what is it for? Just for diarrhea?

Warning

This article does not replace the leaflet of the drugs nor above all the medical opinion; the answers to the most common questions on the various Imodium references are therefore provided for informational purposes only and should be understood as an expression of the author’s opinion, even if formulated according to science and conscience and above all on the basis of official documents and available scientific literature.

In case of doubts, the reader is therefore invited to refer to his own doctor.

What is Imodium?

Imodium is the trade name of a drug based on loperamide, an active ingredient that belongs to the opioid class.

It has a marked antidiarrheal function and acts above all as an inhibitor of intestinal motility, i.e. reducing the involuntary muscle contractions of the intestine and the stimulus to evacuate. However, it also has other mechanisms of action, for example by reducing the secretion of fluids and at the same time promoting the reabsorption of water (which allows for an increase in the consistency of the stools).

There are 3 different references available:

• Imodium 12 buccal tablets (to dissolve in the mouth)
• Imodium 12 cps soft
• Imodium 8 cps
• Imodium Diarrhea and Wind (in combination with simethicone, a substance used to reduce swelling)

How much does it cost?

As an OTC drug, Imodium does not have a fixed price and this can instead be decided independently by the pharmacist.

What is it for?

Imodium is indicated for the symptomatic treatment of diarrhea occasional (sharp).

It is worth emphasizing that the active ingredient (loperamide) only reduces the urge to evacuate by reducing the muscular movements of the intestine and has no action on the cause of the problem. In the case of gastroenteritis (viral or from food poisoning) this means preventing the body from expelling the microorganisms (or related toxins) responsible for the symptom and therefore potentially prolonging the disorder. Loperamide is therefore contraindicated in the treatment of infectious-type diarrhoea.

Also for this reason, in the case of self-prescription, if after two days of therapy the diarrhea has not resolved, it would be necessary to suspend it and consult a doctor (use must therefore always be weighed with particular attention to the risk/benefit ratio).

It is sometimes prescribed off-label for the management of patients with chronic diarrhea, but this is a use that requires express medical advice.

Can it be used for stomach pains as well as diarrhea?

Need recipe?

In Italy, loperamide is an OTC drug (Over The Counter, literally “above the counter”), that is, it can be purchased without a medical prescription. There are several branded equivalents (for example Dissenten, which is technically however a SOP, i.e. a non-prescription and non-OTC drug) and generics (“loperamide” followed by the name of the manufacturer).

Can it be given to children?

In children aged between 6 and 12 years of age Imodium can only be administered with a doctor’s prescription (adjusting the doses if necessary according to the indications received).

When to take it? Before or after meals?

Loperamide can be taken either with or without meals.

Can it be taken during pregnancy?

No, Imodium is contraindicated in pregnancy and breastfeeding.

Dosage: how to take?

The doses do not change between capsules, tablets and buccal tablets.

The recommended doses are as follows:

• Adults: The recommended dosage involves taking 2 capsules together and, in the event of further and subsequent discharges of diarrhea, 1 capsule after each successive evacuation of unformed stools for a maximum of 8 capsules per day.
• Children and adolescents (between 6 and 17 years of age): It is recommended to follow the pediatrician/doctor’s instructions, but generally the treatment is started with 1 capsule and a further one after any further evacuation of unformed faeces. The maximum dose is calculated on the basis of body weight (3 capsules every 20 kg), but must not in any case exceed 8 capsules per day.

After how long does it take effect?

Imodium is considered to take effect within about 30 minutes, sometimes even less.

How long can it be taken?

The intake of Imodium must be stopped as soon as the stools are formed again, or in any case in the absence of new discharges for at least 12 hours.

Unless otherwise advised by a doctor, if after 2 days of therapy no resolution of the symptoms has been observed, it is advisable to suspend and consult a doctor.

Does it have any side effects?

Imodium can cause tiredness, dizziness, or lightheadedness, so great caution is needed if you need to drive or operate dangerous machinery.

Like all medicines, Imodium can cause side effects, although not everybody gets them. At the recommended doses, however, it is generally very well tolerated, because systemic absorption is limited and the substance therefore acts almost only in the intestine (the most common side effect is presumably rebound constipation).

It is recommended to discontinue the drug immediately and consult a doctor in case of:

• severe allergic reactions (anaphylactic shock) which may be accompanied by
• swelling of the abdomen associated with pain, nausea, vomiting, inability to evacuate, signs of intestinal obstruction or megacolon;
• severe skin rashes with redness, peeling and/or blistering (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis).
• upper abdominal pain, abdominal pain spreading to the back, tenderness of the abdomen, fever, rapid pulse, nausea, vomiting, which may be symptoms of inflammation of the pancreas (acute pancreatitis).

Other possible side effects include (most common in bold):

• Heachache
• Dizziness
• Difficulty evacuating (constipation)
• Nausea and/or vomiting
• Excess of gas in the abdomen (flatulence).
• Tiredness and drowsiness
• Abdominal pain or discomfort (especially located in the upper abdomen)
• Dry mouth
• Digestive difficulties (dyspepsia)
• Pupil contraction (miosis)
• Skin rash, characterized by blisters, blotches on the skin (hives) and/or itching
• Decreased diuresis (urinary retention)
• Tongue pain (glossodynia)
• Swelling of the abdomen
• Complete arrest of movements with detachment from external reality (torpor), slowing of mental functions (decreased level of consciousness), fainting (loss of consciousness), increased muscle tone (hypertonia), muscle coordination disorders, fatigue.

Contraindications

Imodium should not be taken by patients:

You also need to be particularly careful when taking:

• quinidine (medicine used in heart rhythm disorders)
• ritonavir (drug used in infections due to viruses)
• ketoconazole and itraconazole (drugs used in fungal infections)
• gemfibrozil (drug that lowers blood cholesterol levels)
• desmopressin (a drug used for example in type 1 diabetes)
• drugs with indications or effects similar to those of Imodium
• drugs that accelerate or slow down intestinal peristalsis (levosulpiride, metoclopramide, …)
• drugs that inhibit cytochrome CYP450.

Can Imodium and Buscopan be taken together?

No, Imodium must NOT be combined with other drugs (such as Buscopan) that reduce intestinal motility.

It can be associated with lactic ferments

Yes, it is possible to combine it with lactic ferments.