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Loperamide is a medicine to treat diarrhoea (runny poo). It can help with short-term diarrhoea or irritable bowel syndrome (IBS). Loperamide is also used for recurring or longer lasting diarrhoea from bowel conditions such as Crohn's disease, ulcerative colitis and short bowel syndrome. If you have a colostomy (an opening in your stomach to collect poo from your body), loperamide can make your poo thicker. It does this by slowing down your food as it passes through your gut. You can buy loperamide from pharmacies and supermarkets. It is also available on prescription for treating some bowel conditions. It comes as tablets, including tablets that melt on your tongue, capsules and a liquid. The liquid is only available on prescription. The tablets that melt are called Imodium Instants or Imodium Instant Melts Loperamide is also available combined with simeticone. Simeticone is used to treat farting (flatulence or wind). Taking these medicines together helps if you have diarrhoea with painful stomach cramps and bloating. Loperamide mixed with simeticone is known by the brand names Imodium Plus Caplets and Imodium Plus Comfort Tablets. 2. Key facts
3. Who can and cannot take loperamideYou can buy loperamide from pharmacies and supermarkets or you can get it on prescription. Loperamide is available to buy without a prescription for:
It's available on prescription only for:
Younger childrenOnly give loperamide to children aged 11 years or under if their doctor prescribes it. Loperamide is not suitable for some people. Do not take loperamide if you:
Check with your doctor before taking loperamide if you:
If you have diarrhoea and IBS, talk to your doctor before taking loperamide if you:
4. How and when to take loperamideIf you've bought loperamide from a pharmacy or shop, follow the instructions that come with the packet. If your doctor has prescribed loperamide for you or your child, follow their instructions about how and when to take it. How to take itYou can take loperamide with or without food. Capsules and tablets: swallow these whole, with a drink of water. Tablets that melt in your mouth: put the tablet on your tongue and let it melt in your saliva. You can then swallow it without a drink. Do not chew it. Liquid: this comes with a measuring cup, plastic syringe or spoon to help you measure the right dose. If you do not have one, ask your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount of medicine. Dosage and strengthLoperamide comes as:
The recommended dose depends on the type of diarrhoea you have and your age. Adults (over 18), with short-term diarrhoea or IBSThe usual starting dose is:
Stop taking loperamide as soon as your symptoms settle down. The recommended maximum dose in 24 hours is:
Do not take loperamide for more than 48 hours without talking to a doctor. Adults (over 18) with long-lasting or recurring diarrhoeaMost cases of diarrhoea get better in 5 to 7 days. If your diarrhoea does not stop in 7 days, talk to your doctor. It is important to understand the causes and to treat any complications, for instance dehydration. If your doctor prescribes loperamide for long-lasting diarrhoea, they will tell you how much to take. The usual starting dose is:
Your doctor will adjust your dose according to your symptoms and how well loperamide is working, up to a maximum of:
Once you're on the right dose, your doctor will usually recommend dividing your daily dose, so you take half in the morning and half in the afternoon or evening. Occasionally patients with a colostomy (stoma) need a higher dose. Only take a higher dose if your doctor tells you to. Children's dosesDo not give loperamide to children under 12 years old unless their doctor prescribes it.
If a doctor prescribes loperamide for your child, they will use their weight or age to work out the right dose. The dose also depends on their symptoms. What if I forget to take it?If you miss a dose of loperamide, do not worry. Just take a dose after you next go to the toilet and have a runny poo. Do not take a double dose to make up for the one you forgot. What if I take too much?Do not take more than the recommended amount. If you take 1 extra dose of loperamide as a one-off, it's unlikely to harm you. But taking higher doses can cause serious heart problems. The signs include having a fast or irregular heartbeat. Urgent advice: Contact 111 for advice now if:
Go to 111.nhs.uk or call 111 If you need advice for a child under the age of 5 years, call 111. 5. Side effectsLike all medicines, loperamide can cause side effects, but many people have no side effects or only minor ones. Common side effectsThese common side effects happen in more than 1 in 100 people. Talk to your doctor or pharmacist if these side effects bother you or do not go away:
Serious side effectsIt's rare to have a serious side effect with loperamide. Tell a doctor straight away if you:
Serious allergic reactionIn rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to loperamide. Immediate action required: Call 999 or go to A&E now if:
You could be having a serious allergic reaction and may need immediate treatment in hospital. These are not all the side effects of loperamide. For a full list, see the leaflet inside your medicines packet. Information: You can report any suspected side effect using the Yellow Card safety scheme. Visit Yellow Card for further information. 6. How to cope with side effects of loperamideWhat to do about:
7. Pregnancy and breastfeedingLoperamide in pregnancyLoperamide is not usually recommended in pregnancy. This is because there is not enough information to say whether it is safe or not. If you're pregnant, talk to your doctor before taking loperamide. They'll be able to advise you about the benefits and possible harms of taking it. This will depend on how many weeks pregnant you are and why you need to take it. If you’re trying to get pregnant, talk to your doctor if you take loperamide on prescription as part of ongoing treatment for a bowel condition. Loperamide and breastfeedingIt is OK to take loperamide for a couple of days while you're breastfeeding. Hardly any loperamide passes into breast milk, and so it will not affect your baby. If you notice that your baby isn’t feeding as well as usual, seems unusually sleepy, or if you have any other concerns about your baby, then talk to your doctor, midwife or health visitor. Non-urgent advice: Tell your doctor if you're:
For more information about how taking this medicine can affect you and your baby, read this leaflet about loperamide on the Best Use of Medicines in Pregnancy (BUMPs) website. 8. Cautions with other medicinesThere are some medicines that can affect the way loperamide works. Check with a pharmacist or doctor if you're taking:
Speak to your doctor if your diarrhoea is very severe and you take metformin for diabetes, or medicines for high blood pressure or heart failure. Your doctor may tell you to stop taking these medicines for a few days until your diarrhoea is better. Mixing loperamide with herbal remedies or supplementsThere's very little information about taking herbal remedies and supplements with loperamide. Medicine safetyTell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. 9. Common questions about loperamideHow does loperamide work? Loperamide is an anti-motility medicine. This means that it slows down food as it goes through your gut. Your body can then draw in more water from your intestines, so that your poos get firmer and you poo less often. How long does loperamide take to work? Loperamide usually starts to work within 1 hour to make your diarrhoea better. How long will I take it for? Most people only need to take loperamide for 1 to 2 days. You may need to take it for longer if your diarrhoea is because of a bowel condition such as Crohn's disease, ulcerative colitis or short bowel syndrome. If you've bought loperamide from a shop or pharmacy, do not take it for more than 48 hours without talking to a doctor. Why is it important not to take loperamide for longer than recommended? If you've bought loperamide from a shop or pharmacy, do not take it for more than 48 hours without talking to a doctor. Although diarrhoea is usually nothing to worry about, it can sometimes lead to dehydration. This can be serious if you do not get the correct treatment. Diarrhoea can also sometimes be a warning sign of another problem. For this reason, it's important to see a doctor to find out the cause of your diarrhoea if it continues beyond 7 days. Is it safe to take for a long time? If you've bought loperamide for short-term diarrhoea, do not take it for longer than 48 hours without talking to a doctor. Loperamide may be used for long-lasting diarrhoea and by people who have a colostomy (stoma) if their doctor prescribes it. Can I take loperamide to prevent diarrhoea? Do not take loperamide to prevent diarrhoea, unless your doctor tells you to. It's not been officially approved and tested for preventing diarrhoea. Can I drink alcohol with it? It's best not to drink alcohol while you're taking loperamide. Alcohol makes you more likely to have side effects such as feeling sleepy or dizzy and having difficulty concentrating. Is there any food or drink I need to avoid? Apart from avoiding alcohol, you can eat and drink normally while you're taking loperamide. However, if you have diarrhoea it's best to avoid fatty or spicy food. Can I drive or ride a bike? Loperamide can make you feel dizzy, tired or sleepy. You might also feel less alert, feel faint or pass out. If this happens to you do not drive, cycle or use machinery or tools until the effect has worn off. Can I take loperamide with painkillers? Yes, you can take loperamide at the same time as everyday painkillers like paracetamol and ibuprofen. Are there any other treatments that could help diarrhoea? There is another medicine for diarrhoea called co-phenotrope. This works in a similar way to loperamide to slow down your gut. You do not usually need an antibiotic for diarrhoea. However, occasionally your doctor will prescribe an antibiotic if you have severe diarrhoea caused by a specific kind of bacteria. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Your pharmacist can recommend oral rehydration sachets. These are powders that you mix with water and then drink. If you've been diagnosed with a particular health problem that's causing your diarrhoea, treating the problem may help improve your symptoms. For example, you can help relieve IBS with changes to your diet and medicines. What medicine immediately stops diarrhea?Look for over-the-counter products like Imodium or Pepto-Bismol, which have the ingredients loperamide and bismuth subsalicylate, respectively. The active ingredient in Imodium works swiftly because it slows the movement of fluid through the intestines. This can quickly restore normal bowel function.
How do I stop liquid diarrhea?Drink plenty of liquids, including water, broths and juices. Avoid caffeine and alcohol. Add semisolid and low-fiber foods gradually as your bowel movements return to normal. Try soda crackers, toast, eggs, rice or chicken.
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