Loperin

Introduction
Loperin is used in the treatment of diarrhea. It should not be used in patients with dysentery (diarrhea with blood). Loperin is taken with or without food in a dose and duration as advised by the doctor. You should keep taking this medicine for as long as your doctor recommends. If you stop treatment too early your symptoms may come back and your condition may worsen. Let your doctor know about all other medications you are taking as some may affect, or be affected by this medicine. The most common side effects are headache, nausea, and constipation. Most of these are temporary and usually resolve with time. Contact your doctor straight away if you are at all concerned about any of these side effects. It may also cause dizziness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. Avoid drinking alcohol while taking this medicine as it can worsen your sleepiness. Diarrhea can cause water loss and electrolyte imbalance, so drink plenty of fluids to help keep yourself hydrated. It is important to avoid this medicine if you have blood in your stool or if you are severely constipated.

_
Uses of Loperin
Diarrhea
Side effects of Loperin
Common
Constipation
Nausea
Headache
Stomach pain
How to use Loperin
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Loperin may be taken with or without food, but it is better to take it at a fixed time.
How Loperin works
Loperin is an anti-diarrhoeal medication. It works by slowing down the contraction of the intestines thereby decreasing the speed at which the contents pass through it. This allows more time for reabsorption of fluids and nutrients, making the stools more solid and less frequent.
Quick Tips
You have been prescribed Loperin for the treatment of diarrhea.
Diarrhea can cause water loss and electrolyte imbalance. Drink plenty of fluids to help keep you hydrated.
Consult your doctor if your diarrhea lasts for more than 48 hours.
Do not use Loperin if you have blood in your stool or if you are severely constipated.
Use caution while driving or doing anything that requires concentration as Loperin can cause dizziness and sleepiness.
Stop taking the medication as soon as your symptoms are relieved.
Brief Description
Indication
Diarrhea
Administration
May be taken with or without food.
Adult Dose
Acute Diarrhea 4 mg initially, then 2 mg after each loose stool; not to exceed 16 mg/day (8 mg/day for self-medication); discontinue if no improvement seen within 48 hours Chronic Diarrhea 4 mg initially, then 2 mg after each loose stool until controlled, and then 4-8 mg/day in divided doses Traveler’s Diarrhea 4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day

_
Child Dose
Acute Diarrhea First Day of Treatment 2-6 years (13-20 kg): 1 mg q8hr PO 6-8 years: (20-30 kg): 2 mg q12hr PO 8-12 years (>30 kg): 2 mg q8hr PO Second & Subsequent Doses 0.1 mg/kg PO after each loose stool; not to exceed dose recommended for first 24 hours Chronic Diarrhea 0.08-0.24 mg/kg/day PO divided q12hr Traveler’s Diarrhea <6 years: Safety and efficacy not established 6-8 years: 2 mg after first loose stool, then 1 mg after each subsequent stool; not to exceed 4 mg/day 8-12 years: 2 mg after first loose stool, then 1 mg after each subsequent stool; not to exceed 6 mg/day >12 years: 4 mg after first loose stool, then 2 mg after each subsequent stool; not to exceed 8 mg/day

_
Contraindication
Conditions when inhibition of peristalsis is undesirable (e.g. ileus or megacolon); antibiotic induced colitis; active inflammatory bowel disease; if abdominal distention develops during use; abdominal pain in the absence of diarrhoea.
Mode of Action
Loperamide inhibits peristalsis and prolongs transit time by acting directly on intestinal wall muscles. It also reduces faecal volume, increases viscosity and decreases fluid and electrolyte loss.. Slows intestinal motility through opioid receptor; has direct effects on circular and longitudinal muscle;.
Precaution
Concomitant specific therapy must be given in those with infectious diarrhoea; hepatic dysfunction; infants; pregnancy, lactation. Lactation: Not known if distributed in breast milk; use caution

_
Side Effect
Abdominal pain, distention, and discomfort; paralytic ileus; constipation, dry mouth, drowsiness, dizziness, fatigue, rash. Potentially Fatal: Toxic megacolon.

_
Interaction
Bioavailability increased by co-trimoxazole, ritonavir, saquinavir. Respiratory depression reported when administered with quinidine. Loperamide increases GI absorption of desmopressin and decreases exposure to saquinavir.