Is it possible or not to take loperamide while breastfeeding?

Many people doubt whether Loperamide can be taken while breastfeeding (BF). Some experts assure that the medicine is absolutely safe for infants, others assure that taking Loperamide during lactation is strictly prohibited. What to do, who to believe? Let's figure it out.

Basic information

Loperamide is a drug of the opiate class, similar in structure to cphenylpiperidines and the painkillers fentanyl and pyritramide. It has an inhibitory effect on intestinal peristalsis (motility), but does not provide a pronounced analgesic effect.

Loperamide has been known since 1973 under the trade name Imodium. Later, liquid forms of this drug appeared on the pharmacological market: syrup and drops. Now on pharmacy counters you can see a great many analogs of Imodium: Loperamide, Lopedium, Diara, Superilop, Enterobene, etc.

In Russia, Loperamide is included in the WHO List of Essential Medicines and is almost the main component of any home medicine cabinet, along with activated carbon and analgin.

Pharmacodynamics

Due to the effect of Loperamidine on the opioid receptors of the nervous system, there is a significant decrease in intestinal contractility and a slowdown in the movement of feces. At the same time, the flow of fluid into the lumen of the intestinal tube is reduced, and the feces thicken. The tone of the anal sphincter increases, feces are retained, and the urge to defecate stops.

Pharmacokinetics

Only 40% of the active substance is absorbed in the gastrointestinal tract, after which almost all of this volume binds to blood albumin. Loperamide does not penetrate the blood-brain barrier (the physiological boundary between the circulatory system and the central nervous system), and therefore does not have a pronounced analgesic effect. The drug undergoes breakdown in the liver, and is excreted from the body mainly with bile through the intestines, and only a small part of it is excreted through the kidneys.

Indications

Loperamide is prescribed in the following cases: Important! Loperamide is not recommended for use during breastfeeding due to the lack of necessary clinical trials. Therefore, to the question “is it possible to take Loperamide while breastfeeding,” experts answer this way: only if the benefit of treatment for the mother outweighs the risk of possible consequences for the child.

Directions for use and doses

For adults, the drug is prescribed once in the amount of 2 tablets. at the appointment, then 1 tablet. after each bowel movement (if diarrhea continues), but not more than 8 tablets per day.

Instructions for Loperamide during lactation do not differ from the rules of administration for adults. However, some women prefer to take tablets according to the children's regimen: 1 tablet. after each case of diarrhea (maximum 3 tablets per day).

So, if Loperamide can be taken while breastfeeding, then only under the supervision of a doctor. And during the treatment period, it would be even better to play it safe so as not to harm the baby’s health, and replace mother’s milk with formula.