Imodium (Loperamide)
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Fact Table
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| Formula | C29H33ClN2O2·HCl (loperamide hydrochloride); C29H33ClN2O2 (loperamide base) |
| License | FDA approved; first approved as prescription Imodium in 1976 and available OTC since 1988 |
| Bioavailability | Very low systemic bioavailability; commonly reported as <1% because of poor absorption and extensive first-pass metabolism |
| Legal status | Over-the-counter (OTC) for many oral products; prescription formulations also exist; not a controlled substance |
| Chemical Name | 4-[4-(4-chlorophenyl)-4-hydroxypiperidin-1-yl]-N,N-dimethyl-2,2-diphenylbutanamide hydrochloride |
| Elimination half-life | Apparent elimination half-life ~10.8 hours; range 9.1–14.4 hours |
| Dosage (Strength) | Common products: 2 mg tablets/caplets/capsules and 1 mg/7.5 mL oral liquid. OTC adult dose: 4 mg after first loose stool, then 2 mg after each subsequent loose stool; maximum 8 mg/day OTC or 16 mg/day prescription |
| Pregnancy | Use during pregnancy only if potential benefit justifies potential fetal risk; OTC label advises asking a health professional before use if pregnant or breastfeeding |
| Brands | Imodium, Imodium A-D, Imotil, Kaopectate 1-D, Pepto Diarrhea Control; generics available |
| Protein binding | About 95% plasma protein bound |
| PubChem CID | 3955 (loperamide); 71420 (loperamide hydrochloride) |
| MedlinePlus | a682280 |
| ChEBI | 6532 |
| ATC code | A07DA03 |
| DrugBank | DB00836; DBSALT000709 (loperamide hydrochloride) |
| KEGG | D00729 (loperamide hydrochloride); D08144 (loperamide); C07080 |
| Routes of administration | By mouth (oral tablets, caplets, capsules, oral solution/suspension) |
Imodium A-D (loperamide hydrochloride) is a medication used to control diarrhea, including Travelers' Diarrhea. It works by slowing intestinal movement, allowing the body to absorb more water and electrolytes from the stool. Each caplet typically contains 2 mg of loperamide and is available without a prescription.
Directions
Adults and children 12 years of age and older should take 2 caplets after the first loose stool, followed by 1 caplet after each subsequent loose stool. Do not take more than 4 caplets in 24 hours. Children 9 to 11 years (60 to 95 lbs) should take 1 caplet after the first loose stool, followed by half a caplet after each subsequent loose stool, up to 3 caplets in 24 hours. Children 6 to 8 years (48 to 59 lbs) should take 1 caplet after the first loose stool, followed by half a caplet after each subsequent loose stool, up to 2 caplets in 24 hours. Drink plenty of clear fluids to help prevent dehydration caused by diarrhea.
Ingredients
The active ingredient is loperamide hydrochloride. Inactive ingredients may include anhydrous lactose, carnauba wax, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, and pregelatinized starch.
Cautions
Before using this medication, you may want to consult a healthcare provider about the following:
- Any existing health conditions
- Any allergies
- A list of all medications currently being taken
Taking more than the directed dose of loperamide may cause serious heart problems or death.
Consult a doctor before use if you have a fever, mucus in the stool, a history of liver disease, or an abnormal heart rhythm.
Loperamide may interact with certain prescription drugs. Consult a doctor or pharmacist before use if you are taking any prescription medication.
Pregnant or breastfeeding individuals should consult a healthcare professional before using this product.
Contraindications
Avoid taking or using this medication if any of the following apply:
- Known allergy or previous allergic reaction, such as a rash, to loperamide hydrochloride
- Bloody or black stools are present
- Children under 2 years of age
Side Effects
Common side effects of Imodium A-D include:
- Tiredness
- Drowsiness
- Dizziness
Stop use and contact a doctor if symptoms get worse, diarrhea lasts for more than 2 days, or abdominal swelling or bulging occurs.
Be careful when driving or operating machinery, as drowsiness or dizziness may occur.
Frequently Asked Questions about Imodium
What is Imodium?
Imodium is a brand-name antidiarrheal medicine that contains loperamide hydrochloride. It is used to help control symptoms of diarrhea, including traveler’s diarrhea, by reducing how often loose stools occur.
How does Imodium work?
Imodium works mainly in the intestines by slowing bowel movement and helping the body absorb more fluid from the stool. This can make stools less watery and reduce urgency and frequency.
What is Imodium used for?
Imodium is commonly used for short-term relief of acute diarrhea and traveler’s diarrhea. Prescription loperamide may also be used in certain chronic diarrhea conditions or to reduce ileostomy output when directed by a healthcare professional.
How should Imodium be taken?
Imodium should be taken exactly as directed on the package label or by a healthcare professional. Many over-the-counter adult products are taken after the first loose stool and then after later loose stools, but the maximum daily amount depends on the product and should not be exceeded.
How long can Imodium be used?
For acute diarrhea, Imodium should generally not be used for more than 2 days unless a healthcare professional gives different instructions. If diarrhea lasts longer than 48 hours, gets worse, or is accompanied by concerning symptoms, the medication should be stopped and medical advice sought.
What are common side effects of Imodium?
Common side effects may include constipation, nausea, stomach cramps, dizziness, tiredness, dry mouth, or bloating. Drowsiness or dizziness can occur, so caution is advised with driving or operating machinery if affected.
What serious side effects can Imodium cause?
Taking more Imodium than directed can cause serious heart rhythm problems, fainting, cardiac arrest, or death. Severe constipation, abdominal swelling, worsening stomach pain, allergic reaction, or fainting should be treated as warning signs that need prompt medical attention.
Who should not use Imodium?
Imodium should not be used by anyone allergic to loperamide. It should also be avoided in diarrhea with bloody or black stools, and many over-the-counter Imodium products should not be used in children under 12 unless a healthcare professional specifically recommends an appropriate product.
When should a healthcare professional be asked before using Imodium?
A healthcare professional should be asked before use if there is fever, mucus in the stool, liver disease, a history of abnormal heart rhythm, or use of prescription medicines that may interact with loperamide. Diarrhea caused by certain infections or inflammatory bowel conditions may worsen if bowel movement is slowed.
Can Imodium be used during pregnancy or breastfeeding?
People who are pregnant, planning pregnancy, or breastfeeding should ask a healthcare professional before using Imodium. The decision depends on symptoms, hydration status, other medical conditions, and whether another cause of diarrhea needs evaluation.
