Dosage & administration:
Administration
* Diarrimide
is administered orally with clear fluids.
- For the treatment of diarrhea:
For the treatment of acute nonspecific diarrhea including AIDS-associated
diarrhea with no identifiable infectious cause:
Oral dosage:
- Adults and adolescents: 4 mg by oral initially, followed by 2 mg by oral after
each unformed stool. The maximum dosage is 16 mg/day.
- Children 9 to 11 years (>30 kg): 2 mg by oral three times per day on the first
day.
- Children 6 to 8 years (20-30 kg): 2 mg by oral twice daily on the first day.
- Children 2 to 5 years (13-20 kg): 1 mg by oral three times per day on the
first day.
NOTE:
The maintenance dose in children is 0.1 mg/kg by oral only after an unformed
stool. Total daily maintenance doses should not exceed those recommended for the
first day.
- For the treatment of chronic diarrhea:
Oral dosage:
- Adults and adolescents: 4 mg by oral initially, followed by 2 mg after each
subsequent unformed stool until symptoms are controlled. Dosages should then be
reduced accordingly for maintenance therapy, (typically 4-8 mg/day by oral for
adults, given as a single dose or in divided doses).
NOTE:
If symptoms do not improve following 10 days of treatment with maximum daily
doses of
Diarrimide,
i.e., 16 mg/day, then improvement is not likely to occur with further
Diarrimide
therapy.
- For self medication (over-the-counter) of acute nonspecific
diarrhea:
Oral dosage:
- Adults and adolescents: 4 mg by oral initially, followed by 2 mg by oral after
each unformed stool; dosage should not exceed 8 mg/day for 2 days unless
directed by a physician.
- Children 9-11 years (27.3-43.2 kg): 2 mg by oral after the first unformed
stool, followed by 1 mg by oral after each subsequent unformed stool, not to
exceed 6 mg/day for 2 days.
- Children 6-8 years (21.8-26.8 kg): 2 mg by oral after the first unformed
stool, followed by 1 mg by oral after each subsequent unformed stool, not to
exceed 4 mg/day for 2 days.
NOTE:
This drug should not be used for self medication in children under 2 years of
age unless directed by the physician.
Diarrimide
therapy should be discontinued if improvement is not apparent after 48 hours.
- Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not
available; it appears that no dosage adjustments are needed.
Contraindications
:
- Diarrimide
(Loperamide) and other drugs that inhibit intestinal motility or prolong
transit time can induce toxic mega colon in patients with acute ulcerative
colitis. Patients with ulcerative colitis should be monitored closely and
Diarrimide
therapy discontinued if signs of toxicity (e.g., abdominal distension) occur.
- Diarrimide
is relatively contraindicated in cases of diarrhea caused by poisoning or
infection with enterotoxin-producing bacteria (bacterial gastroenteritis)
because expulsion of the toxic intestinal contents may be a necessary protective
mechanism.
Diarrimide
is contraindicated in cases of diarrhea caused by pseudomembranous colitis.
- Patients with hepatic disease should be monitored closely for CNS toxicity
while receiving
Diarrimide.
Because
Diarrimide
(Loperamide ) undergoes extensive first-pass metabolism, a decrease in hepatic
function could result in elevated plasma concentrations of the drug.
- Diarrimide
is contraindicated in cases of acute dysentery (hemafecia and elevated
temperature >38.3 degrees C).
- Diarrimide
is not recommended for use in children under 2 years of age due to variable
responses in this age group. Children under 2 years of age may be more
susceptible to the opioid effects of
Diarrimide.
- Diarrimide
should be given with caution to breast-feeding women. It is not known whether
Diarrimide
is excreted into breast milk.
Drug
interaction :
* bethanechol * cholestyramine * cisapride
* erythromycin * metoclopramide
- Cholestyramine reportedly inhibited the effect of
Diarrimide
(Loperamide) in patients, which appeared to be the result of binding in the GI
tract. A causal relationship has not been established; however,
Diarrimide
(Loperamide) should be administered at least 2 hours apart from cholestyramine
until the significance of this interaction is known.
- Pharmacodynamic interactions between
Diarrimide
(Loperamide) and drugs that enhance peristalsis are theoretically possible. It
is wise to avoid use
Diarrimide
(Loperamide) in patients who require bethanechol, cisapride, metoclopramide, and
also erythromycin.
Side effects:
- abdominal pain - constipation - dizziness
- drowsiness - fatigue - nausea/vomiting
- xerostomia
Instructions
to the patients:
* Diarrimide
(Loperamide) helps to control and relieve the symptoms of diarrhea including
traveler's diarrhea and the diarrhea associated with inflammatory bowel
diseases.
* Take
Diarrimide
tablets or capsules by mouth. Swallow the tablets or capsules with a drink of
water. Take your doses at regular intervals.
* Special precautions for use in children: This medicine is not for children
under 2 years old. Young children may have a very variable response to this
medicine and are more susceptible to the effects of dehydration.
* Elderly patients may have a more variable response to the effects of
Diarrimide,
and are more susceptible to the effects of dehydration.
What side effects may I notice from taking Diarrimide?
Serious side effects with
Diarrimide
(loperamide) are rare, they include :
* bloated, swollen feeling * blurred vision * loss of appetite
* skin rash * stomach pain
Call your doctor as soon as you can if you get any of these side effects.
Minor side effects with Diarrimide
include:
* drowsiness or dizziness * dry mouth * constipation
* nausea, vomiting * tiredness
Let your doctor know about these side effects if they do not go away or if they
annoy you.
Your mouth may get dry. Sucking hard candy or chewing sugarless gum and drinking
plenty of water can help. Drinking plenty of water can also help prevent
dehydration that can occur with diarrhea.
Pregnency
& lactation :
Generally it is not recommended in pregnancy & lactation.
