Loperamide

ATC CodeA07DA03
CAS number53179-11-6
PUB number3955
Drugbank IDDB00836
Empirical formulaC29H33ClN2O2
Molar mass (g·mol−1)477,04
Physical statesolid
Melting point (°C)222–223
PKS value8,6

Basics

Loperamide is a so-called peristaltic inhibitor. It is used for the symptomatic treatment of diarrhoea. It is the most widely sold active ingredient of this type and is also included on the WHO's list of essential medicines.

Loperamide does not require a prescription and is usually taken in the form of a tablet.

Pharmacology

Pharmacodynamics

Loperamide has structural properties of an opioid and therefore binds to certain opioid receptors in the nerves of the intestine. This reduces the activity of the small intestinal muscles and the intestinal contents take longer to pass through. This gives more time for the intestinal contents to extract water. Loperamide, unlike conventional opioids, has no effect on the central nervous system.

Pharmacokinetics

Plasma protein binding is 97% and plasma half-life is 9-14 hours. Loperamide is metabolized mainly in the liver and subsequently excreted almost entirely in the stool.

Drug interactions

When taken with quinidine, verapamil or ketoconazole, respiratory depression may occur.

Toxicity

Signs of overdose include dizziness, nausea, fatigue, and constipation.

Side effects

Common side effects include constipation, nausea, dizziness, headache, and flatulence.

Toxicological Data

Oral, mouse: LD50 = 105 mg/kg.

Markus Falkenstätter, BSc

Markus Falkenstätter, BSc

Mag. pharm. Stefanie Lehenauer

Mag. pharm. Stefanie Lehenauer



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