ロペラミド

使用用途

• Diarrhea
• Diarrhea
• Management of non-specific acute and chronic diarrhoea, and irritable bowel syndrome
• Antidiarrheal (Rabbits)
• Antidiarrheal (Mice, Rats, Gerbils, Hamsters, Guinea pigs, Chinchillas)
• Antidiarrheal
• Antidiarrheal
• Antidiarrheal
• Adjunctive treatment for diarrhea associated with chemotherapy
• Antidiarrheal
• Antidiarrheal
• Management of non-specific acute and chronic diarrhoea, and irritable bowel syndrome

投与方法

考えられる副作用

• Constipation
• Bloat
• Sedation
• Paralytic ileus
• Toxic megacolon
• Pancreatitis
• CNS depression (especially in MDR1-mutant dogs)
• Excitatory behavior (cats)
• Excitability (especially in cats)
• Profound sedation and ataxia (in MDR1 mutant dogs)

注意事項と禁忌

• Dogs tested positive for the ABCB1-1Δ (MDR1) mutation
• Untested dogs of herding breeds susceptible to the MDR1 mutation
• Diarrhea caused by toxic ingestion (until the toxin is eliminated)
• Known hypersensitivity to narcotic analgesics
• Infectious enteritis (relative contraindication, as decreased motility can delay pathogen clearance)
• Intestinal obstruction
• Dogs likely to be ivermectin-sensitive (MDR1/ABCB1 mutation, e.g., Collies, Australian Shepherds)
• Infectious enteritis (where decreased motility may delay pathogen clearance)
• Toxigenic diarrhea
• Use with caution in patients with **hypothyroidism, severe renal insufficiency, adrenocortical insufficiency (Addison's disease)**, and in geriatric or severely debilitated patients. Use with extreme caution in patients with **head injuries or increased intracranial pressure**, as well as acute abdominal conditions (e.g., colic), as opiates may obscure the diagnosis or clinical course. Use with extreme caution in patients suffering from **respiratory disease** or acute respiratory dysfunction (e.g., pulmonary edema secondary to smoke inhalation). Use with extreme caution in patients with **hepatic disease** exhibiting CNS clinical signs of hepatic encephalopathy, as hepatic coma may result. **Small Patient Dosing:** Many clinicians recommend avoiding tablet/capsule forms in dogs weighing less than 10 kg due to potency; dosage titration using liquid forms is recommended for safe use.

薬物相互作用

• Amiodarone: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Carvedilol: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Erythromycin: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Ketoconazole: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Itraconazole: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Quinidine: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Tamoxifen: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Verapamil: Inhibits P-glycoprotein (P-gp), which may increase loperamide plasma concentrations and risk of CNS toxicity.
• Other antimotility drugs: Additive reduction in GI motility, increasing risk of ileus
• P-glycoprotein inhibitors (e.g., ketoconazole, cyclosporine, spinosad): May increase CNS penetration of loperamide, leading to neurotoxicity
• CNS depressants: Additive sedation if loperamide crosses the blood-brain barrier

よくある質問