Loperamide + Simethicone

Indications

Loperamide + Simethicone is used for: Diarrhea, Flatulence

Adult Dose

Adult Diarrhea/Flatulence After each loose bowel movement: 2 tablets once initially, then 1 tab/dose with each subsequent loose stool up to 4 tab/day

Child Dose

Child Diarrhea/Flatulence <6 years: Safety and efficacy not established 6-8 years: 1 tablet once initially, then one-half tablet/dose, up to 2 tablets/day 9-12 years: 1 tablet once initially, then one-half tablet/dose, up to 3 tablets/day > 12 years: After each loose bowel movement: 2 tablets once initially, then 1 tab/dose with each subsequent loose stool up to 4 tab/day

Renal Dose

Administration

Contra Indications

Hypersensitivity, bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis Patients in whom constipation must be avoided Abdominal pain without diarrhea Avoid use as primary therapy with acute dysentery (bloody stools and high fever, acute ulcerative colitis, bacterial enterocolitis [caused by Salmonella, Shigella, and Campylobacter), pseudomembranous colitis associated with antibiotic use) Age <2 years

Precautions

loperamide May cause drowsiness or dizziness, which may impair physical abilities to operate heavy machinery or tasks requiring mental alertness Hypersensitivity reactions reported, including anaphylaxis, rash, urticaria, and rare cases of Steven’s Johnson syndrome or toxic epidermal necrolysis Discontinue if no improvement seen within 48 hr in patients with acute diarrhea, symptoms worsen, or abdominal swelling or bulging develops Discontinue promptly if constipation, abdominal pain or distention, blood in stool, or ileus develops; do not use when peristalsis inhibition should be avoided (ie, due to potential for ileus, megacolon, or toxic megacolon) Discontinue therapy if symptoms of abdominal distention occur in patients with AIDS; cases of toxic megacolon reported with infectious colitis, resulting from viral or bacterial pathogens simethicone Can cause false-negative gastric guaiac test Lactation: Unknown if distributed in to breast milk, use caution

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Loperamide + Simethicone : Frequency Not Defined Dizziness Fatigue Headache Abdominal pain Dry mouth Nausea Diarrhea Vomiting Pancreatitis

Mechanism of Action

Slows intestinal motility by direct effects on circular & longitudinal muscle (loperamide); changes surface tension of gas bubbles, causing collapse of foam bubbles, thus allow easier passage (simethicone)