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Loperamide Simethicone Brand Names
Imodium Advanced | Imodium Multi-Symptom Relief
What is Loperamide Simethicone
Loperamide and simethicone are used together to treat acute diarrhea accompanied by bloating, cramps, and pressure.
Loperamide treats diarrhea by slowing intestinal motility, inhibiting fluid and electrolyte secretion and/or increasing water absorption.
Simethicone reduces gas symptoms by dispersing and preventing the formation of mucus-surrounded gas pockets in the GI tract.
Simethicone works by decreasing the surface tension of gas bubbles in the GI tract thereby allowing the foamy gas bubbles to coalesce into one large pocket of gas which is easily eliminated.
Tolerance to the antidiarrheal effect of loperamide has not been observed, and it does not appear to produce physical dependence.
However, intentional misuse or abuse of high loperamide doses has been observed in patients attempting to self-treat opioid withdrawal or achieve an euphoric feeling.
These intentional overdoses, along with elevated loperamide concentrations resulting from drug interactions, have been associated with at least 48 cases of loperamide-induced cardiac events. Of these 48 cases, 31 required hospitalization and 10 resulted in death.
Due to the severity of these adverse events, the FDA issued a Drug Safety Communication in June 2016 to alert health care providers of the potential for serious cardiac events following use of high loperamide doses.
Also, fluid and electrolyte depletion often occur in patients who experience diarrhea.
The use of loperamide simethicone does not preclude the need for appropriate fluid and electrolyte therapy.
Imodium Advanced was approved in 1997; later renamed Imodium Multi-Symptom Relief.
Generic products were first approved in October 2002
Indications
- diarrhea
For self-treatment of acute diarrhea accompanied by bloating, cramps, pressure or flatulence
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- bullous rash
- constipation
- dizziness
- drowsiness
- dyspepsia
- erythema multiforme
- flatulence
- headache
- ileus
- nausea
- pruritus
- rash
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- toxic megacolon
- urinary retention
- urticaria
- vomiting
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abdominal pain
- acquired immunodeficiency syndrome (AIDS)
- breast-feeding
- cardiac arrest
- cardiac arrhythmias
- children
- constipation
- driving or operating machinery
- dysentery
- fever
- gastroenteritis
- geriatric
- hepatic disease
- ileus
- infants
- infection
- neonates
- pregnancy
- pseudomembranous colitis
- QT prolongation
- respiratory depression
- substance abuse
- syncope
- torsade de pointes
- toxic megacolon
- ulcerative colitis
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Propoxyphene
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Aldesleukin, IL-2
- Alfentanil
- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alosetron
- Amantadine
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Anagrelide
- Apomorphine
- Aprepitant, Fosaprepitant
- Arformoterol
- Aripiprazole
- Armodafinil
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azithromycin
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Bethanechol
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Bosentan
- Brigatinib
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Cabozantinib
- Cannabidiol
- Capmatinib
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carvedilol
- Ceritinib
- Chloramphenicol
- Chlorcyclizine
- Chlordiazepoxide; Clidinium
- Chloroquine
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Cholestyramine
- Cimetidine
- Ciprofloxacin
- Cisapride
- Citalopram
- Citric Acid; Potassium Citrate
- Citric Acid; Potassium Citrate; Sodium Citrate
- Clarithromycin
- Clofazimine
- Clomipramine
- Clopidogrel
- Clozapine
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Conivaptan
- Crizotinib
- Crofelemer
- Cyclosporine
- Dabrafenib
- Daclatasvir
- Danazol
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Deferasirox
- Degarelix
- Delavirdine
- Desflurane
- Desipramine
- Desvenlafaxine
- Deutetrabenazine
- Dexamethasone
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dicyclomine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Duloxetine
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Eluxadoline
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Enalapril; Felodipine
- Encorafenib
- Enflurane
- Entrectinib
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Eslicarbazepine
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etravirine
- Ezogabine
- Fedratinib
- Felbamate
- Felodipine
- Fenofibric Acid
- Fentanyl
- Fesoterodine
- Fingolimod
- Flavoxate
- Flecainide
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flutamide
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Fosamprenavir
- Foscarnet
- Fosphenytoin
- Fostamatinib
- Gemfibrozil
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glecaprevir; Pibrentasvir
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- grapefruit juice
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Potassium Guaiacolsulfonate
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Hetastarch; Dextrose; Electrolytes
- Histrelin
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxychloroquine
- Hydroxyprogesterone
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibritumomab Tiuxetan
- Ibrutinib
- Ibuprofen; Oxycodone
- Ibutilide
- Idelalisib
- Iloperidone
- Imatinib
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indinavir
- Inotuzumab Ozogamicin
- Iodine; Potassium Iodide, KI
- Isavuconazonium
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Istradefylline
- Itraconazole
- Ivacaftor
- Ivosidenib
- Ixabepilone
- Ketoconazole
- Lapatinib
- Lasmiditan
- Ledipasvir; Sofosbuvir
- Lefamulin
- Leflunomide
- Lenvatinib
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levofloxacin
- Levorphanol
- Linaclotide
- Lithium
- Lofexidine
- Lomitapide
- Long-acting beta-agonists
- Lopinavir; Ritonavir
- Lorcaserin
- Lubiprostone
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Macimorelin
- Maprotiline
- Mefloquine
- Meperidine
- Meperidine; Promethazine
- Metaproterenol
- Methadone
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methscopolamine
- Metoclopramide
- Metronidazole
- Midostaurin
- Mifepristone
- Mirabegron
- Mirtazapine
- Mitotane
- Modafinil
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nafcillin
- Nefazodone
- Nelfinavir
- Neratinib
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Nicardipine
- Nicotine
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Ondansetron
- Oritavancin
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxcarbazepine
- Oxybutynin
- Oxycodone
- Oxymorphone
- Ozanimod
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Perampanel
- Perindopril; Amlodipine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Phenytoin
- Pimavanserin
- Pimozide
- Pirbuterol
- Pirfenidone
- Pitolisant
- Ponatinib
- Posaconazole
- Potassium
- Potassium Acetate
- Potassium Bicarbonate
- Potassium Chloride
- Potassium Citrate
- Potassium Gluconate
- Potassium Iodide, KI
- Pramlintide
- Primaquine
- Primidone
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Propoxyphene
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranitidine
- Ranolazine
- Remifentanil
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rifaximin
- Rilpivirine
- Risperidone
- Ritonavir
- Rivaroxaban
- Rolapitant
- Romidepsin
- Salmeterol
- Sapropterin
- Saquinavir
- Sarecycline
- Scopolamine
- Segesterone Acetate; Ethinyl Estradiol
- Selpercatinib
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Simeprevir
- Siponimod
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Solifenacin
- Sorafenib
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sunitinib
- Tacrolimus
- Tamoxifen
- Tapentadol
- Telaprevir
- Telavancin
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Terbinafine
- Terbutaline
- Teriflunomide
- Testosterone
- Tetrabenazine
- Tezacaftor; Ivacaftor
- Thioridazine
- Ticagrelor
- Ticlopidine
- Tiotropium; Olodaterol
- Tipranavir
- Tolterodine
- Topiramate
- Toremifene
- Trametinib
- Trandolapril; Verapamil
- Trazodone
- Triclabendazole
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimethoprim
- Trimipramine
- Triptorelin
- Tucatinib
- Ulipristal
- Umeclidinium; Vilanterol
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Verapamil
- Voriconazole
- Vorinostat
- Zafirlukast
- Ziprasidone
- Zonisamide
