Loperamide
Loperamide (loe PER a mide) is a generic medication prescribed for treating diarrhea in certain situations. Loperamide belongs to a group of drugs called antidiarrheals.
Loperamide (loe PER a mide) is a generic medication prescribed for treating diarrhea in certain situations. Loperamide belongs to a group of drugs called antidiarrheals.
- Generic
- • Capsule
- • 2mg
- • 10 Capsules
Dosage settings
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Intro
Introduction
Written by Helen Marshall, BPharm, MRPharmS
Medically reviewed by Alex Brewer, PharmD, MBA
Updated on July 27, 2023
Loperamide (loe PER a mide) is a generic medication prescribed for treating diarrhea in certain situations. Loperamide belongs to a group of drugs called antidiarrheals.
Boxed warning: Risk of torsades de pointes and sudden death
Loperamide has a boxed warning about the risk of torsades de pointes (a type of irregular heart rhythm) and sudden death. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).
For details, see the “Interactions and warnings for loperamide” section.
Side effects
Side effects of loperamide
Loperamide may cause mild or serious side effects. More common mild side effects of loperamide and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.
To learn more about loperamide’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for loperamide listed in the “Resources” section.
Mild side effects
More common mild side effects reported with loperamide are listed below.
This article doesn’t include all possible mild side effects of the drug. To learn more about loperamide’s side effects, refer to the prescribing information for loperamide listed in the “Resources” section.
With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.
Loperamide oral capsule’s mild side effects include:
- constipation
- dizziness
- abdominal pain or cramps
- nausea or vomiting
- mild allergic reaction*
* For details about this side effect, see the “Interactions and warnings for loperamide” section.
Serious side effects
Serious side effects of loperamide are listed below. This article doesn’t include all possible serious side effects of the drug. To learn more about loperamide’s side effects, refer to the prescribing information for loperamide listed in the “Resources” section.
With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.
In general, loperamide’s serious side effects include:
- blockage or tear in the intestines
- severe skin reactions
- boxed warning: risk of torsades de pointes and sudden death*
- severe allergic reaction*
* For details about this side effect, see the “Interactions and warnings for loperamide” section.
Uses
Uses of loperamide
The Food and Drug Administration (FDA) approves prescription drugs such as loperamide for certain conditions. Approved uses for loperamide are described below.
Use for diarrhea
Doctors may prescribe loperamide oral capsule for treating diarrhea in certain situations. With diarrhea, you have frequent bowel movements and pass loose or watery stools. Specifically, it’s prescribed for:
- treating acute (short-term) diarrhea in adults and children ages 2 years and older
- treating chronic (ongoing) diarrhea related to inflammatory bowel disease in adults
- reducing the amount of waste discharge from ileostomies in adults
Loperamide may be prescribed as a short-term or long-term treatment, depending on the situation.
Acute diarrhea lasts up to a few days. It’s usually caused by a stomach bug or food poisoning. These are the most common causes of traveler’s diarrhea. Acute diarrhea can also be related to irritable bowel syndrome, menstruation (your period), stress, anxiety, and opioid withdrawal.
Chronic diarrhea lasts at least 4 weeks. It’s usually caused by long-term inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease.
You can also have diarrhea with an ileostomy. An ileostomy is a surgical procedure that redirects the lower end of your small intestine to an opening in your abdominal wall, called a stoma. Your digestive waste passes through the stoma into a collection bag, instead of leaving your body through your large intestine and anus. With an ileostomy, you may produce a large volume of watery digestive waste.
Loperamide makes your stools less watery, firmer, and smaller. It also makes your bowel movements less frequent.
FAQs
Common questions about loperamide
Below you’ll find answers to a few commonly asked questions about loperamide.
What is loperamide’s mechanism of action? How does the drug work?
Loperamide works by slowing down the muscle contractions in your intestines. This slows down the passage of food through your intestines, allowing more fluid and salts to be reabsorbed back into your body. This makes your stools less watery, firmer, and smaller. It also makes your bowel movements less frequent.
Loperamide usually starts working within about 1 hour. It may take up to 2 days for acute (sudden) diarrhea to get better. It may take about 5–10 days to manage chronic (ongoing) diarrhea.
If you’d like to know more about this, talk with your doctor or pharmacist.
Is loperamide available over the counter?
Yes, loperamide is available over the counter (OTC). This means you can buy it without a prescription from a doctor. A brand name version of loperamide, Imodium A-D, is also available as an OTC drug. OTC loperamide comes as an oral capsule, tablet, liquid solution, and liquid suspension (a type of liquid mixture). Imodium A-D comes as an oral tablet, liquid solution, and liquid suspension.
OTC loperamide can be used to treat acute diarrhea in adults and children ages 6 years and older. For chronic diarrhea or diarrhea in younger children, loperamide should only be used if it’s been recommended by a doctor.
Interactions and warnings
Interactions and warnings for loperamide
Below, you’ll find information about loperamide’s possible interactions and warnings.
Interactions of loperamide
Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.
Before you take loperamide, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:
- prescription or over-the-counter drugs
- vitamins, herbs, or supplements
To learn about drug-condition interactions, see the “Warnings for loperamide” section below.
Warnings for loperamide
Some people should not take loperamide and others should take it cautiously.
Boxed warning: Risk of torsades de pointes and sudden death
Loperamide has a boxed warning about the risk of torsades de pointes and sudden death. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).
With torsades de pointes, you have a type of irregular heart rhythm that can cause your heart to stop beating. This can lead to sudden death.
This side effect wasn’t reported in studies of loperamide, but has occurred since the drug was approved for use. It’s been reported in adults who took the recommended and higher than recommended dosages of loperamide. It’s also been reported in children under 2 years old who had treatment with loperamide. Keep in mind that loperamide should not be used in children under 2 years old. Do not take more loperamide than prescribed by your doctor.
Symptoms of torsades de pointes may include fast heartbeat, dizziness, and fainting. You may also have trouble breathing and chest pain. If your heart stops, you’ll have no pulse, lose consciousness, and collapse. If you experience any of these symptoms, someone must call 911 or your local emergency number right away.
Taking other medications that can affect your heart rhythm can raise your risk of this side effect. Due to this risk, doctors typically avoid prescribing loperamide with certain other medications that can affect your heart rhythm. Before you start treatment, be sure to tell your doctor and pharmacist about all medications you take. This is so they can check for drug interactions with loperamide.
Doctors also usually avoid prescribing loperamide if you have existing risk factors for torsades de pointes, including having an existing heart rhythm condition. To learn more, talk with your doctor or pharmacist.
Other warnings
Loperamide could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether loperamide is a safe option for you.
Ask your doctor about specific warnings for loperamide, and be sure to tell your doctor about your:
- current health, including any allergies to medications
- past health conditions or surgeries
Allergic reaction
Loperamide can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.
If you’ve had an allergic reaction to loperamide or any of its ingredients, your doctor will likely not prescribe loperamide. They can tell you about medications that are safer options for you.
A mild allergic reaction may cause the following symptoms:
A severe allergic reaction may cause the following symptoms:
- swelling under your skin, usually in your hands, feet, eyelids, or lips
- swelling of your mouth, throat, or tongue, which can cause breathing problems
If you have an allergic reaction to loperamide, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.
Overdose of loperamide
You should not take more loperamide than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.
If you think you’ve taken too much loperamide, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
Pregnancy or breastfeeding and loperamide
Information about loperamide and pregnancy and breastfeeding is described below.
Loperamide and pregnancy
It’s not known whether loperamide should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.
Loperamide and breastfeeding
It’s not known whether loperamide should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.
Ask your doctor
What to ask your doctor
Let your doctor know whether you have questions about loperamide or would like more details about it.
Here’s a list of some possible questions you may want to ask your doctor:
- How long can I take loperamide for?
- Can I take loperamide for diarrhea caused by other drugs?
- What should I do if I still have diarrhea after taking the recommended dosage of loperamide?
- How does loperamide compare with other treatments for diarrhea?
- Does loperamide interact with my other medications?
Resources
Resources
- Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
- Loperamide hydrochloride capsule, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/330677ff-5426-40bd-af45-e3836cb77893/spl-doc
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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