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A RETROSPECTIVE ASSESSMENT OF LOPERAMIDE TOXICITY 2000-2011. Wiles DA, Spiller HA, Russell JL, Casavant MJ

A RETROSPECTIVE ASSESSMENT OF LOPERAMIDE TOXICITY 2000-2011.

Wiles DA, Spiller HA, Russell JL, Casavant MJ

International Journal of Pharmacology & Toxicology Science 2014; 4(2): 1-8

Abstract

Loperamide is an over-the-counter medication which acts on gastrointestinal opiate receptors, reducing GI tract activity, and indicated for control of diarrhea. There is limited data available on the toxicity of loperamide including risk after unintentional ingestion in children. We sought to describe the exposure profile of this medication in a nationwide sample of cases.
Method: Retrospective review of all single substance loperamide human exposures reported to US Poison Control Centers between 2000 and 2011.
Result: There were 11,156 exposures with a mean and median age of 18 and 3 years respectively. Serious outcomes were infrequent: 2 fatalities and 23 major effects (defined as life-threatening signs or symptoms or significant disability or disfigurement) over a 12 year period. We observed 2 deaths, both adults; 23 major outcomes and 219 moderate outcome. One of 23 major effects and 40 of 219 moderate effects (defined as prolonged, or systemic signs or symptoms, usually requiring treatment) were children <6 years.
Conclusion: Serious medical outcome after loperamide exposure is extremely unlikely and hospital referral may not be warranted unless there is history of intentional self-harm, misuse and/or a large exposure. Exploratory exposures by children > 6mos old may be safely monitored at home.

Key words: Antidiarrheal, loperamide, poison control, toxicology.
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