Loperamide During Pregnancy: Its Safety and Effects

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Loperamide During Pregnancy

Loperamide is available under the brand name Imodium and is used for treating acute diarrhea and irritable bowel syndrome (1)

. However, you should check with a doctor before taking Loperamide during pregnancy. Although diarrhea may cause discomfort and nutritional deficiencies in pregnant women, taking Loperamide unsupervised is not advisable. The medication may also be used after intestinal surgery for regulating bowel activity. This post discusses the safety of taking Loperamide when pregnant, its risks, and possible side effects.

In This Article

Key Pointers

  • Loperamide is used for treating diarrhea and IBS and should only be taken during pregnancy if prescribed by a doctor.
  • It is available in the form of liquid, tablets, and capsules.
  • Pregnant women should strictly follow the instructions given by the doctor regarding the use and dosage of loperamide.
  • Some side effects associated with loperamide intake are headache, vomiting, blurred vision, dizziness, fatigue, and abdominal cramps.
  • Pregnant women should tell their medical practitioner about any pre-existing conditions and medications they consume to avoid adverse outcomes due to drug interactions.

What Is Loperamide (Imodium) And How Does It Work?

Loperamide is used to treat diarrhea

Image: Shutterstock

Loperamide belongs to a group of drugs known as antidiarrheals. This opioid receptor agonist is used to treat short bouts of diarrhea, and could also be prescribed to treat IBS. It is available under different brand names – Imodium, Imodium Advanced, Pepto Diarrhea Control, Diocalm Ultra, Diar-aid, K-Pek II, Imotil, Vaprino, Entrocalm Loperamide, and more (2).

Diarrhea is a condition of loose and watery stools or a frequent urge to pass stools. It is common during pregnancy due to hormonal changes, suppression of the immune system, and food sensitivity.

Loperamide acts by slowing the intestinal mobility, reducing the water and electrolyte movement, and thus increasing the transit time of stool in the intestine. It also increases the anal sphincter tone (ability to control), thereby reducing the inconsistency and urgency to empty the bowel. But can you take Imodium while pregnant? Read on to know more.

Is It Safe To Take Loperamide When Pregnant?

Take loperamide only upon prescription

Image: Shutterstock

Do not take loperamide during pregnancy unless the doctor prescribes it based on the severity of diarrhea and the stage of gestation. Your doctor will prescribe the drug only if the potential benefits outweigh the risks.

You should not self-medicate to treat diarrhea during pregnancy. Your healthcare provider is the best person to decide what is right for you and your baby.

Under Which Pregnancy Category Does Loperamide Fall?

The US FDA has categorized loperamide under the pregnancy C category (3). Medications are usually classified into A, B, C, D, and E based on their safety during pregnancy. Categorization under the C class means that the drug has been tested only on animals and there are no adequate and well-controlled studies in humans. However, the drug may be prescribed to pregnant women if the potential benefits outweigh the potential risks (4).

When Is Loperamide Prescribed For Pregnant Women?

A doctor may prescribe loperamide in case of severe diarrhea

Image: Shutterstock

Usually, gastrointestinal symptoms such as common diarrhea can be addressed with some dietary changes for a day or two. But if you have severe diarrhea with abnormal urine and stools, then visit your doctor. Your doctor may prescribe the medication in the cases of:

  • Acute or chronic allergic diarrhea
  • Digestive issues
  • Gastrointestinal tract disorders or gut health issues
  • Infectious diarrhea
  • Impaired metabolism
  • Diarrhea against ileostomy (surgery made to open the belly)

How To Take Loperamide During Pregnancy?

Take the recommended dosage of medicine

Image: Shutterstock

Your doctor might prescribe loperamide for diarrhea treatment if they see the need for it. You should strictly follow their instructions on the dosage and usage of the drug. Loperamide is available as capsules, tablets, oral liquid medicine, or chewable tablets. However, the Imodium brand is available only as a chewable medicine.

Note that loperamide is not a substitute for dehydration caused during diarrhea; it only reduces the frequency of bowel movements. Therefore, you need to have lots of liquids and stay hydrated (3). If the symptoms persist for more than two days, visit your doctor again.

Also, you should consult the doctor if you have skin rashes or any other adverse reactions after taking loperamide.

protip_icon Caution
Individuals with acute dysentery (which causes blood in stools and high fever) or acute ulcerative colitis should avoid loperamide (3).

Possible Side-effects Of Loperamide In Pregnancy

Consuming loperamide during pregnancy may have side effects

Image: Shutterstock

When taking Imodium/ loperamide, you may have certain side effects, which might subside as your body adjusts to the medication. Here are a few of the possible side-effects (5):

  • Abdominal pain or stomach pain, constipation, nausea, and vomiting.
  • You may also feel dizzy, drowsy, fatigued, have blurred vision, restlessness, and a headache.
protip_icon Be watchful
Do not exceed the prescribed dose of loperamide. An overdose may result in adverse cardiac, CNS, and respiratory reactions (3).

What If You Have Been Already Using Loperamide When You Are Pregnant?

If you are taking this medication and know about your pregnancy only later, you should tell your healthcare provider about it. They will decide whether you still require the medication or not and in what dosage.

Can Taking Loperamide Cause Birth Issues In Your Baby?

According to the US FDA, teratology (effects on fetus development) studies on rats and rabbits have not shown any evidence of harmful effects on the fetus (3).

However, a small study in Sweden has found a “moderate increase of risk for a malformation in the infant” if the mother took loperamide in early pregnancy (6).

There is also no solid scientific affirmation that fetal exposure to loperamide is likely to have preterm labor, miscarriage, or a low birth weight baby.

Caution While Taking Loperamide/ Imodium

You should not take loperamide without a doctor’s prescription. Also, take the following precautions:

  • Do not take more than the prescribed amount of the drug.
  • Let your doctor know if you are taking any other obstetric medicines and check their suitability with this medication.
  • Let your doctor know if you have a history of cardiac disturbances.
  • If you have any queries regarding the medication, talk to your doctor.

protip_icon Caution
Avoid driving or using a tool or machine if you feel tired or sleepy when on loperamide (3).

A final note: You can take loperamide during pregnancy only if your doctor strongly feels that the drug will benefit you. You cannot self-medicate as it might have some unwanted effects on your maternal health and fetal development.

Frequently Asked Questions

1. How long does it take for loperamide to work?

Loperamide usually starts working within one hour (7).

2. Is there any risk to my baby if the father has taken loperamide?

There is no risk to the baby if the father has taken loperamide before or around your pregnancy (8).

3. Can taking loperamide cause behavioral or learning issues in my child?

Yes. Since your baby’s brain development continues till the end of pregnancy, it may be possible that taking loperamide at any stage causes behavioral or learning issues in your child. However, no studies have found that loperamide has adversely affected the learning and behavior of the child (8).

4. What if I was already on loperamide before pregnancy?

Taking loperamide during pregnancy for some time may not affect your baby’s well-being. However, if you have been taking loperamide for a long time due to illness, you should discuss it with your doctor (8).

5. How long does 2mg of loperamide last?

The half-life (time for a drug to reduce to half of its concentration in blood) of loperamide ranges from nine to 14 hours. It takes about four to five times this duration for the drug to get completely eliminated from the body (3) (9).

6. How much loperamide is toxic?

The toxic loperamide dose during pregnancy is not known. However, the maximum human dose of loperamide per day should not exceed 12mg (six units of 2mg each) (10). It is advisable to strictly adhere to the dose prescribed by your doctor.

7. What are some home remedies for treating diarrhea during pregnancy without using loperamide?

Eating a bland diet, known as the BRAT diet, which includes bananas, applesauce, rice, and toast, can help soothe your stomach and firm up stools. Avoid fatty, spicy, or high-fiber foods to reduce symptoms and support recovery. It’s also important to stay hydrated, so drink plenty of water, clear broths, or drinks that replace electrolytes to prevent dehydration. Including probiotic foods like yogurt may help your gut recover from diarrhea (11).

8. What should I do if I have side effects from loperamide during pregnancy?

If you experience side effects from taking Loperamide (Imodium) while pregnant, you should consult your healthcare provider immediately. Be sure to follow their dosage instructions and let them know about any unusual symptoms. They can assess your condition and decide on the safest approach for you and your baby.

Loperamide is a commonly used medicine for diarrhea. Expectant mothers who are experiencing diarrhea may question if it is safe to take loperamide during pregnancy. Loperamide should not be used during pregnancy without your doctor’s consent. The safety of loperamide during pregnancy is tested only on animals and not on humans. Your doctor will prescribe the drug only if the benefits outweigh the risks. If your doctor has prescribed the medication, make sure you take it solely as recommended by your doctor.

Infographic: Possible Side Effects Of Loperamide In Pregnancy

Your doctor may have advised you to take loperamide during pregnancy for medical reasons. Still, this drug may cause notable side effects in pregnant women, some of which are listed in the infographic below.

common adverse effects of loperamide during pregnancy (infographic)

Illustration: Momjunction Design Team

Illustration: Is It Safe To Take Loperamide During Pregnancy?

Loperamide During Pregnancy_illustration

Image: Dall·E/MomJunction Design Team

Medications like loperamide may be a known prescription for diarrhea. However, is it safe for the baby? Learn more about this drug with the following video.

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Hanauer SB; The role of loperamide in gastrointestinal disorders; US National Library of Medicine National Institutes of Health.
2. Loperamide; U.S National Library of Medicine.
3. Imodium Capsules; U.S Food & Drug Administration (2016)
4. FDA pregnancy categories; Chemical Hazards Emergency Medical management, U.S. Department of Health & Human Services
5. Loperamide (gastro-stop, imodium, lopedium, gastrex, diareze, diacare); St Vincent’s Hospital Melbourne
6. Bengt Källén, Emma Nilsson, and Petra Otterblad Olausson; Maternal use of loperamide in early pregnancy and delivery outcome; Acta Pediatrica
7. Loperamide; NHS
8. Loperamide; Medicines in Pregnancy
9. Jericho Hallare and Valerie Gerriets; Half Life; national Library of Medicine
10. Imodium Original 2mg Capsules; Electronic Medicines Compendium, UK
11. What To Eat When You Have Diarrhea; Cleveland Clinic


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Dr. Mona Hardas is a practicing Ob/Gyn from Flint, Michigan, with over 20 years of experience in private practice. She is also actively involved in teaching medical students and residents as an associate clinical professor from MSU College of Human Medicine.

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Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company.

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Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Dr. Joyani Das
Dr. Joyani DasM.Pharm, PhD
Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

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