Loperamide/simethicone Loperamide/simethicone Loperamide/simethicone is combination medication marketed under the trade name Imodium Multi-Symptom Relief (formerly Imodium A-D Advanced) used to treat diarrhea and gas simultaneously. It is manufactured by the McNeil Consumer Healthcare Division of McNeil PPC, Inc. Loperamide is a μ-opioid receptor agonist that works in the intestines. Although it is an opioid, it has no effects on the central nervous system. It reduces diarrhea by slowing the transit time of contents through the intestinal tract thereby allowing more water to be reabsorbed from the intestinal lumen. Simethicone reduces gas by allowing smaller gas bubbles to coalesce into larger bubbles
Loperamide with loperamide should be discontinued. The use of loperamide in children under 2 years is not recommended. Rare reports of fatal paralytic ileus associated with abdominal distention have been made. Most of these reports occurred in the setting of acute dysentery, overdose, and with very young children less than 2 years of age. A review of loperamide in children under 12 years old found that serious adverse events occurred only in children under 3 years old. The study reported that the use of loperamide should be contraindicated in children who are under 3, systemically ill, malnourished, moderately dehydrated, or have