Is Loperamide Hydrochloride compatible with breastfeeding? Do we have alternatives for Loperamide Hydrochloride?

Loperamide Hydrochloride

March 22, 2018 (Very Low Risk)

Opioid drug derived from pethidine.
Contraindicated for those children younger than 2 year old.
Indiscriminate use for treatment of gastroenteritis is not justified. Most acute diarrheic disorders are self-limijted conditions. WHO’s Oral Rehydration Solutions and appropriate nutritional support are recommended.

Excreted into breast milk in non-significant levels. Its low oral bioavailability makes it difficult to acceed the infant serum.

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Alternatives

We do not have alternatives for Loperamide Hydrochloride since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Loperamide Oxide

Writings

  • Λοπεραμίδη υδροχλωρική (Greek)
  • Лоперамида Гидрохлорид (Cyrillic)
  • ロペラミド塩酸塩 (Japanese)
  • C29 H33 ClN2 O2, HCl (Molecular formula)
  • 4-(4-p-Chlorophenyl-4-hydroxypiperidino)-NN-dimethyl-2,2-diphenylbutyramide hydrochloride (Chemical name)
  • A07DA03 (ATC Code/s)

Drug trade names

References

  1. Regnard C, Twycross R, Mihalyo M, Wilcock A. Loperamide. J Pain Symptom Manage. 2011Abstract Full text (in our servers)
  2. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010Abstract Full text (link to original source) Full text (in our servers)
  3. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  4. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  5. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000Abstract
  6. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998Abstract
  7. Nikodem VC, Hofmeyr GJ. Secretion of the antidiarrhoeal agent loperamide oxide in breast milk. Eur J Clin Pharmacol. 1992Abstract