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
General Medical Council effect by order of the Privy Council on 3 December 2012. Due to the principle of autonomy and law of consent there is no legislative restriction on who can treat patients or provide medical or health-related services. In other words, it is not a criminal offence to provide what would be considered medical assistance or treatment to another person – and not just in an emergency. This is in contrast with the position in respect of animals, where it is a criminal offence under the Veterinary Surgeons Act 1966 for someone who is not a registered veterinary surgeon (or in