Acute Diarrhoea

NHSL Medicines Guidance
NHS Lanarkshire

Antimotility Drugs

Preferred list (P)

LOPERAMIDE capsules

 

Total list (T)

CO-PHENOTROPE tablets

  • PLEASE NOTE CO-PHENOTROPE IS NOW ONLY AVAILABLE AS AN UNLICENSED PREPARATION

Prescribing Notes:

  • Oral rehydration therapy should be considered to replace fluid and electrolyte loss in diarrhea. This is listed in Chapter 9. Nutrition and Blood: Fluids and Electrolytes.

  • Antidiarrhoeal drugs should not be given in acute inflammatory bowel disease or pseudomembranous colitis, as they may increase the risk of developing toxic megacolon, nor in acute infective diarrhoea with bloody stools. Adsorbents such as kaolin are not recommended.

Older Patients - Antidiarrhoeal drugs

Older patients with acute or prolonged diarrhoea are particularly likely to require fluid replacement.  Faecal impaction can give rise to “overflow diarrhoea” and must be excluded before antidiarrhoeals are started.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.