Loperamide

Imodium, Imodium AeD, and generics
Antidiarrheal

C	1	No	No	No
Key

Dosing

• Caps (OTC): 2 mg
• Tabs (OTC): 2 mg
• Oral solution (OTC): 1 mg/7.5 mL (120, 240 mL); may contain propylene glycol and sodium benzoate; each 30 mL contains 16 mg of sodium
• Acute diarrhea (see remarks):
  • Child (initial doses within the first 24 hr):
    • 2-5 yr (13e<21 kg): 1 mg PO TID
    • 6-8 yr (21-27 kg): 2 mg PO BID
    • 9-11 yr (>27-43 kg): 2 mg PO TID
    • Max. single dose: 2 mg
    • Follow initial day’s dose with 0.1 mg/kg/dose after each loose stool (not to exceed the aforementioned initial doses).
  • ≥12 yr and adult: 4 mg/dose 1, followed by 2 mg/dose after each stool up to max. dose of 8 mg/24 hr for 12e<18 yr and 16 mg/24 hr for adult
• Chronic diarrhea (see remarks):
  • Infantechild (limited data): 0.08-0.24 mg/kg/24 hr PO O BIDeTID; max. dose: 2 mg/dose

Notes

• Contraindicated in acute dysentery; acute ulcerative colitis; bacterial enterocolitis caused by Salmonella, Shigella, Campylobacter, and Clostridium difficile; and abdominal pain in the absence of diarrhea. Avoid use in children <2 yr due to reports of paralytic ileus associated with abdominal distention. Rare hypersensitivity reactions including anaphylactic shock have been reported. May cause nausea, rash, vomiting, constipation, cramps, dry mouth, and CNS depression. Use of higher than recommended dosages via abuse or misuse can cause serious cardiac events (e.g., Torsades de Pointes, arrhythmias, cardiac arrest, and QT prolongation).
• Discontinue use if no clinical improvement is observed within 48 hr. Naloxone may be administered for CNS depression.