Therapeutic Classification: antidiarrheals
Absorption: Not well absorbed following oral administration.
Distribution: Does not cross the blood-brain barrier.
Protein Binding: 97%.
Metabolism/Excretion: Metabolized partially by the liver, undergoes enterohepatic recirculation; 30% eliminated in the feces. Minimal excretion in the urine.
Half-Life: 10.8 hr.
Acute Diarrhea
- PO (Adults and Children ≥12 yr): 4 mg initially, then 2 mg after each loose stool. Maintenance dose usually 4–8 mg/day in divided doses (not to exceed 8 mg/day for OTC use or 16 mg/day for Rx use).
- PO (Children 9–11 yr or 30–47 kg): 2 mg initially, then 1 mg after each loose stool (not to exceed 6 mg/24 hr; OTC use should not exceed 2 days).
- PO (Children 6–8 yr or 24–30 kg): 1 mg initially, then 1 mg after each loose stool (not to exceed 4 mg/24 hr; OTC use should not exceed 2 days).
- PO (Children 2–5 yr or 13–20 kg): 1 mg initially, then 0.1 mg/kg after each loose stool (not to exceed 3 mg/24 hr; OTC use should not exceed 2 days).
Chronic Diarrhea
- PO (Adults ): 4 mg initially, then 2 mg after each loose stool. Maintenance dose usually 4–8 mg/day in divided doses (not to exceed 16 mg/day for Rx use).
- PO (Children ): 0.08–0.24 mg/kg/day divided 2–3 times/day (not to exceed 2 mg/dose).
Reduction of Ileostomy Output
- PO (Adults ): 2 mg 2–3 times daily (tablets or capsules only); may ↑ dose in 2 mg/day increments if output remains elevated (not to exceed 16 mg/day for Rx use).
