Loperamide

Loperamide – symptomatic antidiarrheal means.

Form of release and structure

Dosage forms:

• Tablets: a ploskotsilindrichesky form, with dividing risky and a facet, have color, white or white with a yellow shade (in a blister strip packaging on 10 pieces, in a cardboard pack 1-2 packagings, or on 20 pieces, in a cardboard pack 1 packaging; on 100 or 200 pieces in bottles from polyethylene of high pressure, in a cardboard box 72 bottles);
• Capsules (in a blister strip packaging: on 10 pieces, in a cardboard pack 1, 2 or 3 packagings; on 5 pieces, in a cardboard pack 2 or 4 packagings; on 7 pieces, in a cardboard pack 1, 2 or 4 packagings; in a glass jar of dark color or a polymeric bottle on 20 pieces, in a cardboard pack of 1 bank or 1 bottle).

Active ingredient of Loperamide – loperamide a hydrochloride:

• 1 tablet – 2 mg;
• 1 capsule – 2 mg.

Auxiliary components:

• Tablets: lactose, magnesium stearate, potato starch, polyvinylpirrolidone;
• Capsules: sugar milk, magnesium stearate, starch corn, aerosil, talc.

Indications to use

Use of Loperamide is shown for symptomatic therapy of chronic and acute diarrhea of various etiology, including medicinal, allergic, emotional and beam, and also the diarrhea caused by change of qualitative structure of food and a diet, disturbance of metabolism and absorption.

Drug is appointed for regulation of a chair at an ileostoma and as a part of complex therapy of diarrhea of infectious genesis.

Contraindications

• Monotherapy of infections of digestive tract (including acute dysentery);
• Ulcer colitis in an aggravation stage;
• Pseudomembranous coloenteritis;
• Intestinal impassability;
• I trimester of pregnancy;
• Breastfeeding period;
• Hypersensitivity to drug components.

With care it is necessary to appoint drug sick with a liver failure and functional disorder of a liver.

Purpose of loperamide in II and III trimesters of pregnancy is possible only if the potential threat for a fruit is less than expected effect of therapy for mother.

Besides, use of Loperamide is contraindicated:

• Tablets: at locks, abdominal distention, a subileus; to children under 4 years;
• Capsules: at glyukozo-galaktozny malabsorption, a lactose intolerance, deficit of lactase, a divertuculosis, to children under 6 years.

Route of administration and dosage

• Tablets: apply lingvalno, (having put on language and having waited several seconds of its full dissolution then swallow with saliva, without washing down with water). The recommended dosing for adults: acute diarrhea – 2 tablets (an initial dose), then on 1 tablet after each liquid chair, but no more than 8 tablets a day; chronic diarrhea – 1 tablet (the first dose), then individually select a dose at which chair frequency at the patient does not exceed one-two times a day (from 1 to 6 tablets). Dosing for children: 4-8 years – on ½ tablets 3-4 times a day, duration of reception are 3 days; 9-12 years – on 1 tablet 4 times a day, a course of treatment – 5 days;
• Capsules: swallow entirely, washing down with water. At the beginning of therapy of an acute or chronic form of diarrhea adults accept 2 capsules, then on 1 capsule after each defecation with liquid structure a calla. The maximum daily dose – 8 capsules. To children 6 years with acute diarrhea are more senior appoint on 1 capsule after each liquid chair, but no more than 3 capsules a day. In the absence of defecation more than 12 hours administration of drug should be stopped.

Side effects

• Tablets: the alimentary system – nausea, dryness in a mouth, swelling, abdominal pains, a lock; a nervous system – drowsiness, increased fatigue, dizziness; allergic reactions – skin rash;
• Capsules: emergence of allergic reaction (skin rash), drowsiness or sleeplessness, dizziness, a hypovolemia, electrolytic disturbances, pain or discomfort in a stomach, intestinal colic, a xerostomia, nausea, a gastralgia, vomiting, a meteorism; seldom – an ischuria; extremely seldom – intestinal impassability.

Special instructions

In the absence of clinical effect after two days of reception of loperamide it is necessary to see a doctor for specification of the diagnosis and an exception of infectious nature of a disease.

At emergence of abdominal distention or having bungled drug it is necessary to cancel.

During therapy it is necessary to control carefully a condition of patients with a liver failure and functional disorder of a liver as there is a risk of toxic defeat of a nervous system.

At treatment of diarrhea plentiful drink is shown to the patient, it is recommended to offset loss of liquid and electrolytes regularly.

It is impossible to apply tablets in the clinical situations demanding oppression of a vermicular movement of intestines.

As an antidote it is necessary to apply Naloxonum to treatment of overdose of loperamide.

During administration of drug patients need to be careful when performing potentially dangerous types of the works demanding the increased speed of psychomotor reactions and concentration of attention, including control of vehicles.

Medicinal interaction

The concomitant use with Colestyraminum can reduce efficiency of drug.

The loperamide combination with ritonaviry or co-trimoxazole increases its bioavailability.

Terms and storage conditions

To protect from children. To store in the protected from light, dry place at a temperature up to 25 °C.

Period of validity: tablets – 3 years, capsules – 2 years.