What medication helps with diarrhea?

From the Guidelines

Loperamide is the most effective medication for diarrhea relief in adults, as it slows intestinal movement and reduces water loss, and can be taken as 2mg after each loose stool, not exceeding 8mg per day for adults 1.

Key Points to Consider

• Loperamide is a locally acting opioid receptor agonist that decreases the muscular tone and motility of the intestinal wall, making it an effective treatment for diarrhea 1.
• The recommended dose of loperamide is 2mg after each loose stool, not exceeding 8mg per day for adults, with a maximum daily dose of 16mg in some cases 1.
• It is essential to stay hydrated during diarrhea episodes by drinking plenty of clear fluids and considering oral rehydration solutions like Pedialyte to replace lost electrolytes.
• If diarrhea is severe, persists beyond 2 days, contains blood, or is accompanied by fever over 102°F, seek medical attention as these could indicate a more serious condition requiring different treatment.

Important Considerations

• Loperamide should not be given to children <18 years of age with acute diarrhea, and its use is not recommended in suspected or proven cases where toxic megacolon may result in inflammatory diarrhea or diarrhea with fever 1.
• Other medications, such as bismuth subsalicylate, may also be effective in treating diarrhea, but loperamide is generally considered the most effective option 1.
• It is crucial to monitor patients taking high-dose loperamide for the risk of causing paralytic ileus, although this is rare 1.

From the FDA Drug Label

Treatment of diarrhea with loperamide hydrochloride is only symptomatic. Dehydration, particularly in pediatric patients less than 6 years of age, may further influence the variability of response to loperamide hydrochloride. The medication that helps with diarrhea is loperamide.

• It is used to treat diarrhea, but it does not address the underlying cause.
• Loperamide should be used with caution, especially in pediatric patients, due to the risk of serious cardiac adverse reactions and respiratory depression 2.
• It is also important to administer appropriate fluid and electrolyte therapy to patients with diarrhea, as dehydration and electrolyte depletion can occur 2.

From the Research

Medications for Diarrhea

• Loperamide is an effective therapy for various diarrheal syndromes, including acute, nonspecific diarrhea, traveler's diarrhea, and chemotherapy-related diarrhea 3, 4, 5, 6.
• It is also effective in treating diarrhea-predominant irritable bowel syndrome and inflammatory bowel disease 3, 4.
• Loperamide works by decreasing peristalsis and fluid secretion, resulting in longer gastrointestinal transit time and increased absorption of fluids and electrolytes from the gastrointestinal tract 6.
• It has a longer duration of action than diphenoxylate and is generally well tolerated at recommended nonprescription doses 3, 4, 5, 6.

Comparison with Other Medications

• Loperamide has been compared to bismuth subsalicylate in the management of acute diarrhea, and it was found to be more effective in reducing the average number of unformed bowel movements and providing faster relief 5.
• Loperamide oxide, a derivative of loperamide, has also been shown to be effective in treating acute diarrhea in adults, with a lower dose of 1 mg being preferred due to equal efficacy with the 2 mg dose 7.

Side Effects and Safety

• Common side effects of loperamide include abdominal pain, distention, bloating, nausea, vomiting, and constipation 3, 6.
• Loperamide is considered to be free of abuse potential and has minimal central nervous system effects due to its low oral absorption and inability to cross the blood-brain barrier 6.