Loperamide capsules instructions for use for children. Instructions for use of tablets and capsules. Interaction with other drugs

Loperamide is a medicine for diarrhea and other diseases of the digestive tract.

Drug manufacturers usually recommend reading the instructions for use instead of throwing them away. For the product to work, you need to know how to use it. It is important to comply correct dosage. If the patient takes a smaller amount of the drug (in in this case Loperamide) than he needs, the ailment will not disappear and will continue to poison the life of the person and his family. Excess permissible dose provokes a deterioration in health and even poses a threat to the patient’s life. In addition, sometimes people do not read the ingredients of medications and buy those that can cause an allergic reaction. All these troubles can be avoided in a simple way– familiarize yourself with the characteristics of the drug before purchasing or using it.

Therapeutic effect

Thanks to Loperamide, intestinal motility slows down and the tone of the anal sphincter increases. As a result, the urge to defecate becomes less frequent. The product almost never enters the bloodstream, interacting exclusively with digestive system. Has no harmful effect on nervous system. Reduces the production of electrolytes and fluid in the intestines.

One of positive properties medicines - fast acting. The maximum effect occurs 1 hour after taking it. The drug is excreted through the intestines and kidneys. You also need to pay attention that the liver is involved in the processing of the drug, so in case of its diseases it can be detected increased concentration Loperamide in the blood and urine.

Composition and release form

Loperamide is produced in the form of tablets or capsules, each containing 2 mg of loperamide hydrochloride (the active substance). Other components of the capsules:

  • colloidal silicon dioxide (Aerosil);
  • lactose (milk sugar);
  • corn starch;
  • talc.

Basics active substance refers to opioid drugs. Capsules and tablets are packaged in blisters (10 pieces each). Packs usually contain 1 or 2 blisters.

Indications

The main purpose of Loperamide is to combat diarrhea (both acute and chronic) of various origins:

  • infectious (in this case it is carried out combination treatment, because antiviral or antibacterial medications are needed);
  • on nerves;
  • after radiation therapy or a course of antibiotics;
  • for conditions associated with unusual foods.

In addition, these capsules are often taken by patients who have had an ileostomy (i.e. due to cancer, diverticulitis or Crohn's disease, part of the intestine is removed, and the end ileum brought to the front abdominal wall) because they have a higher incidence of diarrhea and an increased risk of dehydration (compared to healthy people).

Contraindications

In some diseases, taking Loperamide can worsen the patient's health. It is not recommended for those who have:

  • intestinal obstruction;
  • colitis (especially acute ulcerative and pseudomembranous, which arose during antibiotic treatment);
  • diverticulosis;
  • acute dysentery.

There are some other categories of people for whom this antidiarrheal drug is contraindicated:

  • allergy sufferers;
  • children under two years of age, and in some cases under six years of age.

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Mode of application

Capsules should be swallowed whole, being careful not to bite through. You can take no more than 0.016 g (16 mg) of Loperamide per day.

  1. Acute diarrhea. When starting treatment, adults should take 2 capsules, after which the dosage is reduced to 1 capsule after each bowel movement until the diarrhea stops. For children from 4 to 8 years old, a three-day treatment is usually recommended, prescribing 1 mg 3-4 times a day (half the contents of a standard capsule). For children over 8 years old and under 12 years old, the dosage is doubled (2 g at a time), and the duration of therapy is 5 days.
  2. Chronic diarrhea. First, take 1 capsule, and then the doctor selects a treatment regimen, focusing on individual characteristics patient, achieving a reduction in the frequency of bowel movements to 1 - 2 times a day.

Overdose

The main signs that the patient has taken an excessive dose of Loperamide are well known in medical practice:

  • intestinal obstruction;
  • depression of the central nervous system, up to a state of stupor;
  • breathing problems;
  • feeling drowsy;
  • increased muscle tone and impaired coordination of movements.

These signs are often life-threatening for the patient, so immediately after they appear, the victim needs to be given a sorbent (Activated carbon), do a gastric lavage and call a doctor to inject Naloxone (an antidote, antidote drug) intravenously. Provide symptomatic therapy as necessary.

Side effects

Some patients reported unpleasant sensations arising from the use of this medication. Most often they were concerned about:

  • skin rashes;
  • pain in the lower abdomen and epigastric region;
  • increased muscle tone;
  • headache;
  • dizziness;
  • feeling drowsy;
  • cramps in the intestines;
  • the appearance of intestinal obstruction.
  • nausea and vomiting.

If a person feels these signs of illness, these capsules are not suitable for him. Their use is discontinued. In this case, it is imperative to report the problem to a therapist or gastroenterologist.

special instructions

Loperamide can be taken during pregnancy and breastfeeding, but do so with caution and under the supervision of a doctor.

The effect should occur after 2 days of treatment. If this does not happen, you need to consult a doctor.

Storage: terms and conditions

The shelf life of the drug is no more than 24 months at temperatures up to +5 degrees Celsius.

At the same time, contact with certain factors should be avoided. environment:

- moisture;

- light.

Of course, everyone knows that every medicine is not a toy for small children, so you need to hide it from children.

Release from pharmacies

It is sold in pharmacies and online without a prescription, so it is suitable if diarrhea begins suddenly.

Price

The price depends on the form of release and the number of tablets or capsules in the package.

20 capsules of 2 mg each can be purchased at a cost from 24 rubles to 48 rubles 50 kopecks, and 10 pieces are sold at a price from 13 to 30 rubles.

Packaging of tablets from 10 to 20 pcs. can be purchased for 11 - 12 rubles.

Analogs

Loperamide is not the only medication used for diarrhea. It has analogues for the active substance:

  1. Lopedium.
  2. Diarol.
  3. Enterobene.
  4. Imodium.
  5. Diara (chewable tablets).
  6. Neo-enteroseptol.
  7. Loperacap.

All these products differ in their auxiliary components and prices, but are similar in the list of indications for use.

Also, in the treatment of diarrhea, sorbents (Activated carbon, Enterosgel, Polysorb, Sorbex, Neosorb) and probiotics (Bifikol, Acylact, Atsipol, Bifidumbacterin, Lactobacterin) can be used. The choice of treatment regimen depends on the nature of the diarrhea and general condition patient's health.

For diarrhea and other digestive tract disorders

Diarrhea is a common occurrence during the hot season when outbreaks occur infectious diseases, and people are eager to try everything that is sold on the beaches and in small eateries, they do not always follow proper storage vegetables and fruits and forget about hygiene. This means that in the end you have to look for medications that will relieve a person of painful diarrhea as soon as possible. Of course, sick and cured people exchange experiences on forums, in in social networks and on various medical portals. Thus, they say about Loperamide that it “acts very quickly, within forty minutes after administration”, “effective”, “eliminates diarrhea quickly enough”, “helps well with diarrhea”. There are also those who are disappointed in the medicine, because “there are side effects“,” “sometimes there is no bowel movement for 3 days,” etc. Of course, most consumers were satisfied with the result, but there were still those who encountered troubles. If the patient doubts the correctness of his choice, a therapist or gastroenterologist will help him. Diarrhea is not a joke, but a problem that needs to be solved.

Formula: C29H33ClN2O2, chemical name: 4-(4-Chlorophenyl)-4-hydroxy-N,N-dimethyl-alpha,alpha-diphenyl-1-piperidine butanamide (as hydrochloride).
Pharmacological group: organotropic agents/ gastrointestinal drugs/ antidiarrheals.
Pharmachologic effect: antidiarrheal.

Pharmacological properties

Loperamide interacts with opiate receptors located in the circular and longitudinal muscles of the intestinal wall and inhibits the release of prostaglandins and acetylcholine. Loperamide inhibits intestinal motility and increases intestinal transit time. Loperamide increases the tone of the anal sphincter, helps reduce the urge to defecate and retain feces. Loperamide inhibits the release of electrolytes and fluid into the intestinal lumen and/or stimulates their absorption from the intestine. In high doses, loperamide may reduce gastric formation of hydrochloric acid. The effect of loperamide develops quickly and lasts 4–6 hours.
There were no cases of development after taking loperamide. drug addiction or tolerance. But morphine-like dependence was observed in monkeys when high doses of loperamide were used.
IN gastrointestinal tract poorly absorbed (approximately 40% of the dose). Due to the high degree of biotransformation during the “first pass” through the liver and the high affinity of the drug for the receptors of the intestinal wall, the content of unchanged loperamide after using 2 mg of the drug is less than 2 ng/ml. The maximum concentration in the blood is achieved 2.5 hours after taking the solution and 5 hours after taking the capsules. Loperamide is 97% protein bound. The half-life is 9.1–14.4 hours (average approximately 10.8 hours). Loperamide is metabolized in the liver, mainly excreted in the form of metabolites in bile and feces, and partially excreted in the urine. In a study in rats (duration 1.5 years), no carcinogenic effect of loperamide was found when using doses exceeding the MRDC up to 133 times. Mutagenicity studies of loperamide have not been performed. In reproduction studies in rats, it was found that loperamide can cause decreased fertility in males and infertility in females when using high doses of the drug (150-200 times the MRDI). In reproduction studies in rabbits and rats, it was shown that when using doses of loperamide no more than 30 times higher than the MRDC, the drug does not harm the offspring and does not have teratogenic effects. It is not known whether loperamide passes into breast milk. In a study of post- and prenatal development of rat offspring, a decrease in offspring survival was noted when 40 mg/kg loperamide was used in lactating females.

Indications

Symptomatic treatment of chronic and acute diarrhea, which is caused by changes in quality composition food and diet, impaired absorption and metabolism, as well as emotional, allergic, radiation, medicinal origin; for diarrhea infectious origin, as an aid; ileostomy (to reduce the volume and frequency of stool, to make its consistency denser).

Method of administration of loperamide and dose

Loperamide is taken orally (regardless of food intake; the lingual tablet is placed on the tongue, after a few seconds it disintegrates, after which, without washing down with water, it is swallowed with saliva; capsules are taken with water, without chewing). The dosage regimen depends on the indications. Acute diarrhea, adults: 4 mg – initial dose, then after each shapeless stool 2 mg, 16 mg – maximum daily dose; chronic diarrhea, adults 4 mg/day. If there is no stool for more than 12 hours or normalization of stool consistency, therapy should be discontinued. Children 2–12 years old are prescribed under the supervision of a physician, depending on age and body weight.
If at acute diarrhea Within 2 days, constipation, partial intestinal obstruction, bloating develops, or no clinical improvement is observed, then loperamide should be stopped. For chronic diarrhea, the use of loperamide is possible only as prescribed by a doctor and under his supervision. Use loperamide with caution in children younger age due to high sensitivity to the opiate-like properties of loperamide - effects on the central nervous system. When treating diarrhea (especially in children), it is necessary to replenish the loss of electrolytes and fluids. Dehydration may cause changes in the response to loperamide. Loperamide should be used with caution in elderly patients (as the response to loperamide may vary and symptoms of dehydration may be masked). In patients with liver dysfunction, careful monitoring should be carried out for signs of toxic damage to the central nervous system (due to slower metabolism of loperamide). In patients with traveler's diarrhea, decreased intestinal motility caused by loperamide may cause long-term increase temperature due to inhibition of the excretion of microorganisms (Salmonella, Shigella, some strains of Escherichia coli and others) and their penetration into the intestinal mucosa. Extreme caution should be used when driving during loperamide therapy. Vehicle or when working with technology.

Contraindications for use

Hypersensitivity, diverticulosis, intestinal obstruction, pseudomembranous colitis, which is caused by taking antibacterial agents wide range actions; spicy ulcerative colitis, other conditions in which intestinal motility cannot be suppressed; acute dysentery (especially if there is blood in the stool and accompanied by hyperthermia) and others infectious diseases gastrointestinal tract (which are caused, including Shigella spp., Salmonella spp. and Campylobacter spp.); age up to 6 years.

Restrictions on use

Severe liver dysfunction, age from 2 to 12 years (only under medical supervision).

Use during pregnancy and breastfeeding

You should not use loperamide during pregnancy (especially in the 1st trimester) and breastfeeding, since strictly controlled and adequate studies have not been conducted in lactating and pregnant women.

Side effects of loperamide

Digestive system: bloating, constipation, intestinal colic, abdominal discomfort or pain, nausea, dry mouth, vomiting, intestinal obstruction, additionally for lozenges: a tingling or burning sensation of the tongue that occurs immediately after taking the tablets;
nervous system: drowsiness, fatigue, dizziness;
allergic reactions: urticaria, skin rash, very rarely - bullous rash, including toxic epidermal necrolysis; anaphylactic shock;
others: urinary retention.

Interaction of loperamide with other substances

Concomitant use of loperamide with opioid analgesics may increase the risk of developing severe constipation. When loperamide and cholestyramine are used together, the effectiveness of loperamide may be reduced. When loperamide is used together with ritonavir, co-trimoxazole, the bioavailability of loperamide increases.

Overdose

In case of an overdose of loperamide, the following occur: intestinal obstruction, depression of the central nervous system (drowsiness, miosis, stupor, muscle hypertonicity, respiratory depression, impaired coordination of movements).
Therapy: if necessary, use the antidote - naloxone. Given that the duration of action of loperamide is longer than that of naloxone, repeated use of naloxone is possible. It is also necessary to carefully and long-term (at least 1 day) observation of the patient and conduct symptomatic treatment, gastric lavage, taking activated carbon, artificial ventilation lungs (if necessary).

Cases of sudden onset of diarrhea are not uncommon. A person cannot do business or leave the house. When this situation occurs frequently, people know that the drug Loperamide will help. It is important to carefully study the instructions so that use does not cause complications.

Indications for use of Loperamide

This antidiarrheal drug does not treat the cause of the disease, but only relieves the main symptom - diarrhea. The instructions describe what the main active substance in the drug - loperamide hydrochloride - does not affect reproduction coli. When ingested, this remedy:

  • slows down intestinal motility;
  • reduces tone muscle fibers;
  • reduces motor skills;
  • slows down the time of movement of feces;
  • increases sphincter tone;
  • reduces the number of urges;
  • promotes fecal retention;
  • gives density to feces.

The use of Loperamide hydrochloride helps in the treatment of chronic and acute form Not infectious diarrhea. Indications for use according to the instructions are diarrhea, which manifests itself as a result of:

Loperamide - what it helps with

According to the instructions, the use of Loperamide is prescribed for severe diarrhea that continues long time. Indications include stool regulation after surgery in patients with ileostomy. What makes Loperamide most effective? The medicine has indications for use in the following cases:

Composition of Loperamide

The list of substances that are included in the structure of the drug is headed by active ingredient– loperamide hydrochloride. Pharmaceutical companies can introduce the remaining ingredients into different combinations depending on the form of release - tablets or capsules. The composition of the drug Loperamide includes:

  • lactose;
  • corn (potato) starch;
  • Aerosil;
  • magnesium (calcium) stearate;
  • silicon dioxide

Instructions for use of Loperamide

The medicine is produced in the form of drops, tablets and capsules, but liquid solution did not gain distribution in Russia. The instructions for Loperamide prescribe its use for non-infectious diarrhea, or as a concomitant treatment for infections. Recommended during use:

  • follow the dosage for adults and children;
  • take into account contraindications and side effects;
  • Avoid simultaneous use with alcohol.

According to the instructions, when using Loperamide you must consider:

  • the medicine begins to take effect within an hour;
  • it is necessary to replenish the loss of fluid and microelements;
  • use with caution in old age;
  • at chronic form diseases, the dosage and treatment regimen are prescribed by the doctor;
  • there is no compatibility with opioid analgesics - constipation may occur;
  • The effect of the product lasts up to 5 hours.

When using Loperamide, the instructions instruct you to carefully consider the following points:

  • stop using it, consult a doctor to clarify the diagnosis if diarrhea does not stop for two days;
  • the medicine slows down the reaction - you should be careful when working with equipment or using transport;
  • take with caution when liver failure– possible disruption of the central nervous system;
  • Stop using the medicine if constipation, bloating, or signs of intestinal obstruction occur.

Loperamide - instructions for use for children

Only a pediatrician should treat diarrhea in childhood. This is due to the fact that babies common cause diarrhea there are infections that require treatment with antibiotics. Loperamide should not be used for children under 4 years of age - there are cases of intestinal paralysis and possible effects on the central nervous system. There are contraindications for the use of Loperamide:

The instructions recommend the use of Loperamide, starting from 6 years of age, in capsule form. It is necessary to correlate the dosage with the age of the child. Maximum per day it should not exceed 8 mg. At the age of 6 to 8 years, for acute forms of diarrhea, 1 capsule is prescribed at the first dose, then, after each case of diarrhea, one more. If after two days of treatment it does not get better - the diarrhea does not stop - it is permissible to increase the dosage, but only as prescribed by a doctor. Children over 8 years of age are prescribed one capsule three times a day.

Can children be given Loperamide for diarrhea?

Although Loperamide's annotation allows for the use of the drug in children from 4 years of age, pediatricians insist on its prohibition. Especially if parents do it on their own, without a doctor’s prescription. Diarrhea is often caused infectious processes, in which diarrhea is a blessing because it removes toxins. IN otherwise Possible poisoning of the body. In addition, parents often forget to give their child water to compensate for the loss of water, which causes dehydration.

Loperamide can be given to children only after 6 years of age under the strict supervision of a doctor. This is due to the fact that during the use of the medicine the following are possible:

  • stopping peristalsis;
  • retention of food bolus in the intestines;
  • absorption of fluid with toxins into the blood;
  • bloating of the large intestine;
  • tissue necrosis;
  • circulatory disorders;
  • intestinal paralysis;
  • life threat.

Loperamide during pregnancy

Although the drug is inexpensive and available, it can be dangerous for pregnant women to take. Can pregnant women take Loperamide? In the first three months it is strictly prohibited. This is due to the formation of basic systems and organs in the unborn child during this period, which may be disrupted. For more later The decision to take medication should be made by a doctor, taking into account the threat to life expectant mother and fruit. The effect of Loperamide on intrauterine development the child has not been fully studied.

How to take Loperamide

What the drug has good feedback and is freely sold at an affordable price does not mean its thoughtless use. It is advisable to discuss this issue with your doctor. How to take Loperamide? This depends on the nature of the disease. For the chronic form in adults, 4 mg is prescribed per day. Acute illness Diarrhea is treated with a maximum daily dose of 16 milligrams. Treatment regimen:

  • first dose – 2 tablets or capsules;
  • after each diarrhea - one.

Loperamide tablets

Positive reviews received the drug, produced in the form of tablets, the price of which is an order of magnitude lower than that of its analogue, Imodium. They are covered with a special shell and are white or pale yellow in color. Conveniently, Loperamide does not need to be taken with water - they are placed on the tongue and dissolved. During use, you may experience a tingling or burning sensation in the mouth. The drug begins to act within an hour. The dosage is 2 mg.

Loperamide capsules

The affordable price of the drug makes it possible to have it on hand when a person needs to quickly cope with non-infectious diarrhea. According to the instructions, taking the medicine in the form of a capsule for diarrhea requires drinking water. Inside the gelatin shell is powdery substance white or yellowish color. Capsules are swallowed without chewing, the dosage is similar to tablets.

Loperamide - contraindications

Loperamide instructions do not recommend the use of the drug during infectious diarrhea. In such a situation, harmful bacteria and viruses must be eliminated from the body, and diarrhea contributes to this. If it is stopped, the absorption of toxins into the blood will begin, which will worsen the patient’s condition. For the same reason, the use of this antidiarrheal medicine for poisoning is prohibited.

There are contraindications for Loperamide during an acute form of dysentery with blood in the discharge and fever. According to the instructions, the use of the drug is prohibited in the following cases:

  • intestinal obstruction;
  • acute ulcerative colitis;
  • lactose intolerance;
  • constipation;
  • sensitivity to components;
  • 1st trimester of pregnancy;
  • breastfeeding;
  • diverticulosis;
  • monotherapy for dysentery.

Loperamide - side effects

Due to its affordable price, the drug can be found in home medicine cabinets. The medicine is used without the consent of the doctor, without thinking about the possible side effects of Loperamide. If the product is used in large quantities, it is recommended to take the antidote drug Naloxone. According to the instructions, in case of overdose the following are observed:

  • respiratory depression;
  • drowsiness;
  • lack of coordination;
  • stupor;
  • intestinal obstruction.

Because of active influence antidiarrheal medicine on the body, its long and uncontrolled use, the appearance of side effects. Alcohol consumption aggravates this situation. Loperamide instructions note that they observe:

  • allergies;
  • lethargy;
  • skin rashes;
  • dizziness;
  • insomnia;
  • intestinal colic;
  • bloating;
  • nausea;
  • stomach pain;
  • dry mouth;
  • vomiting;
  • abdominal discomfort;
  • flatulence;
  • dehydration;
  • electrolyte disturbances;
  • delay in urine output.

Loperamide price

This drug is sold without a prescription in pharmacies; unlike its analogues, it has affordable price. It is possible to order it on special websites or buy it at an online pharmacy. How much does Loperamide cost? The price depends on the number of tablets, capsules in the package, release form and manufacturer. The cost of Loperamide and its analogues in rubles is for 20 pieces:

  • tablets – 15-100;
  • capsules – 25-95;
  • Loperamide-acri – 50-70;
  • Diara – 250-280;
  • Imodium – 510-640.

Video: how Loperamide works

Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.

Loperamide tablets: instructions for use

Compound

active ingredient: 1 tablet contains loperamide hydrochloride 0.002 g (2 mg); Excipients: lactose monohydrate, potato starch, calcium stearate.

Description

tablets white or almost white, round shape, with a flat surface, with a chamfer;

pharmachologic effect

Agents that inhibit peristalsis. Pharmacological properties. Loperamide hydrochloride slows down the movement of intestinal contents along the intestine, increases the tone of the anal sphincter, promotes fecal retention and reduces the frequency of the urge to defecate. The effect occurs quickly (1 hour after taking the tablets orally, 85% of loperamide is found in the gastrointestinal tract, 5% in the liver) and lasts 4-6 hours. The maximum concentration of Loperamide in blood plasma is determined after 4 hours. Excreted in bile and feces.

Pharmacokinetics

Indications for use

For the symptomatic treatment of acute diarrhea of ​​any etiology, including cases of exacerbation of chronic diarrhea, for a period of up to 5 days in adults and children over 8 years of age. For the symptomatic treatment of chronic diarrhea in adults.

Contraindications

Intestinal obstruction; acute ulcerative colitis and pseudomembranous colitis resulting from the use of broad-spectrum antibiotics; I trimester of pregnancy and breastfeeding period; childhood up to 5 years, increased sensitivity to the drug.

The drug is prescribed with caution to patients with impaired liver function, dehydration, and the elderly (risk of loss of fluid and electrolytes).

Pregnancy and lactation

Directions for use and doses

Loperamide is prescribed orally.

For acute diarrhea for adults and children over 12 years of age, the initial dose is 4 mg, then 2 mg after each bowel movement. Installed optimal dose prescribed once or in several doses. The average daily maintenance dose is 4 - 8 mg. The maximum daily dose is 16 mg. The therapeutic effect usually develops within 48 hours.

In children from 9 to 12 years old, no more than 2 mg 4 times a day for 5 days.

For chronic diarrhea, the initial dose for adults is 4 mg, then a maintenance dose is established to ensure stool frequency normal consistency 1 - 2 times a day (2 - 12 mg per day), but not exceeding the maximum daily dose - 16 mg.

Use in the elderly There is no need for dose adjustment in the elderly

Use in patients with impaired renal and hepatic function. The need for dose adjustment in patients with renal failure No. In patients with impaired liver function, despite the lack of data from pharmacokinetic studies, it should be used with caution due to possible reduction first pass metabolism through the liver.

Side effect

As a rule, they are observed only when long-term use drug. Possible: headache, pain and discomfort under the breasts, dry mouth, allergic reactions in the form skin manifestations, pain or discomfort in the lower abdomen; rarely - drowsiness or sleep disturbance, dizziness, intestinal cramps, nausea, vomiting, constipation; in isolated cases - intestinal obstruction.

If these side effects occur, stop using the drug and consult a doctor immediately!

Overdose

Symptoms: central nervous system depression (stupor, loss of coordination, drowsiness, miosis, increased tone muscles, respiratory depression), intestinal obstruction.

If these symptoms appear, it is necessary to rinse the stomach, take Activated carbon and call a doctor.

Interaction with other drugs

If you are taking any other medications, be sure to tell your doctor.

It is not recommended to prescribe Loperamide together with atropine and other anticholinergic drugs (to avoid mutually enhancing effects), erythromycin, metoclopramide. It is recommended to prescribe cholestyramine no later than 2 hours before taking Loperamide. Clinically significant interaction of Loperamide with medicines no other groups were identified.

Opioid analgesics increase the risk of developing severe constipation.

Features of application

Loperamide tablets contain lactose and should be administered with caution to patients with lactose intolerance, galactosemia and glucose/galactose malabsorption. During the treatment of diarrhea (especially in children), it is necessary to replace the loss of fluid and electrolytes and follow a diet.

If there is no effect of the drug within 2 days, it is necessary to clarify the diagnosis and exclude the infectious genesis of diarrhea. If the cause of the disease is known, it is necessary to use etiotropic drugs (the drug does not replace antibacterial treatment for infectious diseases).

Despite the lack of data on the teratogenic and embryotoxic properties of the drug, prescribe loperamide in II and III trimester pregnancy is possible only if therapeutic effect outweighs the potential risk to the fetus. After normalization of stool or if there is no stool within 12 hours, stop taking the drug.

Name:

Loperamide

Pharmacological
action:

The drug has antidiarrheal (antidiarrheal) effect. Reduces intestinal tone and motility due to inhibition (suppression) of the release of acetylcholine and prostaglandins, increases the tone of the anal sphincter (circular muscle that compresses the anus).

Indications for
application:

Symptomatic treatment acute and chronic diarrhea caused by changes in diet and quality of food, metabolic and absorption disorders, as well as allergic, emotional, medicinal, radiation origin; for diarrhea of ​​infectious origin - as aid; ileostomy (to reduce the frequency and volume of stool, as well as to make its consistency denser).

Mode of application:

Inside.
For adults at the beginning of treatment, 4 mg, and after each shapeless stool, 2 mg (but not more than 16 mg per day). The drug can be prescribed in drops: the first dose is 60 drops, then 30 drops after each loose stool; maximum dose - 30 drops 6 times a day. For chronic diarrhea, adults are prescribed 4 mg.
Children over 8 years old 2 mg, but not more than 8 mg per day. Children from 2 to 8 years old- based on 0.004 mg/kg.
The drug can be prescribed in drops: the first dose is 30 drops, then 30 drops 3 times a day; maximum dose - 30 drops 4 times a day
For chronic diarrhea children over 5 years old prescribe the drug in daily dose 30 drops or 2 mg.
Children aged 2-5 years the drug can be prescribed in the form of syrup at a dose of 1 mg per 10 kg of body weight; frequency of administration - 2-3 times a day. When stool normalizes or if there is no stool for more than 12 hours, the drug should be discontinued.

The duration of use should not exceed 2 days, as severe constipation may develop. If diarrhea does not stop after 2 days of taking it, you should consult a doctor.

Side effects:

Adverse effects noted during clinical trials loperamide hydrochloride, are difficult to distinguish from symptoms associated with diarrhea syndrome; usually these effects were mild and went away on their own; in most cases they were observed in the treatment of chronic diarrhea. These side effects included the following: hypersensitivity reactions, incl. skin rash, urticaria, extremely rarely - anaphylactic shock and bullous rash, including toxic epidermal necrolysis (in most cases, patients were taking other drugs that could cause or contribute to adverse reactions), abdominal pain, bloating or gastric discomfort, nausea, vomiting, constipation , fatigue, drowsiness, dizziness, dry mouth.

There have been rare case reports of paralytic ileus in post-marketing studies. Most of these reports were recorded in acute dysentery, overdose, and in children under 2 years of age.

Contraindications:

- hypersensitivity, intestinal obstruction, diverticulosis, acute ulcerative colitis, pseudomembranous colitis caused by taking broad-spectrum antibiotics;
- other conditions in which oppression is unacceptable intestinal peristalsis;
- acute dysentery(especially with the presence of blood in the stool and accompanied by elevated body temperature);
- childhood(up to 2 years).

Interaction
other medicinal
by other means:

Cholestyramine It is recommended to prescribe no later than 2 hours before taking loperamide. Maybe pharmacological interaction loperamide with drugs that stimulate intestinal motility ( bethanechol, cisapride, metoclopramide, erythromycin), therefore it is not recommended to prescribe them simultaneously.

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