Loperamide have negative effects from rebound constipation. If a suspicion exists of diarrhea associated with organisms that can penetrate the intestinal walls, such as or "Salmonella", loperamide is contraindicated as a primary treatment. Loperamide treatment is not used in symptomatic "C. difficile" infections, as it increases the risk of toxin retention and precipitation of toxic megacolon. Loperamide should be administered with caution to people with liver failure due to reduced first-pass metabolism. Additionally, caution should be used when treating people with advanced HIV, as cases of both viral and bacterial toxic megacolon have been reported. If abdominal distension is noted, therapy
Medical certificate for certain legal procedures. Medical certificates are used to indicate eligibility of activity, such as the use of disabled parking. Medical certificates can also be used to describe a medical condition a person has, such as blindness. Medical certificates are often used to certify that someone is free of contagious diseases, drug addiction, mental illness, or other health issues. Health criteria are often required when making an application for something, such as an eye examination to get a driver's license. Other times medical criteria are presented voluntarily by an applicant in a self-assessment, without either a doctor or access to