Daily OTC Pearl: Loperamide (Imodium)
Imodium provides relief of acute nonspecific diarrhea and chronic diarrhea associated with inflammatory bowel disease.
OTC/Lifestyle Pearl of the Day: Loperamide (Imodium)
Indication: Loperamide hydrochloride (Imodium) is indicated for the control and symptomatic relief of acute nonspecific diarrhea and chronic diarrhea associated with inflammatory bowel disease. Imodium is also indicated for reducing the volume of discharge from ileostomies.
- Contraindications: Imodium is contraindicated in patients with a known hypersensitivity to loperamide hydrochloride or to any of the excipients.
- Imodium is contraindicated in patients with abdominal pain in the absence of diarrhea.
- Imodium is not recommended in infants below 24 months of age.
- Fluid and electrolyte depletion often occur in patients who have diarrhea.
- Interactions: Nonclinical data have shown that loperamide is a P-glycoprotein substrate. Concomitant administration of loperamide (16 mg single dose) with a 600 mg single dose of either quinidine or ritonavir, both of which are P-glycoprotein inhibitors, resulted in a 2- to 3- fold increase in loperamide plasma levels.
- The adverse effects (AEs) reported during clinical investigations of Imodium are difficult to distinguish from symptoms associated with the diarrheal syndrome. AEs recorded during clinical studies with Imodium were generally of a minor and self-limiting nature.
- Dosing: The recommended initial dose is 4 mg (2 capsules) followed by 2 mg (1 capsule) after each unformed stool. Daily dose should not exceed 16 mg (8 capsules). Clinical improvement is usually observed within 48 hours.