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Loperamide HCl

Loperamide HCl is an antidiarrheal medication used to treat acute and chronic diarrhea. It works by slowing down gut movement, which decreases the number of bowel movements and makes stools less watery. Loperamide is often used for conditions such as traveler's diarrhea, infectious diarrhea, and irritable bowel syndrome.

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Frequently Asked Questions

How quickly does loperamide work?
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Loperamide typically starts to work within 1 to 2 hours after taking the dose.

Can I take loperamide if I have a fever?
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Loperamide should not be used if you have a fever or blood in your stools, as these may indicate a bacterial infection.

What should I do if I miss a dose?
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If you miss a dose and it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up doses.

Are there any dietary restrictions while taking loperamide?
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There are no specific dietary restrictions, but staying hydrated is important, especially if experiencing diarrhea.

Is loperamide safe during pregnancy or breastfeeding?
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Consult your healthcare provider if you are pregnant or breastfeeding to discuss the risks and benefits of using loperamide.

Comprehensive Drug Guide

How Does Loperamide HCl Work?

Loperamide works by acting on the opioid receptors in the gut, specifically the μ-opioid receptors. This action reduces peristalsis (the wave-like muscle contractions that move food through the digestive tract) and increases the transit time of the intestinal contents, allowing for more water absorption and resulting in firmer stools.

Common Dosages

  • Capsules/Tablets: Typically 2 mg per capsule or tablet.
  • Liquid Form: 1 mg/5 mL.

Typical Dosing

  • For acute diarrhea: The usual starting dose is 4 mg, followed by 2 mg after each loose stool. Do not exceed 8 mg per day for OTC use or 16 mg per day for prescription use.
  • For chronic diarrhea: Dosing should be individualized based on the patient’s needs, usually starting at 4 mg and adjusted accordingly.


Typical Dosing

FDA Approved Indications

  • Acute Diarrhea: treatment of non-bacterial diarrhea.
  • Chronic Diarrhea: associated with inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS).
  • Traveler’s Diarrhea: to relieve symptoms.

Who Shouldn't Take Loperamide HCl?

  • Known hypersensitivity to loperamide or any component of the formulation.
  • Bacterial gastroenteritis or colitis caused by organisms such as Salmonella or Shigella.
  • Severe abdominal pain or distension without diarrhea.


Advice From The Pharmacist

  • Use loperamide as directed on the package or by your healthcare provider, and do not exceed the recommended dosage.
  • Monitor for symptoms of dehydration, such as excessive thirst, dry mouth, or decreased urine output.
  • If diarrhea persists for more than 48 hours or if blood appears in the stool, discontinue use and seek medical advice.


Side Effects of Loperamide HCl

Common Side Effects

  • Constipation
  • Dizziness
  • Drowsiness
  • Nausea


Uncommon/Severe Side Effects

  • Severe abdominal pain
  • Signs of allergic reactions (rash, itching, swelling)
  • Toxic megacolon in patients with inflammatory bowel disease.


Risks and Warnings of Loperamide HCl

  • Bacterial Infections: Loperamide should not be used to treat diarrhea caused by bacterial infections or in cases of fever, as it may worsen the condition.
  • Constipation Risk: Overuse can lead to constipation, which can be particularly dangerous in certain populations.
  • Children: Use caution when administering to children, and follow dosage guidelines specific to age and weight.

Interactions with Loperamide HCl

Common Drug Interactions

  • CNS Depressants: Use caution when combining loperamide with other medications that cause sedation, as the effects may be additive.
  • Other Antidiarrheals: Avoid concurrent use of other antidiarrheal medications unless directed by a healthcare provider.

Alternatives to Loperamide HCl

  • Other Antidiarrheals: Such as bismuth subsalicylate (Pepto-Bismol) for diarrhea.
  • Probiotics: To help restore gut flora in cases of antibiotic-associated diarrhea.
  • Dietary Changes: BRAT diet (bananas, rice, applesauce, toast) may help in managing diarrhea.