What happens if I overdose Lbx?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Symptoms may include decreased urination; nausea; severe constipation or drowsiness; vomiting.
Proper storage of Lbx:
Store Lbx at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Lbx out of the reach of children and away from pets.
Overdose of Lbx in details
In cases of overdosage, (including relative overdose due to hepatic dysfunction), urinary retention, paralytic ileus and CNS depression may occur. Children may be more sensitive to CNS effects than adults. Clinical trials have demonstrated that a slurry of activated charcoal administered promptly after ingestion of Lbx hydrochloride can reduce the amount of drug which is absorbed into the systemic circulation by as much as ninefold. If vomiting occurs spontaneously upon ingestion, a slurry of 100 grams of activated charcoal should be administered orally as soon as fluids can be retained.
If vomiting has not occurred, gastric lavage should be performed followed by administration of 100 grams of the activated charcoal slurry through the gastric tube. In the event of overdosage, patients should be monitored for signs of CNS depression for at least 24 hours.
If symptoms of overdose occur, naloxone can be given as an antidote. If responsive to naloxone, vital signs must be monitored carefully for recurrence of symptoms of drug overdose for at least 24 hours after the last dose of naloxone.
In view of the prolonged action of Lbx and the short duration (one to three hours) of naloxone, the patient must be monitored closely and treated repeatedly with naloxone as indicated. Since relatively little drug is excreted in the urine, forced diuresis is not expected to be effective for Lbx hydrochloride overdosage.
In clinical trials an adult who took three 20 mg doses within a 24 hour period was nauseated after the second dose and vomited after the third dose. In studies designed to examine the potential for side effects, intentional ingestion of up to 60 mg of Lbx hydrochloride in a single dose to healthy subjects resulted in no significant adverse effects.
What should I avoid while taking Lbx?
Lbx may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you are taking an antibiotic and you have diarrhea that is watery or has blood in it, call your doctor. Do not use Lbx to stop the diarrhea unless your doctor has told you to.
Lbx warnings
You should not use this medication if you are allergic to Lbx, or if you have stools that are bloody, black, or tarry, or if you have diarrhea that is caused by taking an antibiotic.
Before taking Lbx, tell your doctor if you are allergic to any drugs, or if you have a fever, mucus in your stools, a history of liver disease, or if you are taking an antibiotic.
Drink extra water while you are taking this medication to keep from getting dehydrated. It may take up to 48 hours of taking Lbx before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 10 days of treatment. Lbx can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Lbx passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 2 years old without the advice of a doctor.
Lbx can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor’s instructions about the type and amount of liquids you should drink.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use Lbx to stop the diarrhea unless your doctor has told you to.
What should I discuss with my healthcare provider before taking Lbx?
Some medical conditions may interact with Lbx. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have bloody diarrhea; mucus in your stool; fever; bowel problems (eg, inflammation, blockage, enlarged colon); or diarrhea caused by food poisoning, antibiotic use, or bacterial infection.
- if you have AIDS or liver problems
- if you are taking an antibiotic
Some MEDICINES MAY INTERACT with Lbx. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Disulfiram, furazolidone, or metronidazole because a severe reaction, including nausea, vomiting, flushing, and fast or irregular heartbeat, may occur
- Quinidine or ritonavir because they may increase the risk of Lbx's side effects
- Saquinavir because its effectiveness may be decreased by Lbx
This may not be a complete list of all interactions that may occur. Ask your health care provider if Lbx may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Lbx precautions
In patients with diarrhea, especially in children, fluid and electrolyte depletion may occur. In such cases, administration of appropriate fluid and electrolyte replacement therapy is the most important measure. Lbx should not be given in children <6 years without medical prescription and supervision.
In acute diarrhea, if clinical improvement is not observed within 48 hrs, the administration of Lbx should be discontinued and patients should be advised to consult their physician.
Patients with AIDS treated with Lbx for diarrhea should have their therapy stopped at the earliest signs of abdominal distension. There have been isolated reports of toxic megacolon in AIDS patients with infectious colitis from both viral and bacterial pathogens treated with Lbx.
Although no pharmacokinetic data are available in patients with hepatic impairment, Lbx should be used with caution in such patients because of reduced first-pass metabolism. Patients with hepatic dysfunction should be monitored closely for signs of CNS toxicity.
Since majority of the drug is metabolized, and metabolites or the unchanged drug is excreted in the feces, dose adjustments in patients with a kidney disorder are not required.
Effects on the Ability to Drive or Operate Machinery: Tiredness, dizziness or drowsiness may occur in the setting of diarrheal syndromes treated with Lbx. Therefore, it is advisable to use caution when driving a car or operating machinery.
Use in pregnancy & lactation: Although there are no indications that Lbx possesses teratogenic or embryotoxic properties, the anticipated therapeutic benefits should be weighed against potential hazards before Lbx is given during pregnancy, especially during the 1st trimester.
Small amounts of Lbx may appear in human breast milk. Therefore, Lbx is not recommended during breastfeeding.
What happens if I miss a dose of Lbx?
Since Lbx is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DrugBank. "loperamide". http://www.drugbank.ca/drugs/DB00836 (accessed September 17, 2018).
- MeSH. "Antidiarrheals". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
