Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
October 2022
  • Short Bowel Syndrome (dumping)
  • PO
  • Available a 0.2 mg/mL oral solution, or a 2 mg tablet 
  • Tablets may be split and crushed before administration. 
  • Short Bowel Syndrome (dumping): 0.2-1 mg/kg/day, divided q8h. Lowest effective dose should be used.
  • Maximum mg/dose for newborns is not clearly established. A 2 mg/dose max is suggested for infants > 2 months and children for dumping due to intestinal failure/short gut syndrome, however, the potential for adverse effects increase with escalating doses (see Side Effects section)
  • No data available on the safety/dosing for premature infants. 
Side Effects: 
  • Oral absorption is typically poor, therefore the most common side effects are gastrointestinal (constipation, cramping)
  • Other rare side effects (may be related to higher than recommended doses, but some could occur with therapeutic dosing): drowsiness, skin rash, urinary retention, CNS/respiratory depression, paralytic ileus, arrythmia 
Parameters to Monitor: 
  • Stool output
  • Signs of CNS or respiratory depression
  • Use with caution in hepatic impairment
  • Not recommended for routine use to treat diarrhea in infants. Avoid use in patients experiencing bloody stools or severe dehydration. 
  • Litovitz T, Clancy C, Korberly B, Temple AR, Mann KV. Surveillance of loperamide ingestions: an analysis of 216 poison center reports. J Toxicol Clin Toxicol. 1997;35(1):11-9.
  • Motala C, Hill ID, Mann MD, Bowie MD. Effect of loperamide on stool output and duration of acute infectious diarrhea in infants. J Pediatr. 1990 Sep;117(3):467-71.
  • Li ST, Grossman DC, Cummings P. Loperamide therapy for acute diarrhea in children: systematic review and meta-analysis. PLoS Med. 2007 Mar 27;4(3):e98.
  • Lexi-Comp Online Database, Accessed Sept 2022
  • The Hospital for Sick Children 2020 Drug Handbook and Formulary. 

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