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Loperamide

Loperamide
Loperamide.svg
Loperamide 3D ball.png
Clinical data
Pronunciation /lˈpɛrəmd/
Trade names Imodium, others
AHFS/Drugs.com Monograph
MedlinePlus a682280
Pregnancy
category
  • AU: B3
  • US: C (Risk not ruled out)
Routes of
administration
by mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 0.3%
Protein binding 97%
Metabolism Liver (extensive)
Biological half-life 9–14 hours
Excretion Faeces (30–40%), urine (1%)
Identifiers
Synonyms R-18553
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard 100.053.088
Chemical and physical data
Formula C29H33ClN2O2
Molar mass 477.037 g/mol (513.506 with HCl)
3D model (Jmol)
 NYesY (what is this?)  

Loperamide, sold under the brand name Imodium among others, is a medication used to decrease the frequency of diarrhea. It is often used for this purpose in gastroenteritis, inflammatory bowel disease, and short bowel syndrome. It is not recommended for those with blood in the stool. The medication is taken by mouth.

Common side effects include abdominal pain, constipation, sleepiness, vomiting, and a dry mouth. It may increase the risk of toxic megacolon. Loperamide's safety in pregnancy is unclear, but there is no evidence of harm. It appears to be safe in breastfeeding. It is an opioid with no significant absorption from the gut and does not cross the blood brain barrier when used at normal doses. It works by slowing the contractions of the intestines.

Loperamide was first made in 1969 and used medically in 1976. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Loperamide is available as an inexpensive generic medication. The wholesale cost in the developing world is about US$0.004 to US$0.04 per dose. In Aug 2016, the US retail cost is about US$0.31 per dose.

Loperamide is effective for the treatment of a number of types of diarrhea. This includes control of acute nonspecific diarrhea, mild traveler's diarrhea, irritable bowel syndrome, chronic diarrhea due to bowel resection, and chronic diarrhea secondary to inflammatory bowel disease. It is also useful for reducing ileostomy output. Off-label uses for loperamide also include chemotherapy induced diarrhea, especially related to irinotecan use.


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