For adults with acute diarrhoea: take two tablets/capsules as soon as possible, then take one tablet/capsule after each time you go to the toilet with diarrhoea.
Have lots of water to drink to prevent you from becoming dehydrated. Eat as normally as possible, as soon as you feel able.
Loperamide must not be taken by children under 12 years of age unless it is prescribed for them by a doctor.
|Type of medicine||An antimotility medicine|
|Used for||Acute diarrhoea|
|Also called||Diah-Limit®; Diaquitte®; Diocalm®; Entrocalm® Loperamide; Imodium®; Norimode®; Normaloe®|
|Available as||Capsules, tablets, 'instant' (dissolve-in-the-mouth) tablets, and oral liquid medicine|
Loperamide is a medicine that can help if you have acute diarrhoea. Acute diarrhoea in adults starts suddenly and in most cases eases within a few days. The main treatment is to have lots to drink to prevent dehydration. The most common cause of acute diarrhoea is an infection. Many bacteria, viruses, and other germs can cause diarrhoea. In most cases the diarrhoea settles as your body's immune system clears the infection. Antidiarrhoeal medicines like loperamide may not be necessary; however, they can be helpful if you wish to reduce the number of trips that you need to make to the toilet. Most people only need to take loperamide for a day or so.
Loperamide works by slowing down the activity of your bowel. This reduces the speed at which the contents pass through, and so food remains in your intestines for longer. This allows more water to be absorbed back into your body and results in firmer stools that are passed less often.
Because loperamide regulates the passage of food through the digestive system, it can also help people with diarrhoea associated with irritable bowel syndrome, and people who need help to regulate their bowel activity following surgery on the intestines.
You can buy loperamide from retail outlets or get it on prescription from your doctor; however, it is not suitable for children under the age of 12 years unless it has been prescribed by a doctor.
Before taking loperamide
To make sure this is the right treatment for you, before you start taking loperamide it is important that you speak with your doctor or pharmacist:
- If you are pregnant or breast-feeding.
- If you have liver problems.
- If you have a long-term bowel condition such as ulcerative colitis.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take loperamide
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about loperamide and will provide you with a full list of the side-effects which you may experience from taking it.
- Take loperamide exactly as your doctor tells you to, or as directed on the label. The usual dose for acute diarrhoea in an adult is 4 mg (two tablets/capsules) taken straightaway, followed by 2 mg (one tablet/capsule) after each time you go to the toilet with diarrhoea. This usually means taking three or four tablets/capsules a day. Never take more than eight tablets/capsules a day. If your symptoms continue for more than 48 hours, you should speak with a doctor if you have not already done so. Stop taking loperamide as soon as your symptoms settle down.
- Most loperamide capsules and tablets are best swallowed with a drink of water. However, if you have been given a brand called Imodium® Instants, these are specially designed to dissolve in your mouth - place the tablet on your tongue and allow it to dissolve there before you swallow.
- Loperamide should only be taken by a child under 12 years of age on the advice of a doctor. If your child has been prescribed loperamide liquid medicine, check the label on the bottle carefully to make sure you know what dose to give.
- If you forget to take a dose, do not worry, just take a dose after the next time you go to the toilet with diarrhoea. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- It is important that you have lots to drink to prevent you from becoming dehydrated. Drinking plain water is ideal, but juice and/or soup are also suitable. Try to avoid drinks that contain a lot of sugar, such as cola or pop, as they can sometimes make diarrhoea worse.
- Oral rehydration salts can be taken to help prevent dehydration and replace lost salts. These are especially recommended for children and for people who are frail or who have underlying health problems. You can buy these from a pharmacy.
- Eat small, light meals as soon as you are able. Plain foods such as bread and rice are good foods to try eating first.
- If your symptoms continue for more than 48 hours, speak with a doctor or pharmacist for advice if you have not already done so. If loperamide has been prescribed by your doctor and your diarrhoea has not settled after five days, you should return to your doctor for further advice.
- If your symptoms get worse, or if you develop a high temperature, or if you pass blood in the diarrhoea, you should consult a doctor for advice as soon as possible.
Can loperamide cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with loperamide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common loperamide side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Constipation||Stop taking loperamide|
|Wind (flatulence), feeling dizzy||This should soon pass. If it becomes troublesome, stop taking loperamide|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Feeling sick||Try taking loperamide after eating some food if you are not already doing so|
If you experience any other symptoms which you think may be due to loperamide, speak with your doctor or pharmacist for further advice.
How to store loperamide
- Keep all medicines out of the sight and reach of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Imodium® Classic 2 mg Capsules; McNeil Products Ltd, The electronic Medicines Compendium. Dated July 2012.
- Manufacturer's PIL, Imodium® Instant Melts; McNeil Products Ltd, The electronic Medicines Compendium. Dated October 2011.
- Manufacturer's PIL, Imodium® 1 mg/5 ml oral solution; Janssen-Cilag Ltd, The electronic Medicines Compendium. Dated April 2014.
- British National Formulary; 68th Edition (Sep 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall