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loperamide
generic
Black Box Warnings .
Torsades de Pointes and Sudden Death
torsades de pointes, cardiac arrest, and death reported w/ higher than recommended doses; avoid use of higher than recommended loperamide doses due to risk of serious cardiac adverse rxns; contraindicated in pts <2 yo
Adult Dosing .
Dosage forms: CAP: 2 mg; TAB: 2 mg; SUSP: 1 mg per 7.5 mL; SOL: 1 mg per 5 mL
diarrhea, acute
- [4 mg PO x1, then 2 mg PO x1 after each loose stool]
- Max: 16 mg/day
diarrhea, chronic
- [4-8 mg/day PO divided qd-qid]
- Start: 4 mg PO x1, then 2 mg PO x1 after each loose stool until maint. dose established; Max: 16 mg/day; Info: for pts w/ inflammatory bowel dz
high-output ileostomy
- [4-8 mg/day PO divided qd-qid]
- Max: 16 mg/day
short bowel syndrome (off-label)
- [2-4 mg PO tid-qid]
- Info: for pts w/ high-output ostomy; refer to ESPEN guidelines
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: CAP: 2 mg; TAB: 2 mg; SUSP: 1 mg per 7.5 mL; SOL: 1 mg per 5 mL
diarrhea, acute
- [2-5 yo, 13-20 kg]
- Dose: 1 mg PO tid x1 day, then 0.1 mg/kg/dose PO x1 after each loose stool; Max: 3 mg/day
- [6-8 yo, 20-30 kg]
- Dose: 2 mg PO bid x1 day, then 0.1 mg/kg/dose PO x1 after each loose stool; Max: 4 mg/day
- [8-12 yo, >30 kg]
- Dose: 2 mg PO tid x1 day, then 0.1 mg/kg/dose PO x1 after each loose stool; Max: 6 mg/day
- [13 yo and older]
- Dose: 4 mg PO x1, then 2 mg PO x1 after each loose stool; Max: 16 mg/day
diarrhea, chronic (off-label)
- [0.08-0.24 mg/kg/day PO divided bid-tid]
- Max: 2 mg/dose
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised