Loperamide

Loperamide

[1 tablet 3 cents]

ADMINISTRATION ROUTES:

  • PO, NG

ALTERNATIVE NAMES:

  • Imodium, Nodia, Diamide

ICU INDICATIONS:

  1. diarrhoea

PRESENTATION AND ADMINISTRATION:

  • PO:
    Tablets:
    Imodium Caplets 2mg (light green) Nodia 2mg tablets (green)
    Capsules:
    Diamide 2mg capsules (mauve / dark green) Imodium 2mg capsules (dark green / light grey)

DOSAGE:

  • PO:
    Initially 4mg, then 2mg after each unformed stool. Maximum 16mg/day.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • PO:
    0.05-0.1mg/kg 8-12 hourly; increase if required to 0.4mg/kg 8 hourly if required.

CLINICAL PHARMACOLOGY:

  • In vitro and animal studies show that loperamide acts by slowing intestinal motility and by affecting water and electrolyte movement through the bowel. Loperamide inhibits peristaltic activity by a direct effect on the circular and longitudinal muscles of the intestinal wall.

CONTRAINDICATIONS:

  1. Pseudomembranous colitis or other infectious diarrhoea
  2. hypersensitivity to loperamide

WARNINGS

  • Loperamide therapy should be discontinued promptly if abdominal distention, constipation, or ileus occurs.

PRECAUTIONS

  • General:
    In acute diarrhoea, if clinical improvement is not observed in 48 hours, the administration of loperamide should be discontinued. Patients with hepatic dysfunction should be monitored closely for signs of CNS toxicity because of the apparent large first pass biotransformation. In patients with severe hepatic impairment, loperamide may cause CNS depression.
  • Laboratory Tests:
    No tests are indicated in addition to routine ICU tests
  • Drug/Laboratory Test Interactions:
    None known.

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • None of note

ADVERSE REACTIONS

  • Body as a Whole:
    Hypersensitivity reactions (including skin rash), tiredness, drowsiness or dizziness.
  • Gastrointestinal:
    Abdominal pain, distention, or discomfort, nausea and vomiting, constipation, dry mouth.

Critical Care Drug Manual

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