Release form and composition
Imodium is available in the following dosage forms:
- Capsules: size No. 4, hard gelatin, with a dark gray body with a white inscription on it “JANSSEN” and a green cap with a white inscription on it “Imodium”; contents of capsules – white powder (6 or 20 pieces in blisters, 1 blister in a cardboard box);
- Lozenges: round, lyophilized, almost white or white (6 or 10 pieces in blisters, 1 or 2 blisters in a cardboard box).
Each pack also contains instructions for using Imodium.
1 capsule contains:
- Active substance: loperamide – 2 mg (in the form of hydrochloride);
- Auxiliary components: lactose monohydrate, talc, corn starch, magnesium stearate.
Capsule shell composition: gelatin, titanium dioxide, yellow and black iron oxide, sodium indigotin disulfonate, sodium erythrosine.
1 tablet contains:
- Active substance: loperamide – 2 mg (in the form of hydrochloride);
- Auxiliary components: aspartame, mannitol, mint flavor, gelatin, sodium bicarbonate.
Permanent resident of the home medicine cabinet
It is difficult to find a home medicine cabinet in which the niche of medicine for diarrhea is not occupied by imodium. The price of the drug is low, and on average is 25 rubles per lozenge. And although comparing the cost of the drug with other anti-diarrhea tablets at first glance is not in favor of Imodium - analogues are cheaper in pharmacy kiosks.
However, the effectiveness of the drug is higher due to the fact that the dosage form of imodium is lozenges: the instructions for use indicate that the substance begins to be absorbed already at the resorption stage, thereby accelerating the antidiarrheal effect. If you rely on effectiveness, given that the active ingredient (loperamide) is the same, then Imodium will win: analogues are absorbed twice as slow and lose in speed, gaining a little in price.
Having become familiar with the factors that are important in choosing the drug Imodium: instructions for use, prices, reviews, analogues, doctor’s recommendations, patients often opt for this medicine.
Pharmacological properties
Pharmacodynamics
The active substance of Imodium, loperamide, binds to opioid receptors in the intestinal wall, resulting in suppression of the release of prostaglandins and acetylcholine. This leads to a slowdown in peristalsis and an increase in the time it takes for contents to pass through the intestines. As a result of therapy, the tone of the anal sphincter increases, which reduces fecal incontinence and suppresses the urge to defecate.
Pharmacokinetics
Absorption of most of loperamide occurs in the intestine. Systemic bioavailability is approximately 0.3%, which is associated with active first-pass metabolism.
According to preclinical studies, loperamide is a substrate of P-glycoprotein. Binding of the substance to blood plasma proteins (mainly albumin) is 95%.
The metabolism of loperamide occurs primarily in the liver, the substance is conjugated and excreted in the bile. The main route of metabolism of loperamide is oxidative N-demethylation, the process occurs with the participation of an inhibitor of the CYP3A4 and CYP2C8 isoenzymes.
The plasma concentration of unchanged substance in the blood is negligible, which is associated with active first-pass metabolism. The half-life averages 11 hours (range 9–14 hours). Excretion of the unchanged substance and its metabolites occurs mainly in the feces.
Pharmacokinetic studies have not been conducted in children. It is assumed that the pharmacokinetics of loperamide and its interactions with other drugs are similar to those in adults.
Which is better - Imodium or Loperamide
The drug has many analogues.
Among them:
- Loperamide;
- Lopedium;
- Stoperan.
These drugs have the same active ingredient. The difference is in the cost, which for analogues is usually lower than for Imodium. It is believed that Imodium is more effective than its analogues.
If we compare Loperamide and Imodium, then Imodium is absorbed and absorbed faster. Therefore, the therapeutic effect will occur faster.
Contraindications
Absolute contraindications:
- Lactase deficiency, lactose intolerance, glucose-galactose malabsorption (capsules);
- Phenylketonuria (tablets);
- I trimester of pregnancy and lactation period;
- Age up to 6 years;
- Individual intolerance to the components of the drug.
Imodium capsules and tablets are contraindicated for use as primary therapy in the presence of the following diseases/conditions:
- Ulcerative colitis in the acute stage;
- Acute dysentery, in which bloody stools and high fever develop;
- Pseudomembranous colitis associated with the use of broad-spectrum antibiotics;
- Bacterial enterocolitis caused by pathogens including Salmonella, Campylobacter and Shigella.
In cases where slowing down peristalsis is undesirable due to the possible risk of developing serious complications (such as intestinal obstruction, megacolon and toxic megacolon), Imodium should not be used.
If bloating, constipation or intestinal obstruction occurs, the drug should be discontinued immediately.
When is it prescribed?
Imodium is useful for the following conditions:
- diarrhea due to poisoning;
- digestive disorders due to chronic inflammation of the gastrointestinal tract;
- traveler's diarrhea;
- diarrhea of nervous origin.
The drug is not prescribed if blood, mucus or fever appear in the stool. In case of these phenomena, you must first consult a doctor to find out the reasons. Sometimes fecal retention due to certain diseases can be very dangerous.
Imodium, instructions for use: method and dosage
Imodium capsules and tablets are taken orally.
The initial dose for the treatment of acute diarrhea for adults and elderly patients is 4 mg, for children over 6 years old - 2 mg. In the future, with loose stools, all age groups of patients should take the drug 2 mg after each act of defecation.
For chronic diarrhea, Imodium is prescribed in the same initial dose as for the treatment of acute diarrhea. Subsequently, the dose should be adjusted so that the frequency of stool is 1-2 times a day, which is usually achieved by taking a maintenance daily dose of 2-12 mg.
For the treatment of acute and chronic diarrhea, the maximum daily dose is:
- Adults – 16 mg;
- Children - 3 mg per 10 kg of body weight (no more than 16 mg).
When stool normalizes or if there is no stool for more than 12 hours, therapy should be discontinued.
Lozenges should be placed on the tongue. Within a few seconds, it dissolves on the surface of the tongue, and it can be swallowed with saliva without washing it down with water.
Side effects
During therapy, it is possible to develop disorders of some body systems:
- Central and peripheral nervous system: drowsiness, fatigue, dizziness;
- Digestive system: dry mouth, bloating and/or constipation, intestinal colic, abdominal discomfort or pain, vomiting, nausea; very rarely - intestinal obstruction;
- Allergic reactions: skin rash;
- Other: tingling or burning sensation of the tongue (appears immediately after taking the drug in the form of lozenges); rarely – urinary retention.
Indications for use
You should not assume that Imodium needs to be taken for any form of diarrhea. The manufacturer specifies that the medication should only be used if the diarrhea is non-infectious. Loperamide is prescribed for diarrhea caused by:
- In case of disruption of the usual diet.
- As a consequence of an allergic reaction of the body to a food product or medicine.
- Under the influence of anxiety and stress.
- As a manifestation of irritable bowel syndrome.
Imodium not only leads to consolidation of the intestines, but also eliminates other symptoms of diarrhea - bloating, rumbling in the stomach, cramps.
For infectious diarrhea, loperamide is used only as part of complex treatment and is usually not prescribed immediately in such situations. The main emphasis in the treatment of infectious diarrhea is given to antibiotics.
Overdose
The main symptoms (including against the background of a relative overdose associated with impaired liver function): intestinal obstruction, urinary retention, signs of depression of the central nervous system, including impaired coordination, stupor, drowsiness, miosis, respiratory depression, muscle hypertonicity. Children may be more sensitive to the effects of loperamide on the central nervous system than adults.
Therapy: Naloxone can be used as an antidote (in some cases, repeated use is required due to differences in the half-life). Patients should be monitored for at least 48 hours.
Reviews
According to medical statistics, Imodium is one of the most effective remedies for diarrhea. This is fully confirmed by reviews from a network of patients who took the drug for the treatment of infectious diarrhea, where it is noted that improvement occurs within half an hour after administration.
Some negative reviews are associated with the onset of side effects after taking the medicine, which indicate that you should not get carried away with the drug. Imodium belongs to the group of drugs intended to eliminate the symptoms of chronic diarrhea or during exacerbation;
special instructions
If constipation or bloating occurs, Imodium should be stopped immediately.
With diarrhea, especially in children, hypovolemia and a decrease in electrolyte levels may develop. In these cases, it is important to carry out replacement therapy to replenish electrolytes and fluids.
Since treatment of diarrhea with Imodium is only symptomatic, etiotropic drugs should be used simultaneously with taking the drug, if possible.
In acute diarrhea, if clinical improvement is not observed within 48 hours, therapy should be stopped and the diagnosis clarified, excluding the infectious origin of diarrhea.
You should not take Imodium if you have diarrhea accompanied by blood in the stool and high fever.
In patients with AIDS, when the first signs of abdominal bloating appear, therapy should be stopped immediately. In some cases, in patients with AIDS with infectious colitis of a bacterial and viral nature, toxic dilatation of the colon may develop during therapy.
Patients with functional liver disorders need to be closely monitored for timely detection of symptoms of toxic damage.
During therapy, it is recommended to follow a diet and monitor timely fluid replenishment.
Please note that lozenges are quite fragile, so to avoid damage, they must be removed from the package with care.
Impact on the ability to drive vehicles and complex mechanisms
While taking Imodium, it is recommended to refrain from driving vehicles and performing potentially dangerous types of work that require high concentration and speed of psychomotor reactions.
Interaction with other drugs
There are no special instructions on this matter from doctors, since Imodium is distinguished by its safety. However, with the simultaneous use of an antidiarrheal agent and cholestyramine, the effectiveness of the former may be significantly reduced.
The bioavailability of Imodium is affected by its parallel administration with Trimaxazole and Ritonavir. This phenomenon was noticed due to the pronounced inhibition of the metabolism of the anti-diarrhea drug during the initial passage of liver tissue.
Otherwise, no complications or adverse reactions were identified during combination treatment or other therapy.
Alcohol compatibility
Imodium should not be combined with alcohol-containing drinks, as it causes depression of the central nervous system and brain cells. Also, there is an increased load on the liver, which is detrimental to its functioning. Patients' general condition worsens and drowsiness appears.
