1.4 Antidiarrhoeal drugs

First-line treatment of acute diarrhoea is the replacement of fluid and electrolytes (see section 9.2.1). Antidiarrhoeal agents reduce both the frequency and urgency of diarrhoea but should be used with caution in the elderly, patients with colitis or where there is suspicion of an invasive organism.  Use of these agents does not reduce the need for fluid replacement.

Codeine phosphate in a dose of 30-60mg every 4-6 hours is an effective antidiarrhoeal but may cause dependence if used long term.  Alternatively, loperamide 2mg capsules may be given in a dose of 4mg stat followed by 2mg after each loose stool up to a maximum of 16mg daily.