Advice after your nerve block for surgery
On this page…
What is loperamide hydrochloride
Loperamide is also sold under the brand Imodium®. It is used to treat diarrhea, or overly soft or loose stools.
It comes in different forms; tablets, capsules, melt under the tongue’ orodispersible tablets, and liquid suspension.
As with any drug, please read the information booklet provided with the medication. This leaflet has been produced to provide further guidance on how this medication can be used for someone living with an ileostomy.
Loperamide can be brought over the counter at local pharmacies or can be prescribed by your General Practitioner.
Why is it taken
Loperamide is used to treat episodes of diarrhea and is usually the first choice of medication recommended to help slow down and reduce your ileostomy output.
How does it work
Loperamide is a synthetic opioid medication that acts to slow down the passage of food through the gut. This slows down the contractions of the intestine, allowing more water to be absorbed back into the body. This works to decrease the number of bowel movements and makes the stool less watery.
What dosage should I take
For people living with an ileostomy, it is recommended that they avoid taking capsules as these are slower to absorb. Take loperamide tablets with a glass of water, the ‘melts’ sublingually without a drink and the suspension on its own.
It is best to take loperamide half an hour before each meal. This helps to slow down the activity of the gut that is stimulated by eating. Most people find that the gut is more active in the morning, and in this case the loperamide is best taken before breakfast.
If you have an ileostomy, the amount you need to take will depend on the consistency and frequency of your output. The ideal consistency for an ileostomy is ‘porridge like’ stool.
Often you will be prescribed 4mg TDS (two tablets three times a day). People vary a great deal in their response to loperamide, so you may have to experiment a little to find the dose that works best for you. If you take more than you need your output may become very thick, but if your output remains very watery and overactive you may need to increase your dose.
Up to 16mg (two tablets four times a day) can be taken in a 24-hour period. Loperamide can be increased safely above 16mg in 24hours, however this should be done with the recommendation of your Stoma Care Nurse or GP. Doses should always be started low and gradually increased over a period of several days.
You may need to titrate the dose of loperamide daily to suit your lifestyle and when it is most active. For example, if you have higher output during the night you may want to take a 4mg dose before your evening meal and before bed to slow down the movement of food leading up to the night.
How long will I need to take loperamide for
Loperamide is often advised to take no longer than a month and this is because it is very effective at treating diarrhea in the short term. However, if you are living with an ileostomy you may need to take loperamide for the duration of living with a stoma and it is safe to continue to use the medication for as long as you need. For long term use your GP will need to provide repeat prescriptions. If loperamide does not seem to be having any effect after 2-3 days contact your GP or Stoma Care Nurse.
When should I not take loperamide
If your ileostomy slows down or stops producing, you feel nauseas or having been vomiting we would recommend withholding loperamide and seeking medical attention.
It is unlikely that the medication would cause an ileostomy ‘blockage’, but we would advise the medication to be withheld, sips of water taken and medical advice taken.
Contact details for the Stoma Care Teams.
Frimley Park Team: 0300 6136301
Wexham Park Team: 0300 6153734
Contact us
If you have any queries relating to this information, please contact the Stoma care service.
About this information
Service:
Stoma care
Reference:
H/107
Approval date:
30 January 2026
Review date:
1 June 2028
Click ‘show accessibility tools’ at the bottom of the page
Then click ‘select language’
Alternative formats
You can use the accessibility toolbar at the bottom of your screen to:
-
Change the text size
-
Adjust the font
-
Modify the colour contrast
-
Use the translate function
If you would like this information in another format, such as Braille, audio, or easy read, please speak to a member of staff.
You can also print as well as download as PDF using the “Print this page” button at the end of the page.
Staff will print a copy for you on request
Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.