Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For loperamide, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to loperamide. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in humans. However, studies in animals have not shown that loperamide causes cancer or birth defects or lessens the chances of becoming pregnant even when given in doses many times the human dose.

Breast-feeding—It is not known whether loperamide passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—This medicine should not be used in children under 6 years of age unless directed by a doctor. Children, especially very young children, are very sensitive to the effects of loperamide. This may increase the chance of side effects during treatment. Also, the fluid loss caused by diarrhea may result in a serious health problem (dehydration). Loperamide may hide the symptoms of dehydration. For these reasons, do not give medicine for diarrhea to children without first checking with their doctor. If you have any questions about this, check with your health care professional.

Older adults—The fluid loss caused by diarrhea may result in a serious health problem (dehydration). Loperamide may hide the symptoms of dehydration. For this reason, elderly persons with diarrhea, in addition to using medicine for diarrhea, must receive a sufficient amount of liquids to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking loperamide, it is especially important that your health care professional know if you are taking any of the following:

• Antibiotics such as cephalosporins (e.g., Ceftin, Keflex), clindamycin (e.g., Cleocin), erythromycins (e.g., E.E.S., PCE), tetracyclines (e.g., Achromycin, Doryx)—These antibiotics may cause diarrhea; loperamide may make the diarrhea caused by antibiotics worse or make it last longer

• Narcotic pain medicine—There is a greater chance that severe constipation may occur if loperamide is used together with narcotic pain medicine

Other medical problems—The presence of other medical problems may affect the use of loperamide. Make sure you tell your doctor if you have any other medical problems, especially:

• Colitis (severe)—A more serious problem of the colon may develop if you use loperamide

• Dysentery—This condition may get worse; a different kind of treatment may be needed

• Liver disease—The chance of severe central nervous system (CNS) side effects may be greater in patients with liver disease