Loperamide
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Reactions 1149 - 28 Apr 2007 ★ Loperamide Urinary retention (first report) in a child: case report A girl developed urinary retention after treatment with loperamide for acute gastroenteritis. At the age of 10 years, the girl was admitted for evaluation with a history of urinary retention. One year earlier, she had received loperamide 2mg for 2 days and, a few days later, was admitted with a 24-hour history of spontaneous micturition disability [time to reaction onset not clearly stated]. At that time, she was not able to feel micturition sensation and she had immediately undergone catheterism, which had resulted in 550cc of urine. She unsuccessfully underwent percutaneous posterior tibial nerve stimulation and urinated only by Cred´ e’s practice. After presenting for evaluation, she had a great micturition feeling at her maximal bladder capacity, an initial urinary residual of 220cc and absent micturition phase. Laboratory investigations showed the following: bladder capacity (BC) 558cc, bladder pressure at capacity 23cm H2O, bladder infusion pressure 18cm H2O, and absence of unhibited contraction and total urinary residual. The girl started intermittent clean catheterisation and micturition with Cred´ e’s manoeuvre. She was diagnosed with loperamide-induced urinary retention. After 3 months, she re- presented for bladder function evaluation and reported that micturition was possible through abdominal press; abundant urine residual was noted following catheterisation. Cysto x-ray showed a regular bladder with a total capacity of approximately 900cc. Intermittent clean catheterisation was increased in frequency. After 6 months, cystomanometry showed the following: appearance of first micturition feeling at 793cc (great one at 854cc), urinary residual 450cc, no unhibited contraction, no micturition phase, total urinary residual and BC 905cc. At follow-up 9 months later, she reported a progressive increase in sensation of bladder repletion, as well as the start of spontaneous micturition between catheterism. Five months later, intermittent clean catheterisation was stopped and she started spontaneous micturition with minor help of Cred´ e’s manoeuvre at the end of micturition. Author comment: "[T]his case suggests that reaction to loperamide should be added to the etiological list of [urinary retention] in young patients." Focarelli B, et al. Loperamide cause of prolonged urinary retention after acute gastroenteritis. European Review for Medical and Pharmacological Sciences 11: 65-67, No. 1, Jan-Feb 2007 - Italy 801072847 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of urinary retention associated with loperamide. The WHO Adverse Drug Reactions database contained 30 reports of urinary retention associated with loperamide. 1 Reactions 28 Apr 2007 No. 1149 0114-9954/10/1149-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Loperamide
Reactions 1149 - 28 Apr 2007
★Loperamide
Urinary retention (first report) in a child: case reportA girl developed urinary retention after treatment with
loperamide for acute gastroenteritis.At the age of 10 years, the girl was admitted for evaluation
with a history of urinary retention. One year earlier, she hadreceived loperamide 2mg for 2 days and, a few days later, wasadmitted with a 24-hour history of spontaneous micturitiondisability [time to reaction onset not clearly stated]. At thattime, she was not able to feel micturition sensation and shehad immediately undergone catheterism, which had resultedin 550cc of urine. She unsuccessfully underwent percutaneousposterior tibial nerve stimulation and urinated only by Crede’spractice. After presenting for evaluation, she had a greatmicturition feeling at her maximal bladder capacity, an initialurinary residual of 220cc and absent micturition phase.Laboratory investigations showed the following: bladdercapacity (BC) 558cc, bladder pressure at capacity 23cm H2O,bladder infusion pressure 18cm H2O, and absence ofunhibited contraction and total urinary residual.
The girl started intermittent clean catheterisation andmicturition with Crede’s manoeuvre. She was diagnosed withloperamide-induced urinary retention. After 3 months, she re-presented for bladder function evaluation and reported thatmicturition was possible through abdominal press; abundanturine residual was noted following catheterisation. Cysto x-rayshowed a regular bladder with a total capacity ofapproximately 900cc. Intermittent clean catheterisation wasincreased in frequency. After 6 months, cystomanometryshowed the following: appearance of first micturition feeling at793cc (great one at 854cc), urinary residual 450cc, nounhibited contraction, no micturition phase, total urinaryresidual and BC 905cc. At follow-up 9 months later, shereported a progressive increase in sensation of bladderrepletion, as well as the start of spontaneous micturitionbetween catheterism. Five months later, intermittent cleancatheterisation was stopped and she started spontaneousmicturition with minor help of Crede’s manoeuvre at the endof micturition.
Author comment: "[T]his case suggests that reaction toloperamide should be added to the etiological list of [urinaryretention] in young patients."Focarelli B, et al. Loperamide cause of prolonged urinary retention after acutegastroenteritis. European Review for Medical and Pharmacological Sciences 11:65-67, No. 1, Jan-Feb 2007 - Italy 801072847
» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of urinary retentionassociated with loperamide. The WHO Adverse Drug Reactionsdatabase contained 30 reports of urinary retention associatedwith loperamide.
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Reactions 28 Apr 2007 No. 11490114-9954/10/1149-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
