Antidiarrheal symptomatic drug
Active substance
Loperamide hydrochloride (loperamide)
Release form, composition and packaging
10 pieces. - contour cell packaging (1) - cardboard packs.
10 pieces. - contour cell packages (2) - cardboard packs.
pharmachologic effect
Dosage
Inside, without chewing, with water.
Adults for acute and chronic diarrhea, initially 2 capsules (0.004 g) are prescribed, then 1 capsule (0.002 g) after each act of defecation in case of loose stools. For acute diarrhea children over 6 years old, appoint 1 capsule (0.002 g) after each act of defecation in case of loose stools.
Maximum daily dose. For acute and chronic diarrhea, adults - 8 capsules (0.016 g); at children - 3 capsules (0.006 g).
After stool normalization or in the absence of stool for more than 12 hours, treatment with Loperamide should be discontinued.
Side effects
Allergic reactions (), drowsiness or insomnia, dizziness, hypovolemia, electrolyte disturbances; dryness of the oral mucosa, intestinal colic, gastralgia, pain or discomfort in the abdomen, nausea, vomiting, flatulence.
Rarely - urinary retention, extremely rarely - intestinal obstruction.
Overdose
Symptoms: depression of the central nervous system (stupor, impaired coordination, drowsiness, miosis, muscle hypertension, respiratory depression), intestinal obstruction.
Treatment: antidote - naloxone; given that the duration of action of loperamide is longer than that of naloxone, it is possible to re-administer the latter.
Symptomatic treatment: , gastric lavage, artificial ventilation.
Medical supervision is necessary for at least 48 hours.
special instructions
In the absence of effect after 2 days. application of Loperamide, you must consult a doctor.
If constipation or bloating develops during treatment, loperamide should be discontinued. Patients with impaired liver function require careful monitoring for signs of toxic damage to the central nervous system.
During the period of diarrhea treatment, it is necessary to replenish the loss of fluid and electrolytes.
During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.
The drug Loperamide belongs to the pharmacological group of drugs for diarrhea. It comes in oral dosage forms and is used for the symptomatic treatment of diarrhea. Contraindications to the use of the drug are individual intolerance, children under 6 years of age, early pregnancy, as well as certain pathological conditions affecting the organs of the digestive system.
Dosage form
Loperamide is available in tablet and capsule dosage form for oral administration. The tablets are round, flat and white. The capsules have an oblong shape and a blue smooth cap. They are packaged in blisters of 10 (tablets) or 12 (capsules) pieces. The cardboard box contains 2 blisters.
Description and composition
The main active ingredient of the drug is loperamide, its content in 1 tablet or capsule is 2 mg. The tablet also contains the following auxiliary compounds:
- Potato starch.
- Calcium stearate.
- Granulac 70.
The capsules contain the following auxiliary components:
- Milk sugar.
- Magnesium stearate.
- Talc.
- Corn starch.
- Aerosil.
Pharmacological group
The mechanism of action of loperamide, which is the main active ingredient of the drug, is to suppress peristalsis (wave-like movements aimed at pushing the contents) of the intestine and increase the tone of the anal sphincter muscles. The implementation of the therapeutic effect is carried out by acting on the opiate receptors of the walls of the hollow organs of the gastrointestinal tract, as well as suppressing the release of acetylcholine, prostaglandin and other biologically active compounds. After taking a pill or capsule inside, the therapeutic effect develops quite quickly and lasts for 4-6 hours.
Indications for use
The main medical indication for the use of Loperamide is diarrhea of \u200b\u200bvarious origins.
for adults
Taking capsules or tablets of Loperamide for adults is indicated for symptomatic relief of the severity of diarrhea, which is of allergic, psychoemotional, medicinal, radiation origin. The drug is used for loosening of the stool associated with a change in the nature of nutrition, exchange or absorption of certain compounds in the intestine. As an adjuvant, the drug can be used for diarrhea of \u200b\u200ban infectious origin.
for kids
Loperamide tablets or capsules can be used in children from 6 years of age for the same medical indications as for adults.
The medicine is not used during pregnancy (especially in the early stages of the first trimester), as well as during lactation.
Contraindications
Taking capsules or tablets Loperamide is contraindicated in certain pathological and physiological conditions:
- Individual intolerance to any of the components of the medication.
- Colon pathology, which includes ulcerative colitis.
- Bowel obstruction of various origins.
- Diverticulosis.
- Diarrhea of \u200b\u200binfectious origin, if the drug is planned to be used as a monotherapy.
- Diarrhea in acute pseudomembranous colitis.
- Children under 6 years of age (for the dosage form in capsules).
The drug is used with caution in case of concomitant liver failure.
Applications and doses
Loperamide capsules are taken orally, they are not chewed and washed down with water. The tablets can be placed on the tongue, then swallowed with saliva after dissolving.
for adults
For acute diarrhea for adults, the starting dosage is 2 mg (1 capsule or tablet). Then, after each act of defecation, provided that loose stools are preserved, it increases by another 2 mg. The maximum dosage should not exceed 16 mg.
For chronic diarrhea in adults, the drug is prescribed at a dose of 4 mg per day. If necessary, it can be increased, but not more than 16 mg per day.
for kids
For children under the age of 6, Loperamide tablets are prescribed. For acute diarrhea, the starting dosage is 2 mg. With each act of defecation, the dose may be increased, while it should not exceed 8 mg. For chronic diarrhea, the average dosage is 2 mg once a day.
for pregnant women and during lactation
Taking Loperamide tablets or capsules for pregnant and breastfeeding women is contraindicated.
Side effects
Against the background of the use of the drug, the following negative reactions may develop:
- Allergic reactions in the form of a skin rash, itching.
- Sleep disturbances such as insomnia or drowsiness.
- Dizziness.
- Electrolyte disturbances, as well as hypovolemia (a decrease in the volume of fluid in the body).
- Intestinal colic, which is more pronounced in childhood.
- Pain, discomfort in the abdomen, including the stomach area.
- Nausea with recurrent.
- Bloating (flatulence).
- Intestinal obstruction, which rarely develops.
An extremely rare side effect is the development of acute urinary retention.
Interaction with other medicinal products
The therapeutic effect of the active ingredient of tablets or capsules of Loperamide is greatly enhanced when used together with opiate pain relievers. This increases the risk of developing severe illness.
special instructions
Before using the drug, be sure to pay attention to the following several special instructions:
- If there is no therapeutic effect within 2 days after the start of taking pills or capsules against the background of an increase in the dosage of the drug, then you should consult a doctor.
- In patients with concomitant impairment of the functional state of the liver while using the drug, it is important to monitor the state of the structures of the central nervous system, since toxic effects cannot be excluded.
- With significant diarrhea, a significant volume of fluid and mineral salts are lost, therefore, in addition to the drug Loperamide, diarrhea therapy should include rehydration.
- Dehydration of the body, which develops against a background of severe diarrhea, enhances the therapeutic effects of the drug and increases the risk of overdose.
- The use of the drug in children over 6 years old requires special care, since the child's body remains very sensitive to the opiate-like effects of the drug.
- Suppression of diarrhea in infectious pathology provokes the retention of toxins in the intestine and their absorption into the systemic circulation with the development of severe intoxication.
- While taking the drug, special care should be taken when performing work associated with the need for increased concentration of attention, as well as the speed of psychomotor reactions.
Overdose
A significant excess of the recommended therapeutic dosage for the drug Loperamide leads to inhibition of the functional activity of the central nervous system and intestines. This is accompanied by depression of consciousness, drowsiness, constriction of the pupils (miosis), increased muscle tone, impaired coordination of movements, respiratory depression, intestinal obstruction.
Overdose treatment consists in washing the stomach, intestines, prescribing intestinal sorbents. In case of severe impairment of the functional state of the structures of the central nervous system, treatment is carried out only in a medical hospital. Naloxone is used as an antidote. Since after the initial administration it is often not possible to achieve the desired therapeutic effect, it may be necessary to reuse the antidote.
Storage conditions
Storage of tablets and capsules should be carried out in a dark, dry place, out of reach of children, at an air temperature not higher than + 25 ° C. Shelf life is 2 years.
Analogs
Structural analogs for Loperamide are the following drugs:
- - medicine in the form of tablets, which contain 2 mg of loperamide. They are used for adults and children over 6 years of age for the symptomatic treatment of diarrhea. The drug is contraindicated for children, pregnant and breastfeeding women, as well as for certain intestinal pathologies.
- Superilop - capsules containing 2 mg of loperamide. They are used for the symptomatic treatment of diarrhea in adults and children over 6 years of age. Pregnant women cannot use the drug during lactation.
Price
The cost of Loperamide is on average 23 rubles. Prices range from 6 to 55 rubles.
1 capsule or tablet contains 2 mg loperamide hydrochloride - active ingredient.
Depending on the manufacturer, the composition of the additional ingredients indicated in the annotation to the medicine may differ, but most often they are: aerosil, lactose, corn starch, magnesium stearate and talc.
Release form
The release forms of the drug are Loperamide tablets or capsules with a different number of pieces in a package (usually 10-20 units).
pharmachologic effect
Antidiarrheal .
Pharmacodynamics and pharmacokinetics
The antidiarrheal efficacy of the drug Loperamide is manifested due to the ability of its active ingredient to bind to opioid (opiate) receptor complexes located in the intestinal walls, as a result of which, under the influence of guanine nucleotides, stimulation occurs adrenergic and cholinergic neurons ... The result of suppression of the release and acetylcholine is an decreased motility and tone smooth intestinal muscles. Capsules or tablets from inhibit intestinal peristalsis and increase the time period during which its contents completely pass through it. Also, the drug enhances anus sphincter tone , reduces the number of urges to have bowel movements ( bowel movements ) and helps to contain feces in it. Capsules and pills for diarrhea begin to act quickly enough and remain effective for 4-6 hours.
Absorption of the drug when taken orally is at the level of 40%. Plasma Cmax is detected after about 150 minutes. Binding to plasma proteins (mostly with) occurs by 97%. The main part of the active ingredient of the drug lends itself to metabolic transformations in the liver by conjugation , does not pass through BBB ... T1 / 2, depending on the individual characteristics of the organism, ranges from 9-14 hours. The primary route of excretion is in the bile, the secondary (in small amounts in the form of conjugated metabolites) is in the urine.
Indications for use of Loperamide
Indications for use Loperamide-Stada and Loperamide-Acri, as well as all other drugs with a similar active ingredient, are:
- fortunes chronic and acute developed for various reasons, including its allergic , medicinal , emotional and beam origin (for symptomatic therapy);
- development situations diarrhea due to the sharp changes food composition and diet in case of malabsorption and metabolism ( traveler's diarrhea );
- infectious diarrhea (as an auxiliary therapeutic agent);
- the need to regulate stool consistency in patients with ileostomy .
Contraindications
In the clinical practice of using the drug, painful and other conditions of the human body have been identified, which are significantly negatively affected by Loperamide capsules and tablets, from which they are prohibited for use when they are detected. Before taking medicines containing this active ingredient, you should make sure that the following conditions are absent, for which the appropriate tests and / or tests are indicated.
Contraindications to the use of the drug include:
- intestinal obstruction ;
- personal hypersensitivity to the active and / or additional ingredients;
- in the acute phase;
- (in the first trimester);
- sharp;
- subileus;
- pseudomembranous enterocolitis ;
- age up to 4 years (for some manufacturers of capsules up to 6 years).
Side effects
- flatulence ;
- (including and / rash skin);
- nausea, vomiting;
- gastralgia ;
- feeling of dryness in the mouth;
- hypovolemia ;
- discomfort / pain in the abdomen;
- electrolyte disturbances;
- intestinal colic ;
- (seldom);
- intestinal obstruction (rarely).
Instructions for use of Loperamide (Way and dosage)
Loperamide tablets, instructions for use
Tablet preparation, for example Vero-Loperamide, is prescribed to adult patients in case diarrhea acute character at an initial dose of 4 mg. Subsequently, after each liquid defecation , 2 mg each, until normal stool consistency is restored.
When chronic diarrhea initially 2 mg of the drug is prescribed, with further individual selection of dosages leading to the frequency of acts hard defecation twice a day. The dose range in this case can vary from 2 to 12 mg.
For a maximum of 24 hours, you can take up to 16 mg of drugs.
Loperamide capsules, instructions for use
Instructions for use Loperamide-Acry, Stada, Grindeksand other companies that produce the drug in capsules, recommends adults with acute diarrhea initial intake of 4 mg and subsequent 2 mg (after each act liquid defecation ).
When chronic diarrhea the reception of Loperamide is shown in a daily dosage of 4 mg.
In both cases, the maximum permissible use is 16 mg of the drug in 24 hours.
Instructions for use for children
The drug in tablets is indicated for children 4-8 years old in a daily dosage of 3-4 mg, divided into 3-4 doses (1 mg at a time), for 3 days; children 9-12 years old - at a dose of 2 mg four times in 24 hours, for 5 days.
Given the contraindications for taking capsules, they begin to be prescribed to children from the age of 6. When acute diarrhea shows taking 2 mg of drugs after each liquid defecation , with a maximum daily dose of 8 mg.
When chronic diarrhea is usually prescribed at 2 mg every 24 hours, with a maximum daily dose of 6 mg per 20 kg of body weight.
Overdose
In the case of an overdose of any of the forms of drugs, the following signs of CNS suppression were noted: lack of coordination , stupor, respiratory depression , miosis , an increase in skeletal muscle tone, and intestinal obstruction .
Careful use and constant monitoring of possible toxic damage to the central nervous system patients with disabilities need .
During treatment diarrhea often seen decreased electrolyte volumes and liquids that require constant replenishment.
Due to the potential for suppressing the central nervous system function by the drug, care should be taken when performing hazardous work, as well as driving vehicles.
Analogs
Matching ATX level 4:Analogues of the drug are represented by combined drugs , Uzara , Loflatil and Diaremix .
Synonyms
The synonyms for drugs are Loperamide-Acri , Diara , Loperamide-Stada , Vero-Loperamide , Loperamide-Lekhim , Superilop etc.
Loperamide or Imodium - which is better?
Give an unambiguous answer which of these two drugs is more effective and safer in symptomatic treatment of diarrhea, very difficult, and this is because both of these agents include the same active ingredient with an identical weight content. It is possible that , produced in Belgium, has a better purification of its active ingredient compared to domestic counterparts, and therefore its effect will be more productive and less toxic.
Loperamide for children
An unambiguous medical opinion whether it is possible to give drugs with this active ingredient to children, for example Loperamide-Stada, from what this drug helps and what risks to the child's body it can lead to, still does not exist. Different manufacturing companies indicate different age restrictions for taking Loperamide, which range from 2-12 years.
Following the recommendations of domestic manufacturers (described above), the appointment of any of the dosage forms of Loperamide for children under 4 years of age is prohibited. It is also contraindicated to use the drug in the form of capsules for the treatment of children under 6 years old, from which Loperamide-Acri, Stada, Grindeks and some other manufacturers, as a rule, producing the drug in capsules, are not prescribed until this age.
With alcohol
Although the official instructions do not contain instructions for the joint administration of Loperamide and alcohol , this combination will definitely negatively affect liver and CNS , due to the complementary suppressive effect on their function. In this regard, during the antidiarrheal therapy alcohol is not recommended.
Loperamide during pregnancy and lactation
The use of Loperamide is absolutely prohibited during (in the first trimester) and ... A relative contraindication, taking into account all possible risks to the fetus in comparison with the positive effect on the body of the expectant mother, is the entire subsequent period pregnancy .
Reviews of Loperamide
In the case of using the drug according to the indications, reviews of Loperamide are positive in 95% of cases and speak of a rather quick and effective action of the drug. Only a few patients in the remaining 5% experience serious negative effects of therapy related to personal hypersensitivity or moderate side effects. Naturally, the treatment carried out can be successful only if the drug is used for its intended purpose and will not be effective, and sometimes even dangerous, if bacterial diarrhea , secretory , viral and other etiology. In this regard, before the start antidiarrheal therapy it is best to accurately determine the cause of the pathological process, and already based on these data, prescribe the appropriate treatment.
Loperamide price where to buy
The price of Loperamide in Russian pharmacies is available to any category of patients and, depending on the manufacturer of the drug and the number of tablets, varies between 15-60 rubles. For example, the price Loperamide-Acry No. 20 on average is 50 rubles, buy 20 capsules of the drug produced by OAO Nizhpharm ( Loperamide-Stada), you can for 35 rubles, and the cost of 20 tablets for diarrhea from Veropharm ( Vero-Loperamide) fluctuates around 15-20 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies of UkraineUkraine
- Internet pharmacies in KazakhstanKazakhstan
ZdravCity
Diara (loperamide) tab. chewing 2mg n12JSC Obolenskoe Pharm. company
Loperamide tab. 2mg n20Ozone OOO
Loperamide-acriquine caps. 2mg n10Akrikhin JSC
Loperamide-acriquine caps. 2mg n20Akrikhin JSC
Content
Cases of sudden onset of diarrhea are not uncommon. A person cannot do business, leave the house. When this situation occurs often, people know that the drug Loperamide will help. It is important to carefully study the instructions so that the use does not cause complications.
Indications for use of Loperamide
This antidiarrheal drug does not treat the cause of the disease, but only relieves the main symptom - diarrhea. The instructions describe that the main active ingredient in the drug - loperamide hydrochloride - does not affect the reproduction of E. coli. When ingested, this remedy:
- slows down intestinal peristalsis;
- reduces the tone of muscle fibers;
- reduces motor skills;
- slows down the time of movement of feces;
- increases the tone of the sphincter;
- reduces the number of urges;
- promotes the retention of feces;
- gives density to feces.
The use of Loperamide hydrochloride helps in the treatment of chronic and acute forms of non-infectious diarrhea. Indications for use according to the instructions are considered diarrhea, which manifests itself as a result of:
- food allergies;
- emotional stress;
- radiation therapy treatment;
- actions of medicines;
- changes in the composition of food, water;
- eating disorders.
Loperamide - what helps
According to the instructions, Loperamide is prescribed for severe diarrhea that lasts a long time. The indication becomes the regulation of stool after surgery in patients with ileostomy. Why does Loperamide help most effectively? The medicine has indications for use in cases:
- malabsorption;
- inflammatory processes;
- irritable bowel syndrome;
- metabolic disorders.
Loperamide composition
The list of substances that are included in the structure of the drug is headed by the active ingredient - loperamide hydrochloride. The rest of the ingredients pharmaceutical companies can enter in different combinations depending on the form of release - tablets or capsules. The composition of the drug Loperamide includes:
- lactose;
- corn (potato) starch;
- aerosil;
- magnesium (calcium) stearate;
- silicon dioxide.
Instructions for the use of Loperamide
The medicine is produced in the form of drops, tablets and capsules, but the liquid solution has not become widespread in Russia. The instruction for Loperamide prescribes its use for non-infectious diarrhea, or as a concomitant treatment for infections. Recommended during use:
- observe the dosage for an adult, a child;
- take into account contraindications and side effects;
- exclude the simultaneous use with alcohol.
According to the instructions, during the use of Loperamide, it is necessary to consider:
- the medicine begins to take effect after an hour;
- it is required to replenish the loss of fluid and trace elements;
- use with caution in old age;
- in the chronic form of the disease, the dosage and treatment regimen is prescribed by the doctor;
- there is no compatibility with opioid analgesics - constipation is possible;
- the action of the agent lasts up to 5 hours.
When using Loperamide, the instruction prescribes to carefully consider the following points:
- stop using, consult a doctor to clarify the diagnosis, if diarrhea does not stop for two days;
- the medicine slows down the reaction - you should be careful when working with equipment, when using transport;
- take with caution in case of liver failure - possible disruption of the central nervous system;
- stop using the medicine if you experience constipation, bloating, signs of intestinal obstruction.
Loperamide - instructions for use for children
Pediatric diarrhea should only be managed by a pediatrician. This is due to the fact that in babies, a common cause of diarrhea is infections that require antibiotic treatment. Loperamide for children is not allowed to be used before 4 years of age - there are cases of intestinal paralysis, possibly affecting the central nervous system. There are contraindications for the use of Loperamide:
- age up to 2 years;
- bloating;
- constipation;
- inflammatory diseases of the gastrointestinal tract;
- colitis after taking antibiotics;
- intolerance to the components;
- dysentery with high blood temperature in the stool.
The instruction recommends the use of Loperamide, starting from 6 years old, in capsule form. It is necessary to correlate the dosage with the age of the child. For the maximum per day, it should not exceed 8 mg. At the age of 6 to 8 years, with an acute form of diarrhea, 1 capsule is prescribed at the first intake, then, after each case of diarrhea, one more. If after two days of treatment it does not get better - diarrhea does not stop - an increase in dosage is permissible, but only as directed by a doctor. Children over 8 years of age are prescribed three times a day, one capsule.
Is it possible to give children Loperamide for diarrhea
Although the annotation of Loperamide allows the use of the drug in children from 4 years of age, pediatricians insist on its prohibition. Especially if parents do it on their own, without a doctor's prescription. Often, diarrhea is caused by infectious processes, in which diarrhea is a blessing, because it removes toxins. Otherwise, poisoning of the body is possible. In addition, parents often forget to give their child water to compensate for water loss, which causes dehydration.
Loperamide is allowed to be given to children only after 6 years under the strict supervision of a physician. This is due to the fact that during the use of the medication it is possible:
- stopping peristalsis;
- delay of the food lump in the intestine;
- absorption of fluid with toxins into the blood;
- bloating of the large intestine;
- tissue necrosis;
- circulatory disorders;
- intestinal paralysis;
- life threat.
Loperamide during pregnancy
Although the drug is inexpensive and available, it can be dangerous for women who are expecting a baby. Can pregnant women use Loperamide? In the first three months it is strictly prohibited. This is due to the formation of basic systems and organs in the unborn child during this period, which can be disrupted. At a later date, the decision to take the medicine should be made by the doctor, taking into account the threat to the life of the expectant mother and the fetus. The effect of Loperamide on the intrauterine development of a child is not fully understood.
How to take Loperamide
The fact that the drug has good reviews and is freely sold at an affordable price does not mean its thoughtless use. It is advisable to discuss this issue with a doctor. How to drink Loperamide? It depends on the nature of the course of the disease. In the chronic form in adults, 4 mg is prescribed per day. Acute diarrhea is treated with a maximum daily dose of 16 milligrams. Treatment regimen:
- first dose - 2 tablets or capsules;
- after each diarrhea - one at a time.
Loperamide tablets
The drug produced in the form of tablets received positive reviews, the price of which is an order of magnitude lower than that of the analogue - Imodium. They are covered with a special shell and are white or pale yellow. Conveniently, Loperamide does not need to be washed down with water - they are put on the tongue and dissolve. During the reception, a tingling sensation, burning sensation in the mouth is possible. The drug begins to act in an hour. The dosage is 2 mg.
Loperamide capsules
The affordable price of the drug makes it possible to have it on hand when a person needs to quickly cope with non-infectious diarrhea. According to the instructions, taking the drug in the form of a capsule for diarrhea requires drinking water. Inside the gelatinous shell there is a powdery substance of white or yellowish color. The capsules are swallowed without chewing, the dosage is similar to the tablets.
Loperamide - contraindications
Loperamide's instruction does not recommend the use of the medication during infectious diarrhea. In such a situation, harmful bacteria, viruses, must be removed from the body, and diarrhea contributes to this. If it is stopped, the absorption of toxins into the blood will begin, which will worsen the patient's condition. For the same reason, the use of this antidiarrheal medicine is prohibited in case of poisoning.
There are contraindications for Loperamide during the acute form of dysentery with blood in the discharge and fever. According to the instructions, the use of the drug is prohibited in case of:
- intestinal obstruction;
- acute ulcerative colitis;
- lactose intolerance;
- constipation;
- sensitivity to components;
- 1 trimester of pregnancy;
- breastfeeding;
- diverticulosis;
- monotherapy for dysentery.
Loperamide - side effects
Due to its affordable price, the drug can be found in home medicine kits. The medicine is used without the consent of the doctor, without thinking about the possible side effects of Loperamide. If the agent is used in large quantities, it is recommended to take the antidote drug - Naloxone. According to the instructions, in case of an overdose, the following are observed:
- respiratory depression;
- drowsiness;
- lack of coordination;
- stupor;
- intestinal obstruction.
Due to the active effect of the antidiarrheal drug on the body, its long and uncontrolled intake, side effects may appear. This situation is aggravated by alcohol consumption. Loperamide's instruction notes that they observe:
- allergies;
- lethargy;
- rashes on the skin;
- dizziness;
- insomnia;
- intestinal colic;
- bloating;
- nausea;
- stomach pain;
- dry mouth;
- vomiting;
- abdominal discomfort;
- flatulence;
- dehydration;
- electrolyte disturbances;
- delay in urine flow.
Loperamide price
This drug is sold without a prescription in pharmacies, unlike analogues - it has an affordable price. It is possible to order it on special sites, to buy it from an online pharmacy. How much does Loperamide cost? The price depends on the number of tablets, capsules in the package, the form of release and the manufacturer. The cost of Loperamide and its analogues in rubles is for 20 pieces:
- tablets - 15-100;
- capsules - 25-95;
- Loperamide-acry - 50-70;
- Diara - 250-280;
- Imodium - 510-640.
Composition of the medicinal product
active substance: loperamide;
1 capsule contains loperamide hydrochloride 2 mg
Excipients: sucrose, corn starch, magnesium stearate.
Dosage form
Hard gelatin capsules with a light blue opaque body and an opaque blue lid or an opaque yellow lid and an opaque yellow body. The contents of the capsules are white, odorless powder.
Manufacturer's name and location
Stirolbiopharm LLC.
Ukraine, 84610, Donetsk region., Gorlovka, st. Horlivka division, 97.
Pharmacological group
Drugs that suppress peristalsis. Loperamide.
ATC code A07D A03.
Loperamide has an antidiarrheal effect. Loperamide hydrochloride binds to opiate receptors in the intestinal wall. As a result, the release of acetylcholine and prostaglandins is suppressed, which leads to a decrease in peristalsis. Loperamide hydrochloride increases the tone of the anal sphincter, thereby reducing fecal incontinence and the urge to defecate. Unlike other opioid agonists, loperamide binds calmodulin, a protein that regulates intestinal ion transport. Loperamide does not have a morphine-like effect on the central nervous system, inherent in other opiate-like agonists, does not have a central action, since the blood-brain barrier practically does not penetrate everywhere; does not cause passion and addiction, is more selective in action, therefore it causes fewer side effects. The action develops quickly and lasts 4-6 hours.
Due to its significant relationship with the intestinal wall and a high degree of metabolism during the first passage, the drug practically does not enter the systemic circulation.
When administered orally, Loperamide is readily and almost completely absorbed in the intestine. 1:00 after ingestion, 85% of loperamide is found in the gastrointestinal tract, 5% in the liver, 0.04% in the brain (in therapeutic doses, it practically does not affect the central nervous system). The maximum concentration of Loperamide in blood plasma is determined after 4:00; the half-life (T ½) is 9-14 hours (average 10.8 hours). In a volume of 5%, loperamide is excreted in the urine as metabolites, 25% in the feces, 70% of the drug is reabsorbed in the intestine. After absorption in a volume of 30%, Loperamide is again excreted into the intestine, in a volume of 40% it is metabolized in the liver and in the form of conjugates is excreted in the bile. With normal liver function, the level of Loperamide in the blood plasma and in the urine is low, with impaired liver function, an increase in doses of the drug is possible.
Elimination occurs by oxidative N-demethylation, which is the main metabolic pathway of loperamide.
Indications
Symptomatic treatment of acute and chronic diarrhea.
In patients with an ileostomy, to reduce stool frequency and volume, and to produce a hard stool.
Contraindications
The drug is contraindicated in patients with hypersensitivity to loperamide hydrochloride or to any of the components of the drug. Loperamide is not used for primary therapy in patients with:
- acute dysentery, characterized by blood in the stool and fever;
- ulcerative colitis in case of exacerbation
- bacterial enterocolitis caused by microorganisms of the genus Salmonella, Shigella, Campylobacter and the like;
- pseudomembranous colitis associated with the use of broad-spectrum antibiotics;
- constipation, diseases with impaired peristalsis (paralytic ileus).
Loperamide should not be used at all if it is necessary to avoid oppression of peristalsis, and it is necessary to stop taking it immediately if constipation, bloating or partial intestinal obstruction develops.
The drug is contraindicated in pregnancy, during lactation, in children under 6 years of age.
Appropriate safety precautions for use
If during treatment with the drug constipation, bloating, partial intestinal obstruction develops, it is necessary to cancel the drug.
In case of acute diarrhea, if there is no clinical effect within 48 hours, it is necessary to stop taking the drug and consult a doctor.
You should not prescribe the drug for a period of more than 4 weeks without the possibility of a second medical examination.
In patients with hyperthermia and in the presence of blood in the stool, the cause of the diarrhea must be determined before prescribing the drug.
The drug contains sucrose, which should be taken into account in patients with diabetes mellitus.
People with diarrhea, especially children, may experience dehydration and electrolyte imbalances. In such cases, the most important measure is the use of replacement therapy for fluid and electrolyte replenishment.
If there is no effect after 2 days of using the drug, it is necessary to clarify the diagnosis.
Loperamide should be used with caution in patients with liver dysfunction. Such patients should be closely monitored for signs of toxic damage to the central nervous system due to the high degree of metabolism of the drug during the first passage.
Application during pregnancy or lactation
The use of the drug during pregnancy is contraindicated.
If it is necessary to use the drug during the treatment period, it is necessary to stop breastfeeding.
The ability to influence the reaction rate when driving vehicles or other mechanisms
Loperamide does not alter the rate of reaction. However, in the event of fatigue, drowsiness or dizziness, it is not recommended to drive a car or work with complex equipment.
Children
The drug is used in children under 6 years of age.
Method of administration and dosage
Capsules are swallowed without chewing, drinking plenty of liquid.
Applied to adults and children over 6 years old.
Acute diarrhea:
initial dose - 2 capsules (4 mg) for adults and 1 capsule (2 mg) for children; further - 1 capsule (2 mg) after each subsequent loose stool.
The duration of treatment for acute diarrhea is up to 5 days.
In acute diarrhea, if no clinical improvement is observed within 48 hours, the drug should be discontinued.
Chronic diarrhea:
the initial dose is 2 capsules (4 mg) daily, for children - 1 capsule (2 mg) daily, this dose is adjusted further so that the frequency of solid stool is 1-2 times a day, usually achieved with a maintenance dose of 1-6 capsules (2 mg - 12 mg) daily.
The maximum daily dose for chronic diarrhea for adults is 8 capsules (16 mg) for children, it should be calculated based on the child's body weight (3 capsules per 20 kg body weight).
Overdose
Symptoms (including relative overdose due to liver dysfunction): depression of the central nervous system (stupor, impaired coordination of movements, drowsiness, miosis, muscle hypertonia, respiratory depression), constipation and intestinal obstruction. Children are more sensitive to the effects on the central nervous system than adults. Treatment: drug withdrawal, gastric lavage. Naloxone can be used as an antidote. Since the duration of action of loperamide is longer than that of naloxone (1-3 hours), repeated administration of naloxone (intravenously at a dose of 0.4 mg / ml at 2-3-minute intervals, repeatedly) may be required. Immediately after an overdose, activated charcoal is administered and the stomach is washed; if necessary, support the respiratory function. To identify possible depression of the central nervous system, the patient must be under close supervision for at least 48 hours.
Side effects
Side effects are observed, as a rule, only with prolonged use of the drug. possible
from the gastrointestinal tract: a feeling of discomfort and pain in the lower abdomen, dyspepsia, nausea and vomiting, ileus, flatulence, constipation, impaired defecation, megacolon and toxic megacolon, extremely rarely - intestinal obstruction;
