Potential of Loperamide Oxide in the Reduction of Ileostomy and Colostomy Output

The effects of a single oral dose of loperamide oxide on stoma output were evaluated in an open trial that included 22 patients - 4 with a colostomy and 18 with an ileostomy, in whom daily stoma output was usually more than 500g. Antidiarrhoeal therapy was stopped from days 2 to 7, and from days 5 to 8 a standardised high-fibre diet was given. Stoma effluent was collected for 24 hours on day 7. On day 8, patients took one dose of loperamide oxide 6mg. In 20 of the 22 patients, stoma output was reduced by 13 to 75% after administration of loperamide oxide. The mean output was reduced by 45% (p = 0.0001). There were no adverse experiences associated with administration of loperamide oxide. The majority of drug recovered in stoma effluent was loperamide, suggesting extensive conversion of loperamide oxide to loperamide. These preliminary findings suggest that a single 6mg dose of loperamide oxide is effective in reducing stoma output in patients with an ileostomy or colostomy.