Antidiarrhoeal drugs for acute gastroenteritis
Antidiarrhoeal drugs are never indicated for acute diarrhoea in infants and childrenShane, 2017.
In adults with mild or moderate acute diarrhoea, antidiarrhoeal drugs are useful for short-term control of symptoms during periods of social inconvenience (eg travel, work). They are contraindicated in patients with bloody diarrhoea, high fever or systemic symptoms (because these patients may have invasive bacterial infection; see Acute infectious diarrhoea) and in patients with severe ulcerative colitis (because there is a risk of toxic megacolon).
If an antidiarrhoeal drug is appropriate for an adult with acute gastroenteritis, use:
1loperamide 4 mg orally, for the first dose, then 2 mg after each unformed stool up to a maximum of 16 mg per day. loperamide loperamide loperamide
Diphenoxylate+atropine is not recommended because it can cause anticholinergic adverse effects, particularly in older persons.