If abdominal distension is noted, therapy with loperamide should be discontinued. There have been rare reports of fatal paralytic ileus associated with abdominal distention. Most of these reports occurred in the setting of acute dysentery , overdose, and with very young children less than two years of age.
The study reported that the use of loperamide should be contraindicated in children under 3 years old, systemically ill, malnourished, moderately dehydrated, or have bloody diarrhea. Studies in rat models have shown no teratogenicity , but there have not been sufficient studies in humans. This, however, was only one study with a small sample size. As an example, when saquinavir concentrations can decrease by half when given with loperamide.
As such, when combined with other antimotility drugs, there is an increased risk of constipation. If you are taking an antibiotic and you have diarrhea that is watery or has blood in it, call your doctor. Do not use loperamide to stop the diarrhea unless your doctor has told you to. What other drugs will affect loperamide? Tell your doctor about all other medicines you use, especially saquinavir Invirase.
This list is not complete and other drugs may interact with loperamide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products.
Do not start a new medication without telling your doctor. Where can I get more information? Your pharmacist can provide more information about loperamide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. There have been isolated reports of toxic megacolon in AIDS patients with infectious colitis from both viral and bacterial pathogens treated with loperamide hydrochloride. Antimotility agents such as loperamide may precipitate ileus and toxic megacolon in patients with ulcerative colitis, and should be avoided in severe acute attacks.
It may be used cautiously in mild or less severe attacks as an adjunct to other measures, but should be discontinued promptly should abdominal distension or other untoward symptoms occur. The stated dose should not be exceeded. 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.
Cardiac events including QT prolongation and Torsades de Pointes have been reported in association with overdose. Some cases had a fatal outcome see section 4. Swallowing of capsules may be difficult for young children who should be carefully supervised to avoid any potential risk of choking. Go to top of the page 4.
Concomitant administration of loperamide 16 mg single dose with quinidine, or ritonavir, which are both P-glycoprotein inhibitors, resulted in a 2 to 3-fold increase in loperamide plasma levels.
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