Absolute contraindications:
(1) anaphylactic reaction to loperamide or an excipient
Relative contraindication:
(1) age < 3 years (some use < 2 years)
(2) acute dysentery (fever, bloody diarrhea)
(3) bacterial enterocolitis (Salmonella, Shigella, Campylobacter)
(4) pseudomembranous enterocolitis (E. coli O157)
(5) Clostridium difficile disease
(6) ulcerative colitis or Crohn’s disease
(7) amebic colitis
In conditions with enteric inflammation loperamide may make the condition more severe or may cause toxic megacolon.
Precautions:
(1) hepatic dysfunction (impaired metabolism)
(2) risk factors for ileus
(3) dehydration and/or malnutrition
(4) potential for opioid abuse
