Experiences with
Loperamide

Loperamide is a medicine to treat diarrhoea (runny poo). It can help with short-term diarrhoea or irritable bowel syndrome (IBS).

Loperamide is also used for recurring or longer lasting diarrhoea from bowel conditions such as Crohn's disease, ulcerative colitis and short bowel syndrome.

Diarrhoea that starts suddenly usually gets better on its own within 5 to 7 days. If you need immediate short-term relief, taking loperamide can reduce the number of times you go to the toilet and it makes your poo less watery.

Loperamide works by slowing down food as it goes through your gut. Your body can then draw in more water from your intestines, so that your poos get firmer and you poo less often.

If you have a colostomy (where part of your bowel is brought through an opening made in your tummy, called a stoma) you may be prescribed loperamide. If you have a lot of poo and fluids coming through it, your stoma team may advise you to take high doses of loperamide to make your poo thicker and reduce the flow.

You can buy loperamide from pharmacies and shops. It's also available on prescription for treating some bowel conditions.

It comes as tablets, including tablets that dissolve on your tongue, and capsules. The tablets that dissolve are called Imodium Instants or Imodium Instant Melts.

Loperamide is also available combined with simeticone. Simeticone is used to treat farting (flatulence or wind). Taking these medicines together helps if you have diarrhoea with painful stomach cramps and bloating.

Loperamide mixed with simeticone is known by several brand names including Imodium Plus Caplets and Imodium Plus Comfort Tablets.

Who can take loperamide

Loperamide is available to buy without a prescription for:

anyone aged 12 years or over with short-term diarrhoea
adults (18 years or over) with short-term diarrhoea caused by irritable bowel syndrome (IBS), but only if a doctor has diagnosed IBS – if you're not sure whether you have IBS, talk to your doctor

It's available on prescription only for:

children aged 11 years or under
adults with long-lasting diarrhoea

Only give loperamide to children aged 11 years or under if their doctor prescribes it.

Loperamide is not suitable for some people.

Do not take loperamide if you:

have severe diarrhoea after taking antibiotics
are having a flare-up of an inflammatory bowel condition like ulcerative colitis
are constipated or your stomach looks swollen

Talk to your doctor before taking loperamide if you:

have ever had an allergic reaction to loperamide or any other medicine
have had diarrhoea for more than 48 hours
have HIV and your stomach becomes swollen
have liver problems
have blood in your poo and a high temperature – these can be signs of dysentery
are trying to get pregnant, are already pregnant or you're breastfeeding

If you have diarrhoea and IBS, talk to your doctor before taking loperamide if you:

are aged 40 years or over and it's some time since your last IBS attack, or if your symptoms are different this time
have recently had blood in your poo (your poo might be bright red or black)
get bad constipation
are feeling or being sick
have lost your appetite or lost weight
have a high temperature
have trouble peeing or find peeing painful
have recently travelled abroad – you may have picked up a stomach bug

Dosage and strength

Loperamide comes as tablets and capsules that contain 2mg of loperamide.

The recommended dose depends on the type of diarrhoea you have and your age.

Dose for adults with short-term diarrhoea or IBS

For adults (18 years or over) the usual starting dose is 2 capsules or tablets, taken immediately. Then take 1 capsule or tablet after each runny poo.

Stop taking loperamide as soon as your symptoms settle down.

The recommended maximum dose in 24 hours is:

6 capsules or tablets, if you buy loperamide from a shop or a pharmacy
8 capsules or tablets, if you have a prescription for loperamide

Do not take loperamide for more than 48 hours without talking to a doctor.

Dose for adults with long-lasting or recurring diarrhoea

Most cases of diarrhoea get better in 5 to 7 days. If your diarrhoea does not stop in 7 days, talk to your doctor. It's important to understand the causes and to treat any complications, for instance dehydration.

If your doctor prescribes loperamide for long-lasting diarrhoea, they will tell you how much to take. The usual starting dose for adults (18 years or over) is 2 to 4 capsules or tablets a day, spaced evenly throughout the day.

Your doctor will adjust your dose according to your symptoms and how well loperamide is working. The maximum dose is 8 tablets or capsules in 24 hours.

When you're on the right dose, your doctor will usually recommend dividing your daily dose, so you take half in the morning and half in the afternoon or evening.

Occasionally people with a colostomy (stoma) need a higher dose. Only take a higher dose if your doctor tells you to.

Dose for children

Do not give loperamide to children under 12 years old unless their doctor prescribes it.

For children aged 12 years or over with short-term diarrhoea, the dose is the same as for adults.

For children aged 12 to 17 years with IBS or long-lasting diarrhoea, follow the instructions from their doctor. This is given on prescription only.

For children aged 11 years or under, follow the instructions from their doctor.

If a doctor prescribes loperamide for your child, they will use your child's weight or age to work out the right dose. The dose also depends on their symptoms.

How to take it

You can take loperamide with or without food.

If you're taking capsules or standard tablets, swallow these whole, with a drink of water.

If you're taking tablets that dissolve in your mouth, put the tablet on your tongue and let it dissolve in your saliva. You can then swallow it without a drink. Do not chew it.

How long to take it for

Most people only need to take loperamide for 1 to 2 days.

If you buy loperamide from a shop or pharmacy, do not take it for more than 48 hours without talking to a doctor.

You may need to take it for longer if your diarrhoea is because of a bowel condition such as Crohn's disease, ulcerative colitis or short bowel syndrome.

Diarrhoea is not usually serious but it can sometimes lead to dehydration. This can be serious if you do not get the correct treatment.

Diarrhoea can also be a symptom of another problem. If your diarrhoea continues for more than 7 days, it's important to see a doctor to find out what's causing it.

If you forget to take it

If you forget a dose of loperamide, do not worry. Just take your usual dose after you next go to the toilet and have a runny poo.

Never have an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.

If you take too much

Do not take more than the recommended dose of loperamide.

Taking 1 extra dose of loperamide once is unlikely to harm you. But taking higher doses can cause serious heart problems. The signs of this include having a fast or irregular heartbeat.

you take 2 extra doses of loperamide or more
you take more than the recommended dose and get a fast or irregular heartbeat

Get help from 111 online or call 111. Call 111 if you need advice for a child under 5 years old

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the loperamide packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of loperamide happen in more than 1 in 100 people. There are things you can do to help cope with them:

If you have difficulty doing a poo, stop taking loperamide.

Get more fibre into your diet such as fresh fruit, vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

Try taking loperamide with or after a meal or snack. It may also help if you avoid rich or spicy food.

Make sure you rest and drink plenty of fluids. Try to avoid drinking alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if the headaches last longer than a week or are severe.

Avoid foods that cause farting (flatulence) like lentils, beans and onions. It might also help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly.

There are products you can buy from a pharmacy to help with farting. Loperamide can be bought mixed with simeticone, a medicine that helps relieve bloating, farting and cramping.

Speak to a pharmacist or doctor if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

It's rare to have a serious side effect with loperamide.

Stop taking loperamide and speak to a doctor or call 111 straight away if you:

feel faint or less alert, or if you pass out (faint)
start moving in a clumsy, uncoordinated way
have stomach pain or tenderness, a high temperature, a fast pulse, or are being sick – these may be symptoms of an inflamed pancreas
have severe constipation
are having difficulties peeing

Serious allergic reaction

It happens rarely, but it's possible to have a serious allergic reaction (anaphylaxis) to loperamide.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of loperamide. For a full list, see the leaflet inside your medicines packet.

Loperamide and pregnancy

Loperamide is not usually recommended when pregnant. This is because there's not enough information to say if it's safe.

If you're pregnant, talk to your doctor before taking loperamide.

They'll be able to advise you about the benefits and possible harms of taking it. This will depend on how many weeks pregnant you are and why you need to take it.

Talk to your doctor if you're trying to get pregnant and are taking loperamide regularly.

Loperamide and breastfeeding

It's OK to take loperamide while you're breastfeeding.

Only tiny amounts of loperamide pass into breast milk, and your baby will not be able to absorb a lot into their body from breastfeeding. It's not expected to cause any side effects in your baby.

As a precaution, if you notice that your baby is not feeding as well as usual, seems constipated or irritable, or if you have any other concerns about your baby, talk to your health visitor, midwife, doctor or pharmacist.

Loperamide and fertility

There's no evidence to suggest that loperamide affects fertility in men or women.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

There are some medicines that can affect how loperamide works.

Tell your doctor or pharmacist if you're taking:

clozapine, a medicine used to treat mental health conditions
ritonavir, a medicine for HIV infection
quinidine, a medicine for abnormal heartbeats or malaria
itraconazole, medicines for fungal infections
gemfibrozil, a medicine for high cholesterol
desmopressin, a medicine for bedwetting or peeing too much
other medicines for diarrhoea, constipation, or any other stomach and bowel problems

Speak to your doctor if your diarrhoea is very severe and you take metformin for diabetes, or medicines for high blood pressure or heart failure. Your doctor may tell you to stop taking these medicines for a few days until your diarrhoea is better.

Mixing loperamide with herbal remedies and supplements

There's not enough information to say that complementary medicines and herbal remedies are safe to take with loperamide. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert