ADMINISTRATION ROUTES:
PO, NG
ALTERNATIVE NAMES:
Imodium, Nodia, Diamide
ICU INDICATIONS:
- Diarrhoea
PRESENTATION AND ADMINISTRATION:
PO:
Tablets:
Imodium Caplets 2mg (light green)
Nodia 2mg tablets (green)
Capsules:
Diamide 2mg capsules (purple / dark green) Imodium 2mg capsules (dark green / light grey)
DOSAGE:
PO:
4 mg then 2 mg after each unformed stool
Max 16 mg per day
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
PO:
0.05 - 0.1 mg/kg TDS or BD
Increase if required to 0.4 mg/kg TDS
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:
- Pseudomembranous colitis or other infectious diarrhoea
- 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 IN 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