Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Imodium Multi-Symptom Relief
Synonyms :
loperamide/simethicone
Class :
Antidiarrheals
Brand Name :
Imodium Multi-Symptom Relief
Synonyms :
loperamide/simethicone
Class :
Antidiarrheals
Dosage forms and strengths
Tablets
2 mg/125 mg-(loperamide/simethicone)
Administer a single dose of loperamide/ simethicone 4 mg/250 mg by oral route after the initial occurrence of loose stool
Subsequently, provide a single dose of loperamide/ simethicone 2 mg/125 mg by oral route after every further episode of loose stool
The recommended maximum dose is loperamide/ simethicone 8 mg/500 mg within 24 hours
Therapy should not exceed two days
Dosage forms and strengths
Tablets
2 mg/125 mg-(loperamide/simethicone)
Dosing based on Age-
Age six-eight: Administer loperamide/ simethicone 2 mg/125 mg by oral route as an initial dose following the initial episode of loose stool, and subsequently administer loperamide/simethicone 1mg/62.5 mg by oral route following every further episode of loose stool
The recommended maximum dose is loperamide/ simethicone is 4 mg/250 mg within a 24 hours
Therapy should not exceed two days
Age nine-eleven: Administer loperamide/ simethicone 2 mg/125 mg by oral route as an initial dose following the initial episode of loose stool, and subsequently administer loperamide/simethicone 1 mg/62.5 mg by oral route following every further episode of loose stool
The recommended maximum dose is loperamide/ simethicone is 6 mg/375 mg within a 24 hours
Therapy should not exceed two days
Age12 years and older-
Administer loperamide/ simethicone 4 mg/250 mg by oral route as an initial dose following the initial episode of loose stool, and subsequently administer loperamide/ simethicone 2 mg/125 mg by oral route following every further episode of loose stool
The recommended maximum dose is loperamide/ simethicone 8 mg/500 mg within a 24 hours
Therapy should not exceed two days
Dosing based on weight
Weight 21.8-26.8 kg-Administer loperamide/ simethicone 2 mg/125 mg by oral route as an initial dose following the initial episode of loose stool, and subsequently administer loperamide/ simethicone 1 mg/ 62.5 mg by oral route following every further episode of loose stool
The recommended maximum dose is loperamide/ simethicone 4 mg/250 mg within a 24 hours
Therapy should not exceed two days
Weight-27.3 -43.2 kg-Administer loperamide/ simethicone 2 mg/125 mg by oral route as an initial dose following the initial episode of loose stool, and subsequently administer loperamide/ simethicone 1 mg/62.5 mg by oral route following every further episode of loose stool
The recommended maximum dose is loperamide/ simethicone 6 mg/375 mg within a 24 hours
Therapy should not exceed two days
Refer adult dosing
Actions and Spectrum
loperamide:
Action:
loperamide primarily acts on the opioid receptors located in the intestinal wall. It directly affects the smooth muscle of the gastrointestinal tract, particularly in the intestines.
Spectrum:
loperamide is primarily indicated for the symptomatic relief of acute and chronic diarrhea. It is commonly used to manage diarrhea caused by various factors, including viral or bacterial infections, food poisoning, and certain gastrointestinal conditions.
simethicone:
Action:
simethicone is an anti-gas agent that alters  the surface tension of gas bubbles in the gastrointestinal tract. It reduces the surface tension, allowing the gas bubbles to combine and form larger bubbles, which are easier to pass through the intestines or be expelled as belching.
Spectrum:
simethicone alleviates symptoms associated with excessive gas in the digestive system, such as bloating, flatulence (gas), and discomfort caused by trapped gas. Medications often include it to relieve symptoms related to indigestion, heartburn, and other gastrointestinal conditions that may cause gas buildup.
Abdominal pain
Nausea
Pancreatitis
Vomiting
Dry mouth
Headache
Diarrhea
Dizziness
Abdominal pain
Fatigue
Black Box Warning:
Combining loperamide and simethicone with specific medications can potentially increase the risk of experiencing cardiac issues.
Contraindication/Caution:
loperamide:
Allergy or hypersensitivity: If you have a known allergy or hypersensitivity to loperamide or any of its components, you should not take this medication.
Bacterial enterocolitis: loperamide is not recommended for individuals with diarrhea caused by bacterial infections like clostridium difficile-associated diarrhea or enterotoxin-producing bacteria.
Intestinal obstruction: loperamide should be avoided in individuals with suspected or confirmed intestinal obstruction, as it can delay the diagnosis by suppressing symptoms and may worsen the condition.
simethicone:
Allergy or hypersensitivity: If you have a known allergy or hypersensitivity to simethicone or any of its components, you should avoid using this medication.
Suspected intestinal perforation: simethicone should not be used if there is a suspicion of intestinal perforation or if you have a history of gastrointestinal perforation.
Pregnancy warnings:Â Â Â
Pregnancy category: N/A
Lactation:Â Excreted into human milk: Yes (loperamide); No (simethicone)
Pregnancy Categories:
Category A:Â Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.
Category C:Â there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D:Â adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X:Â Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N:Â There is no data available for the drug under this category
Pharmacology:
loperamide and simethicone are medications often combined in specific formulations for treating diarrhea and associated symptoms.
Pharmacodynamics:
loperamide:
loperamide is an opioid receptor agonist that primarily acts on the mu-opioid receptors in the gastrointestinal (GI) tract.
simethicone:
simethicone is a drug known for its ability to diminish the surface tension of gas bubbles within the gastrointestinal (GI) tract, thereby functioning as an effective anti-foaming agent.
Pharmacokinetics:
Absorption
loperamide: It is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 2 to 3 hours after oral administration.
simethicone: It is not absorbed systemically from the gastrointestinal tract and acts locally to reduce gas and bloating.
Distribution
loperamide: is extensively distributed throughout the body, including the central nervous system (CNS). It is highly protein-bound and may cross the blood-brain barrier.
simethicone: Since simethicone is not absorbed systemically, it does not undergo significant distribution in the body.
Metabolism
loperamide: It undergoes extensive first-pass metabolism in the liver, primarily via cytochrome P450 (CYP) enzymes, particularly CYP2C8 and CYP3A4.
simethicone: simethicone is not significantly metabolized in the body.
Excretion and Elimination
loperamide: is primarily excreted in feces, with only a small amount excreted in urine. The elimination half-life of loperamide is around 9 to 14 hours.
simethicone: Since it is not absorbed systemically, it is not excreted significantly.
Administration:Â
The dosage of loperamide can vary depending on the individual and the severity of the diarrhea. It is typically taken orally as directed by a healthcare professional.
simethicone is available in various forms, including tablets, capsules, chewable tablets, and liquid drops. The dosage and frequency of administration may vary depending on the specific product.
Patient information leaflet
Generic Name: loperamide/simethicone
Why do we use loperamide/simethicone?
loperamide:
Diarrhea: loperamide is primarily used to relieve symptoms of diarrhea, including loose stools, frequent bowel movements, and abdominal cramps. It helps to restore normal bowel function and reduce fluid loss.
Traveler’s diarrhea: When traveling to areas with inadequate sanitation or unfamiliar food and water, there is an increased risk of developing traveler’s diarrhea. loperamide can alleviate the symptoms until the underlying cause is resolved.
Irritable bowel syndrome (IBS): loperamide may be prescribed for individuals with IBS to help control episodes of diarrhea, as it can reduce bowel movements and provide relieve from associated discomfort.
simethicone:
Gas and bloating: simethicone is often taken to alleviate symptoms of excess gas, bloating, belching, and flatulence. It helps to break down gas bubbles, reducing discomfort and the feeling of fullness.
Preoperative or diagnostic procedures: simethicone is sometimes given before specific medical procedures, such as abdominal X-rays, to decrease gas in the digestive tract, which can improve the accuracy of the examination.
Infant colic: simethicone drops or preparations may relieve colic symptoms in infants, as it helps reduce gas buildup in their digestive system.
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