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LOPERAMIDE is a brand name for Loperamide. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: For the symptomatic treatment of acute diarrhoea in adults and children aged 12 years and over. For the symptomatic treatment of acute episodes of diarrhoea associated with Irritable Bowel Syndrome in adults aged 18 years and over following initial diagnosis by a doctor.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology:
ACUTE DIARRHOEA Adults and children over 12: Two tablets (4 mg) initially, followed by one tablet (2 mg) after each loose stool. The usual dose is 3-4 tablets (6 mg – 8 mg) a day. The total daily dose should not exceed 6 tablets (12 mg).
SYMPTOMATIC TREATMENT OF ACUTE EPISODES OF DIARRHOEA ASSOCIATED WITH IRRITABLE BOWEL SYNDROME IN ADULTS AGED 18 YEARS AND OVER Two tablets (4 mg) to be taken initially, followed by 1 tablet (2 mg) after every loose stool, or as previously advised by your doctor.
The maximum daily dose should not exceed 6 tablets (12 mg). Paediatric population Lopramide is contraindicated in children less than 12 years of age. Elderly No dose adjustment is required for the elderly. Renal impairment No dose adjustment is required for patients with renal impairment.
Hepatic impairment Although no pharmacokinetic data are available in patients with hepatic impairment, Lopramide should be used with caution in such patients because of reduced first pass metabolism. (see
Adults and children aged ≥ 12 years The safety of loperamide HCl was evaluated in 2755 adults and children aged ≥ 12 years who participated in 26 controlled and uncontrolled clinical trials of loperamide HCl used for the treatment of acute diarrhoea.
e. 1%). Table 1 displays ADRs that have been reported with the use of loperamide HCl from either clinical trial (acute diarrhoea) or post-marketing experience. The frequency categories use the following convention: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); not known (cannot be estimated from the available data).
Table 1:
Adverse Drug Reactions IndicationSystem Organ Class Common Uncommon Rare Not known Immune System Disorders Hypersensitivity reactiona Anaphylactic reaction (including Anaphylactic shock)a Anaphylactoid reactiona Nervous System Disorders Headache Dizziness Somnolencea Loss of consciousnessa Stupora Depressed level of consciousnessa Hypertoniaa Coordination abnormalitya Eye Disorders Miosisa Gastrointestinal Disorders Constipation Nausea Flatulence Abdominal pain Abdominal discomfort Dry mouth Abdominal pain upper Vomiting Dyspepsiaa Ileusa (including paralytic ileus) Megacolona (including toxic megacolonb) Abdominal distension Acute pancreatitis Skin and Subcutaneous Tissue Disorders Rash Bullous eruptiona (including Stevens-Johnson syndrome, Toxic epidermal necrolysis and Erythema multiforme) Angioedemaa Urticariaa Pruritusa Renal and Urinary Disorders Urinary retentiona General Disorders and Administration Site Conditions Fatiguea Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
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4 Special warnings and special precautions for use). Method of administration Oral use. The tablets should be taken with liquid. 1. • in children less than 12 years of age. • in patients with acute dysentery, which is characterised by blood in stools and high fever.
• in patients with acute ulcerative colitis. • in patients with bacterial enterocolitis caused by invasive organisms including Salmonella, Shigella and Campylobacter. • in patients with pseudomembranous colitis associated with the use of broad- spectrum antibiotics.
Lopramide must not be used when inhibition of peristalsis is to be avoided due to the possible risk of significant sequelae including ileus, megacolon and toxic megacolon. Lopramide must be discontinued promptly when ileus, constipation or abdominal distension develop.
4 Special warnings and precautions for use Caution is needed in patients with a history of drug abuse. Loperamide is and opioid and addiction is observed with opioids as a class. Treatment of diarrhoea with Lopramide is only symptomatic.
Whenever an underlying etiology can be determined, specific treatment should be given when appropriate. The priority in acute diarrhoea is the prevention or reversal of fluid and electrolyte depletion. This is particularly important in young children and in frail and elderly patients with acute diarrhoea.
Use of this medicine does not preclude the administration of appropriate fluid and electrolyte replacement therapy. Since persistent diarrhoea can be an indicator of potentially more serious conditions, this medicine should not be used for prolonged periods until the underlying cause of the diarrhoea has been investigated.
In acute diarrhoea, if clinical improvement is not observed within 48 hours, the administration of Lopramide should be discontinued and patients should be advised to consult their doctor. Patients with AIDS treated with this medicine for diarrhoea should have therapy stopped at the earliest signs of abdominal distension.
1. • in children less than 12 years of age. • in patients with acute dysentery, which is characterised by blood in stools and high fever. • in patients with acute ulcerative colitis. • in patients with bacterial enterocolitis caused by invasive organisms including Salmonella, Shigella and Campylobacter.
• in patients with pseudomembranous colitis associated with the use of broad- spectrum antibiotics. Lopramide must not be used when inhibition of peristalsis is to be avoided due to the possible risk of significant sequelae including ileus, megacolon and toxic megacolon.
Lopramide must be discontinued promptly when ileus, constipation or abdominal distension develop.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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There have been isolated reports of obstipation with an increased risk for toxic megacolon in AIDS patients with infectious colitis from both viral and bacterial pathogens treated with loperamide hydrochloride. Hepatic impairment Although no pharmacokinetic data are available in patients with hepatic impairment, this medicine should be used with caution in such patients because of reduced first pass metabolism, as it may result in a relative overdose leading to CNS toxicity.
This medicine contains lactose and sodium Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine because it contains lactose. This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
If patients are taking this medicine to control episodes of diarrhoea associated with Irritable Bowel Syndrome previously diagnosed by their doctor, and clinical improvement is not observed within 48 hours, the administration of loperamide HCl should be discontinued and they should consult with their doctor.
Patients should also return to their doctor if the pattern of their symptoms changes or if the repeated episodes of diarrhoea continue for more than two weeks. QT prolongation Cardiac events including QT interval and QRS complex prolongation, torsades de pointes have been reported in association with overdose.
9). Overdose can unmask existing Brugada syndrome. Patients should not exceed the recommended dose and/or the recommended duration of treatment.
Special Warnings to be included on the leaflet:
Only take Lopramide to treat acute episodes of diarrhoea associated with Irritable Bowel Syndrome if your doctor has previously diagnosed IBS. If any of the following now apply, do not use the product without first consulting your doctor, even if you know you have IBS: • If you are aged 40 or over and it is some time since your last IBS attack • If you are aged 40 or over and your IBS symptoms are different this time • If you have recently passed blood from the bowel • If you suffer from severe constipation • If you are feeling sick or vomiting • If you have lost your appetite or lost weight • If you have difficulty or pain passing urine • If you have a fever • If you have recently travelled abroad Consult your doctor if you develop new symptoms, if your symptoms worsen, or your symptoms have not improved over two weeks.