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.
What Is Loperamide (Imodium) And How Does It Work?
Loperamide belongs to a group of drugs known as antidiarrheals. The medication 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. Know more about the causes of diarrhea during pregnancy
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.
Is It Safe To Take Loperamide When Pregnant?
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 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?
Usually, 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
- Infectious diarrhea
- Impaired metabolism
- Diarrhea against ileostomy (surgery made to open the belly)
How To Take Loperamide During Pregnancy?
Your doctor might prescribe loperamide 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.
Possible Side-effects Of Loperamide In Pregnancy
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 cramping, constipation, nausea, and vomiting.
- You may also feel dizzy, drowsy, fatigued, have blurred vision, restlessness, and a headache.
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 the fetus) 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 women taking loperamide are 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 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.
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 health.
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).
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.
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
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Dr. Mona Hardas(MD)
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