MIRATON Capsule Ref.[28277] Active ingredients: Loperamide

Source: Υπουργείο Υγείας (CY)  Revision Year: 2020  Publisher: Codal-Synto Ltd, 21 Constantinoupoleos , 3011 Limassol, Cyprus

4.1. Therapeutic indications

For the symptomatic treatment of acute diarrhoea in adults and children aged 12 years and over. For the symptomatic treatment of acute episodes of diarrhoea associated with Irritable Bowel Syndrome in adults aged 18 years and over following initial diagnosis by a doctor.

4.2. Posology and method of administration

Posology

Acute diarrhoea

Adults and children over 12: Two capsules (4mg) initially, followed by one capsule (2mg) after each loose stool. The usual dose is three to four (6-8 mg) capsules a day. The total daily dose should not exceed 6 capsules (12 mg).

Symptomatic treatment of acute episodes of diarrhoea associated with irritable bowel syndrome in adults aged 18 years and over

Two capsules (4 mg) to be taken initially, followed by 1 capsule (2 mg) after every loose stool, or as previously advised by your doctor. The maximum daily dose should not exceed 6 capsules (12 mg).

Paediatric population

Loperamide is contraindicated in children less than 12 years of age.

Elderly

No dose adjustment is required for the elderly.

Hepatic impairment

Although no pharmacokinetic data are available in patients with hepatic impairment, loperamide should be used with caution in such patients because of reduced first pass metabolism (see section 4.4).

Renal impairment

No dose adjustment is required for patients with renal impairment.

Method of administration

For oral administration only. The capsules should be taken with liquid.

4.9. Overdose

Symptoms

In case of overdose (including relative overdose due to hepatic dysfunction), CNS depression (stupor, coordination abnormality, somnolence, miosis, muscular hypertonia and respiratory depression), constipation, urinary retention and ileus may occur. Children and patients with hepatic dysfunction may be more sensitive to CNS effects.

In individuals who have ingested overdoses of loperamide, cardiac events such as QT interval and QRS complex prolongation, torsades de pointes, other serious ventricular arrhythmias, cardiac arrest and syncope have been observed (see section 4.4). Fatal cases have also been reported. Overdose can unmask existing Brugada syndrome.

Management

If symptoms of overdose occur, naloxone can be given as an antidote. Since the duration of action of loperamide is longer than that of naloxone (1 to 3 hours), repeated treatment with naloxone might be indicated. Therefore, the patient should be monitored closely for at least 48 hours in order to detect possible CNS depression.

6.3. Shelf life

5 years.

6.4. Special precautions for storage

Store below 25°C in the original package, in order to protect from light and moisture.

6.5. Nature and contents of container

Blister boxes with 10 capsules.

6.6. Special precautions for disposal and other handling

Not applicable.

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