capsules or tablets, or 16 spoonfuls of liquid (5ml each), if you have a prescription or buy loperamide from a pharmacy The recommended dose depends on the type of diarrhoea you have and your age. Adults (over 18), with short-term diarrhoea or IBS

Although no pharmacokinetic data are available in patients with hepatic impairment, Imodium Instant Melts should be used with caution in such patients because of reduced first pass metabolism, as it may result in a relative overdose leading to CNS toxicity. If you forget to take a dose, take a dose after the next loose stool (bowel movement). Do not take a double dose. 4 possible side effects You can also report side effects directly via the Yellow Card Scheme at: or search for MHRA Yellow Card in the Google Play or Apple App Store. IMODIUM® can have side effects, like all medicines, although these don’t affect everyone and most are usually mild. Get medical help at once

The concomitant administration of loperamide (4 mg single dose) and itraconazole, an inhibitor of CYP3A4 and P-glycoprotein, resulted in a 3 to 4-fold increase in loperamide plasma concentrations. In the same study a CYP2C8 inhibitor, gemfibrozil, increased loperamide by approximately 2-fold. The combination of itraconazole and gemfibrozil resulted in a 4-fold increase in peak plasma levels of loperamide and a 13-fold increase in total plasma exposure. These increases were not associated with central nervous system (CNS) effects as measured by psychomotor tests (i.e. subjective drowsiness and the Digit Symbol Substitution Test).

If you are breast-feeding do not take this medicine. Small amounts may get into your milk. Talk to your doctor about a suitable treatment. Age 12 to 17 years with IBS or long-lasting diarrhoea – follow the instructions from their doctor. This is given on prescription only. This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free1. Once you're on the right dose, your doctor will usually recommend dividing your daily dose, so you take half in the morning and half in the afternoon or evening. You should only take this medicine as you need it, following the dosage instructions above carefully.If you are pregnant, think you are pregnant or planning a pregnancy: ask your doctor or pharmacist for advice before taking this medicine. Metabolism: loperamide is almost completely extracted by the liver, where it is predominantly metabolized, conjugated and excreted via the bile. Oxidative N-demethylation is the main metabolic pathway for loperamide, and is mediated mainly through CYP3A4 and CYP2C8. Due to this very high first pass effect, plasma concentrations of unchanged drug remain extremely low. Your doctor will adjust your dose according to your symptoms and how well loperamide is working, up to a maximum of: