
• vertigo;
• decreased volume of extracellular fluid circulation; xerostomia;
• negative change in water-electrolyte balance;
• intestinal spasms;
• pain in the epigastric region;
• constipation;
• nausea, vomiting;
• bloating;
• ischuria.

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Overdose

The drug is generally well tolerated, but if the dosage is not correct, the following may occur:

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

If the above symptoms appear, it is necessary to call an ambulance. After the patient is transported to the hospital, he is given an antidote. In this case, Naloxone. At the same time as the antidote, the patient is given a gastric lavage and activated carbon. If the symptoms recur, the patient is given Naloxone again. The patient spends two days in the hospital and when his condition normalizes, he is discharged home.

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Interactions with other drugs

The simultaneous use of Loperamide and opioid analgesics increases the risk of pathological constipation.

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Storage conditions

The medicine is stored in a dry place, away from sunlight and at a temperature of no more than +25C. The location of the medicine should be reliably protected from small children and animals.

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Shelf life

The manufacturing date and the expiration date are marked on the cardboard box and stamped on the blister. The total shelf life is 4 years. It is not recommended to use the drug after the expiration date.

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