Loperamide with simeticone oral
- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Oral formulations of loperamide and simeticone.
Acute diarrhoea and associated symptoms
Two tablets initially, followed by one after each loose stool, up to a maximum dose of 4 tablets per day for no more than two days.
Children aged 12 to 18 years
One tablet initially, followed by one tablet after each loose stool, to a maximum of 4 tablets a day for no more than 2 days.
Children under 12 years
Acute ulcerative colitis
Precautions and Warnings
Glucose-galactose malabsorption syndrome
Advise patient dizziness may affect ability to drive or operate machinery
Advise patient drowsiness may affect ability to drive or operate machinery
Monitor CNS toxicity in patients with hepatic impairment
Monitor periodically for signs of fluid or electrolyte imbalance
Discontinue if abdominal distension develops
Discontinue if constipation develops
Discontinue if no improvement is seen within 48 hours and consult doctor
Patients should not exceed recommended dose
Since treatment of diarrhoea with loperamide and simeticone is symptomatic, diarrhoea should be treated causally whenever such treatment is available.
Stop therapy in patients with AIDS at the earliest signs of abdominal distension. There is an increased risk of toxic megacolon in AIDS patients with infectious colitis from viral and bacterial pathogens treated with loperamide hydrochloride.
Higher than recommended doses of loperamide can cause serious cardiac events, including QT interval and QRS complex prolongation and Torsades de Pointes.
Pregnancy and Lactation
Use loperamide and simeticone with caution during pregnancy.
The manufacturer advises caution if loperamide and simeticone is used during pregnancy, especially during the first trimester. At the time of writing, there is no published experience concerning exposed pregnancies and their outcomes. Reproduction studies in rats show no evidence of impaired fertility, teratogenicity or foetal adverse effects.
Use loperamide and simeticone with caution during breastfeeding.
The manufacturer does not recommend the use of loperamide and simeticone during breastfeeding. Small amounts of loperamide may appear in human breast milk. Schaefer concludes that loperamide may be taken temporarily whilst breastfeeding where dietary measures are insufficient (Schaefer 2015) and Briggs concludes that loperamide is probably compatible (Briggs 2015).
Loss of consciousness (transient)
Toxic epidermal necrolysis
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: November 2022
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.
Summary of Product Characteristics: Imodium Dual Action Relief tablets (P). McNeil Products Ltd. Revised April 2022.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 10 November 2022
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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