Lopera
Generic Name
Loperamide
Manufacturer
Generic Pharmaceutical Company
Country
Global (manufactured worldwide)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lopera 1 mg oral solution | ৳ 80.00 | N/A |
Description
Overview of the medicine
Loperamide is an antidiarrheal medication used to treat acute and chronic diarrhea. It works by slowing down the movement of the gut.
Uses & Indications
Dosage
Adults
Initial dose: 4 mg (20 mL) orally, followed by 2 mg (10 mL) after each loose stool. Do not exceed 16 mg (80 mL) per day for acute diarrhea. For chronic diarrhea, dosage should be individualized.
Elderly
No specific dose adjustment is required.
Renal_impairment
No dose adjustment is required. Use with caution in severe impairment due to theoretical concern of metabolite accumulation.
How to Take
Administer orally. The oral solution can be taken with or without food. Measure the dose accurately using the provided measuring device.
Mechanism of Action
Loperamide acts on the μ-opioid receptors in the intestinal wall, decreasing the activity of the myenteric plexus, thereby inhibiting peristalsis and increasing intestinal transit time. It also reduces fluid and electrolyte secretion into the intestinal lumen and enhances absorption.
Pharmacokinetics
Onset
Within 30-60 minutes.
Excretion
Primarily excreted in the feces, largely as metabolites, and a small amount of unchanged drug. Less than 1% excreted in urine.
Half life
Approximately 9-14 hours (ranging from 7 to 15 hours).
Absorption
Poorly absorbed from the gastrointestinal tract (approximately 0.3%).
Metabolism
Extensive first-pass metabolism in the liver by oxidative N-demethylation (primarily by CYP3A4 and CYP2C8) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to loperamide or any component of the formulation.
- Children less than 2 years of age.
- Patients with acute dysentery (characterized by blood in stools and high fever).
- Patients with acute ulcerative colitis, pseudomembranous colitis associated with broad-spectrum antibiotics.
- Bacterial enterocolitis caused by invasive organisms (e.g., Salmonella, Shigella, Campylobacter).
- Situations where inhibition of peristalsis should be avoided (e.g., risk of ileus, constipation, abdominal distension).
Drug Interactions
Desmopressin (oral)
Increased plasma concentrations of desmopressin when co-administered with loperamide.
Quinidine, Ritonavir
Increased plasma concentrations of loperamide (CYP3A4/2C8 inhibitors), leading to potential for increased adverse effects.
Gemfibrozil, Itraconazole
Increased plasma concentrations of loperamide.
Storage
Store below 30°C in a dry place, away from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms include central nervous system depression (e.g., stupor, miosis, somnolence, muscular hypertonia, respiratory depression) and cardiac toxicity (e.g., QT prolongation, Torsades de Pointes, other ventricular arrhythmias). Treatment involves naloxone as an antidote. Cardiac monitoring is recommended for at least 48 hours.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Small amounts are excreted in breast milk; caution is advised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to loperamide or any component of the formulation.
- Children less than 2 years of age.
- Patients with acute dysentery (characterized by blood in stools and high fever).
- Patients with acute ulcerative colitis, pseudomembranous colitis associated with broad-spectrum antibiotics.
- Bacterial enterocolitis caused by invasive organisms (e.g., Salmonella, Shigella, Campylobacter).
- Situations where inhibition of peristalsis should be avoided (e.g., risk of ileus, constipation, abdominal distension).
Drug Interactions
Desmopressin (oral)
Increased plasma concentrations of desmopressin when co-administered with loperamide.
Quinidine, Ritonavir
Increased plasma concentrations of loperamide (CYP3A4/2C8 inhibitors), leading to potential for increased adverse effects.
Gemfibrozil, Itraconazole
Increased plasma concentrations of loperamide.
Storage
Store below 30°C in a dry place, away from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms include central nervous system depression (e.g., stupor, miosis, somnolence, muscular hypertonia, respiratory depression) and cardiac toxicity (e.g., QT prolongation, Torsades de Pointes, other ventricular arrhythmias). Treatment involves naloxone as an antidote. Cardiac monitoring is recommended for at least 48 hours.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Small amounts are excreted in breast milk; caution is advised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, drugstores
Approval Status
Approved (Generic)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Loperamide has undergone numerous clinical trials establishing its efficacy and safety for various forms of diarrhea. It is a well-established and widely studied drug.
Lab Monitoring
- Routine lab monitoring is not typically required for short-term use. For prolonged use or in specific conditions, monitoring for electrolyte imbalances might be considered.
Doctor Notes
- Emphasize the importance of rehydration therapy alongside loperamide.
- Caution patients against exceeding the recommended dosage due to cardiac risks.
- Assess for underlying causes of diarrhea, especially if symptoms persist or worsen.
Patient Guidelines
- Do not exceed the recommended dose.
- If diarrhea persists for more than 48 hours, consult a doctor.
- Maintain adequate hydration by drinking plenty of fluids.
- Avoid use in children under 2 years old without medical advice.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
Loperamide may cause dizziness or drowsiness. Patients should be warned not to drive or operate machinery if they experience these effects.
Lifestyle Advice
- Drink plenty of clear fluids (e.g., water, oral rehydration solution) to prevent dehydration.
- Follow a bland diet (e.g., toast, rice, bananas) until diarrhea subsides.
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Global Brand Names
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