From the Guidelines
The recommended dose and frequency of Loperamide is 4 mg as initial dose, followed by 2 mg every 4 hours, or after each unformed stool, with a daily total dose not exceeding 16 mg.
Key Points
- The initial dose of Loperamide is 4 mg, which can be followed by 2 mg every 4 hours or after each unformed stool 1, 2, 3, 4.
- The maximum daily dose of Loperamide should not exceed 16 mg 1, 2, 3, 4.
- Loperamide can be used to treat diarrhea in various contexts, including cancer treatment-induced diarrhea 1, 2, 3, irritable bowel syndrome 5, and traveler's diarrhea 4.
- The dosage and frequency of Loperamide may vary depending on the specific condition being treated and the severity of symptoms.
Treatment Considerations
- Loperamide is often used in combination with other treatments, such as dietary modifications and fluid replacement, to manage diarrhea 1, 2, 3.
- In some cases, Loperamide may be used prophylactically to prevent diarrhea, such as before traveling to areas with high risk of diarrhea 4.
- It is essential to follow the recommended dosage and frequency of Loperamide to minimize the risk of adverse effects and ensure effective treatment of diarrhea.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Loperamide hydrochloride capsules are contraindicated in pediatric patients less than 2 years of age due to the risks of respiratory depression and serious cardiac adverse reactions (see CONTRAINDICATIONS) Avoid loperamide hydrochloride capsule dosages higher than recommended in adult or pediatric patients 2 years of age and older due to the risk of serious cardiac adverse reactions (See WARNINGS, OVERDOSAGE). (1 capsule = 2 mg) Patients should receive appropriate fluid and electrolyte replacement as needed Acute Diarrhea Adults and Pediatric Patients 13 Years and Older: The recommended initial dose is 4 mg (two capsules) followed by 2 mg (one capsule) after each unformed stool. The maximum daily dose is 16 mg (eight capsules). Pediatric Patients 2 Years to 12 Years of Age: In pediatric patients 2 years to 5 years of age (20 kg or less), the non-prescription liquid formulation (Imodium A-D 1 mg/5 mL) should be used; for ages 6 to 12, either loperamide hydrochloride capsules or Imodium A-D liquid may be used For pediatric patients 2 to 12 years of age, the following schedule for capsules or liquid will usually fulfill initial dosage requirements: Recommended First Day Dosage Schedule Two to five years (13 to 20 kg): 1 mg three times daily (3 mg total daily dosage) Six to eight years (20 to 30 kg): 2 mg twice daily (4 mg total daily dosage) Eight to twelve years (greater than 30kg): 2 mg three times daily (6 mg total daily dosage) Chronic Diarrhea Adults The recommended initial dose is 4 mg (two capsules) followed by 2 mg (one capsule) after each unformed stool until diarrhea is controlled, after which the dosage of loperamide hydrochloride capsules should be reduced to meet individual requirements When the optimal daily dosage has been established, this amount may then be administered as a single dose or in divided doses. The average daily maintenance dosage in clinical trials was 4 to 8 mg (two to four capsules per day). The maximum daily dosage is 16 mg (eight capsules per day)
The recommended dose and frequency of Loperamide are as follows:
- Acute Diarrhea:
+ Adults and Pediatric Patients 13 Years and Older: 4 mg initially, followed by 2 mg after each unformed stool. Maximum daily dose: 16 mg.
+ Pediatric Patients 2-12 Years:
- 2-5 years: 1 mg three times daily (3 mg total daily dosage)
- 6-8 years: 2 mg twice daily (4 mg total daily dosage)
- 8-12 years: 2 mg three times daily (6 mg total daily dosage)
- Chronic Diarrhea: + Adults: 4 mg initially, followed by 2 mg after each unformed stool until diarrhea is controlled. Average daily maintenance dosage: 4-8 mg. Maximum daily dosage: 16 mg. 6
From the Research
Recommended Dose and Frequency of Loperamide
The recommended dose and frequency of Loperamide vary depending on the condition being treated and the individual patient.
- For acute diarrhea, the dose is typically 4mg initially, followed by 2mg after each loose stool, up to a maximum of 16mg per day 7.
- For chronic diarrhea, a single nightly dose of Loperamide has been shown to be safe and efficient 8.
- In the treatment of acute diarrhea in adults, two tablets of 1mg or 2mg Loperamide oxide were taken initially, and then one tablet after each watery, loose, or pasty stool, to a maximum of eight tablets per day 9.
- It is essential to note that the recommended dose should not exceed 16mg per day, as taking more than this can lead to adverse effects and even death 10.
Important Considerations
- Loperamide is generally well-tolerated at recommended nonprescription doses, with the most common side effects related to the impact on bowel motility 11.
- The possibility of once-daily dosage of Loperamide in chronic diarrhea is an advantage 7.
- Loperamide has been observed to increase anal sphincter tone, which may lead to improvement of fecal continence in patients with and without diarrhea 11.