Loperamide

How does Loperamide work?
Loperamide reduces the spasm in the bowel and reduces the frequency of diarrhoea. It works best if it is started early in the diarrhoea. During diarrhoea, fluid is lost from the body. Fluids should be replaced by drinking 3-4 litres or 6 pints of fluid a day.

The antibiotic azithromycin also speeds recovery in travellers’ diarrhoea.

Avomine, which is prescribed for travel sickness, could also be taken to reduce any associated vomiting which will help reduce fluid loss. This cannot be used if also taking azithromycin.

Cautions
Loperamide should not be taken:

• When diarrhoea starts after a course of antibiotics.
• If diarrhoea is related to an inflammatory bowel condition(e.g. Crohn’s disease, ulcerative colitis).
• Where there has been prolonged constipation before diarrhoea starts.
• Where the diarrhoea contains blood and there is a high fever.
• If you have liver disease.
• Not suitable for children.
• Should not be taken in pregnancy and breastfeeding women.
• Loperamide contains lactose.

Other medications
Some other medications may slightly increase the dose of loperamide in your system:

• Ritonavir (for HIV).
• Quinidine (for abnormal heart rhythms or malaria).
• Itraconazole or ketoconazole (for fungal infections).
• Gemfibrozil (for high cholesterol).

Side effects
There may be no side effects. Possible side effects include:

• Feeling sick(nausea), constipation, headache.
• Loperamide occasionally causes drowsiness or dizziness. If affected you should not drive, cycle, or operate machinery.

Dosage
Take two capsules straight away. Then take one capsule after each episode of diarrhoea for up to 48 hours. The maximum number of capsules in a day is 6 (12mg). The usual amount is 3-4 capsules (6-8mg) daily. It should be stopped and a doctor consulted if there is no improvement after 48 hours.