Loperamide

Loperamide

Digestive Over the counter ATC code: A07DA03

What it is

Loperamide is an opioid receptor agonist that acts on the gut wall, slowing intestinal transit so that more water is reabsorbed and stools become firmer. At normal use it barely enters the brain, so it does not produce opioid effects centrally. It is an over-the-counter treatment for acute non-infectious diarrhoea.

Typical dose
2–4 mg
4× a day

Used for

  • Diarrhoea

What to know while taking it

It can be taken with or without food, but only for short courses: prolonging use masks a problem rather than resolving it. It is not appropriate for infectious diarrhoea, where slowing the bowel traps the organism and can make matters worse — fever or blood in the stool points that way. Loperamide can prolong the QT interval on the ECG, which matters when it is combined with other QT-prolonging medicines or when heart rhythm is already a concern, and this risk rises sharply if the usual amount is exceeded.

When to see a doctor

See a doctor if diarrhoea persists beyond a couple of days, or if there is fever, blood or mucus in the stool, severe abdominal pain, bloating, or palpitations, fainting or an irregular heartbeat.

Worth knowing

  • Short courses only
  • Can prolong the QT interval
  • Not for infectious diarrhoea

Reference information, not medical advice. Discuss any change with your doctor.