📋 Indications & Clinical Dosage
*Symptomatic treatment of acute diarrhoea:*
Adults & Children above 12 yrs: Initially 4 mg, followed by 2 mg for up to 5 days, after each loose stool, usual dose 6-8 mg daily; max. 16 mg per day
Children 4-7 years: 1 mg 3-4 times a day for up to 3 days only;
8-11 years: 2 mg 4 times a day for up to 5 days;
*Chronic diarrhoea:*
Adult: Initially 4-8 mg daily in divided doses, adjusted according to response; maintenance up to 16 mg daily in 2 divided doses.
*Faecal incontinence:*
Adult: Initially 500 mcg daily, adjusted according to response, max. daily dose to be given in divided doses, 16 mg per day
*Pain of bowel colic in palliative care:*
Adult: 2-4 mg 4 times a day
⛔ Contraindications
Conditions where inhibition of peristalsis should be avoided, acute ulcerative colitis, pseudo membranous colitis, abdominal disten-sion.
⚠️ Precautions & Warnings
Acute dysentery, hepatic impairment, children below 12 years.
⚠️ Adverse Reactions / Side Effects
Dizziness, flatulence, headache, nausea, abdominal pain, drowsiness, dry mouth, dyspepsia, rash, vomiting. Rare: fatigue, hypertonia, paralytic ileus, Stevens-Johnson syndrome, toxic epidermal necrolysis, urinary retention.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Advised to avoid
Lactation / Breastfeeding:
Advised to avoid
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.