Loperamide: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "8 mg" to "8mg") |
Neil.m.young (talk | contribs) (Text replacement - "2 mg" to "2mg") |
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==Adult Dosing== | ==Adult Dosing== | ||
*Acute Diarrhea: | *Acute Diarrhea: | ||
** | **2mg PO per dose | ||
***Start: 4 mg PO x1, then | ***Start: 4 mg PO x1, then 2mg PO after each loose stool; Max: 16 mg/day | ||
*Chronic Diarrhea | *Chronic Diarrhea | ||
**4-8mg/day PO divided qd-tid | **4-8mg/day PO divided qd-tid | ||
***Start: 4 mg PO x1, then | ***Start: 4 mg PO x1, then 2mg PO after each loose stool until maint. dose established; Max: 16 mg/day | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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****Use OTC 1 mg/5 sol or 1 mg/7.5 mL susp | ****Use OTC 1 mg/5 sol or 1 mg/7.5 mL susp | ||
**6-8 yo, 20-30 kg | **6-8 yo, 20-30 kg | ||
***Dose: start | ***Dose: start 2mg PO x1, then 1 mg PO after each loose stool | ||
****Max: 4 mg/day | ****Max: 4 mg/day | ||
**8-11 yo, 30-40 kg | **8-11 yo, 30-40 kg | ||
***Dose: start | ***Dose: start 2mg PO x1, then 1 mg PO after each loose stool | ||
****Max: 6 mg/day | ****Max: 6 mg/day | ||
**12 yo and older | **12 yo and older | ||
***Dose: start 4 mg PO x1, then | ***Dose: start 4 mg PO x1, then 2mg PO after each loose stool | ||
****Max: 8mg/day | ****Max: 8mg/day | ||
*Chronic diarrhea | *Chronic diarrhea | ||
**0.08-0.24 mg/kg/day PO divided bid-tid | **0.08-0.24 mg/kg/day PO divided bid-tid | ||
***Max: | ***Max: 2mg/dose | ||
==Special Populations== | ==Special Populations== | ||
Revision as of 00:45, 20 July 2016
Administration
- Type: Anti-diarrheal, opioid
- Dosage Forms: 1mg, 2mg; 1/5 mL
- Routes of Administration: PO
- Common Trade Names: Imodium, Diamode, Imodium A-D, Imodium A-D EZ Chews, Imodium A-D New Formula, Kao-Paverin, Kaopectate 1-D
Adult Dosing
- Acute Diarrhea:
- 2mg PO per dose
- Start: 4 mg PO x1, then 2mg PO after each loose stool; Max: 16 mg/day
- 2mg PO per dose
- Chronic Diarrhea
- 4-8mg/day PO divided qd-tid
- Start: 4 mg PO x1, then 2mg PO after each loose stool until maint. dose established; Max: 16 mg/day
- 4-8mg/day PO divided qd-tid
Pediatric Dosing
- Acute diarrhea:
- 2-5 yo, 13-20 kg
- Dose: 1 mg PO x1 after each loose stool
- Max: 3 mg/day
- Use OTC 1 mg/5 sol or 1 mg/7.5 mL susp
- Dose: 1 mg PO x1 after each loose stool
- 6-8 yo, 20-30 kg
- Dose: start 2mg PO x1, then 1 mg PO after each loose stool
- Max: 4 mg/day
- Dose: start 2mg PO x1, then 1 mg PO after each loose stool
- 8-11 yo, 30-40 kg
- Dose: start 2mg PO x1, then 1 mg PO after each loose stool
- Max: 6 mg/day
- Dose: start 2mg PO x1, then 1 mg PO after each loose stool
- 12 yo and older
- Dose: start 4 mg PO x1, then 2mg PO after each loose stool
- Max: 8mg/day
- Dose: start 4 mg PO x1, then 2mg PO after each loose stool
- 2-5 yo, 13-20 kg
- Chronic diarrhea
- 0.08-0.24 mg/kg/day PO divided bid-tid
- Max: 2mg/dose
- 0.08-0.24 mg/kg/day PO divided bid-tid
Special Populations
- Pregnancy Rating: B
- Lactation risk: Probably safe
Renal Dosing
- Adult:
Hepatic Dosing
- Adult/Pediatric: Reduced first-pass metabolism
- CNS toxicity
Contraindications
- Allergy to class/drug
If given with:
- potassium acid phosphate
- potassium chloride
- potassium citrate
- potassium phosphate
Adverse Reactions
Serious
- toxic megacolon
- paralytic ileus
- angioedema
- anaphylaxis/anaphylactoid reaction
- toxic epidermal necrolysis
- Stevens-Johnson syndrome
- erythema multiforme
- urinary retention
- heat stroke
Common
- constipation
- nausea
- abdominal cramps
- dizziness
Pharmacology
- Half-life: Half-life: 10.8h
- Metabolism: liver; CYP450: 2C8, 3A4 substrate; Info: P-gp substrate; 40% systemic absorption
- Excretion: feces 30%, urine <2%
Mechanism of Action
binds gut wall opioid receptor, inhibiting peristalsis; increases anal sphinctor tone