Loperamide, commonly known as Imodium®, is a popular over-the-counter medication for the treatment of acute diarrhea.A lower loperamide dose is sometimes recommended as a treatment for chronic diarrhea. Whenever taking loperamide, the lowest possible effective dose should be used. Apart from the longevity of the condition, age is the most important factor in determining the appropriate initial loperamide dose to administer.
When treating acute diarrhea, the recommended loperamide dose for the first day is 4 mg given orally with an additional 2 mg after every loose bowel movement. Improvement is generally evident within 48 hours. The total loperamide dose should not exceed 16 mg in 24 hours.
The recommended dose when treating the same condition in children between eight and 12 years of age is just 2 mg initially, with maintenance doses not exceeding 6 mg daily. For children between the ages of six and eight, the maximum daily dose should not exceed 4 mg. Children between two and five years of age should receive just 1 mg initially and no more than 3 mg daily. After a single day of treatment, the drug should only be given after a loose bowel movement, with the patient's total daily dose not exceeding 1 mg per kg of body weight.
When treating chronic diarrhea, adults should first use the standard dose for acute diarrhea to achieve a breakthrough level of treatment. Afterward, the loperamide dose should be reduced to the lowest possible level that is effective in controlling the patient's symptoms. Doses greater than 16 mg daily have not been shown to offer any increased efficacy in the treatment of chronic diarrhea, with the most common efffective maintenance doses averaging between 4 mg and 8 mg given daily. No safe and effective loperamide dose has yet been determined for the treatment of chronic diarrhea in pediatric populations.
Due to the increased risks of loperamide when taken at high doses or over a long period of time, it is important to administer as little of this medication as possible. While generally considered to be a safe medication, some side effects of loperamide may include dizziness, disorientation, drowsiness, constipation, itchy skin mild rash, or mild stomach pain. However, if these conditions become sever or are accompanied by a worsening of the condition, it is possible that they are signs of a serious allergic reaction. The use of loperamide should be discontinued immediately in patients complaining of such symptoms.