Imodium during pregnancy 1-2-3 trimester. Is it possible?

Compound

loperamide hydrochloride as an active substance .
Additional capsule components: lactose, talc, corn starch, magnesium stearate. The capsule shell contains yellow iron oxide, titanium dioxide, erythrosine, black iron oxide, indigo carmine, gelatin. The tablets contain the following excipients: gelatin, aspartame , sodium bicarbonate, mannitol, mint flavor.

Pharmacodynamics and pharmacokinetics

The medicine acts as an antidiarrheal agent. Its active substance is a synthetic selective opioid receptor . It affects the cells of the intestinal walls. The release of acetylcholine and prostaglandins in the gastrointestinal tract is blocked by affecting the functions of cholinergic and adrenergic neurons.

After taking Imodium, an increase in the tone of the anal sphincter and rectum is observed. Feces are better retained, and the urge to defecate becomes less frequent. Intestinal motility decreases. The contents travel through the gastrointestinal tract longer.

The drug normalizes the amount of mucus in the intestinal lumen by reducing its secretion. It also improves the absorption of fluids and electrolytes from the gastrointestinal tract, reduces the likelihood of dehydration and problems with electrolyte balance, which often appear with diarrhea . The active substance reduces pain that can be caused by spasm of the smooth muscles of the intestinal wall.

The medicine is easily absorbed from the gastrointestinal tract. It works quickly. It is broken down in the liver and excreted mainly with bile and feces. Half-life is 9-14 hours. The systemic impact is negligible.

Terms and conditions of storage

The drug should be stored in a dark place, away from children, moisture and direct sunlight. This will prevent the chemical formula from changing.

Imodium during pregnancy

The maximum storage period is 5 years. Use after the expiration date is prohibited. Before you start taking it, you should study the information on the packaging.

Imodium is considered a fairly effective and relatively safe antidiarrheal agent that can be prescribed during pregnancy to relieve acute symptoms of intestinal upset. Treatment should be agreed with a doctor, which will allow you to receive only benefits from the use and reduce the likelihood of negative reactions.

Contraindications

This drug should not be used if you are hypersensitive to its components. In addition, the following contraindications are known:

• acute dysentery (especially with blood in the stool and fever);
• antibiotic- induced pseudomembranous colitis ;
• paralytic ileus and other diseases that are accompanied by impaired intestinal motility;
• lactose intolerance;
• acute ulcerative colitis;
• bacterial enterocolitis;
• constipation.

Prescribe with caution for liver dysfunction. Before using the drug, contraindications must be excluded.

When is it prescribed?

Imodium is useful for the following conditions:

• diarrhea due to poisoning;
• digestive disorders due to chronic inflammation of the gastrointestinal tract;
• traveler's diarrhea;
• diarrhea of ​​nervous origin.

The drug is not prescribed if blood, mucus or fever appear in the stool. In case of these phenomena, you must first consult a doctor to find out the reasons. Sometimes fecal retention due to certain diseases can be very dangerous.

Side effects

Adverse reactions may depend on the nature of the disease:

• Acute diarrhea: constipation , dry mouth, cramps and colic in the abdominal area, flatulence .
• Chronic diarrhea: constipation , dizziness , nausea, headache , pain in the stomach, colic and abdominal cramps , vomiting, bloating .

In addition, the following side effects are known:

• skin: skin rash, itching , urticaria ;
• Gastrointestinal tract: megacolon , indigestion ;
• nervous system: tremor , loss of consciousness, depression of consciousness;
• general disorders: severe hypersensitivity reactions, including anaphylactic shock and anaphylactoid reactions ;
• urinary system: urinary retention.

In rare cases, angioedema and bullous eruptions have been reported.

The medicine may cause drowsiness , therefore, when using it, it is undesirable to perform work that involves the use of dangerous mechanisms.

During clinical trials, the most frequently reported adverse reactions were those characteristic of diarrhea syndrome : abdominal pain, nausea, dry mouth, drowsiness , constipation , discomfort and excessive fatigue, vomiting, dizziness , flatulence . Thus, it is difficult to distinguish these manifestations from side effects.

Is it recommended during pregnancy?

Imodium is often recommended to be taken during pregnancy, as it is highly effective.

The main indications for prescribing to patients during pregnancy:

• Short-term diarrhea, accompanied by acute symptoms and significant deterioration of the condition.
• Long-term stool disorder that occurs due to the use of other medications or the consumption of any food products.
• Chronic diarrhea, the causes of which have been established.

The drug can be used once if diarrhea develops during a trip. The product also helps prevent the development of loose stools if taken beforehand.

Despite the relative safety of the drug, its use is not always allowed, especially during pregnancy. The main contraindication is considered to be intolerance to the components of the composition or a tendency to such manifestations in the patient's medical history.

However, there are other barriers to treatment:

• Diarrhea due to progression of dysentery. In this case, other symptoms are usually present, so it is important to clarify the patient’s complaints before prescribing the remedy.
• Chronic constipation with other gastrointestinal symptoms. The drug may aggravate the symptoms of the disease, especially during pregnancy.
• Constipation due to hormonal changes. Quite often during pregnancy, the patient develops persistent constipation, which is sometimes replaced by short-term diarrhea.
• Acute ulcerative lesions of the mucous membrane of the stomach and intestines. With such a disorder, the condition may worsen significantly when taking tablets or capsules.
• Bacterial colitis or enteritis in acute form.
• Indigestion due to spasm of the muscular layer of the digestive tract. Usually, with stenosis of the esophagus, as well as the lower parts of the stomach, there is a deterioration in the functioning of the digestive system, and taking pills can provoke complications, even if the patient has diarrhea.
• Intestinal atony or severe forms of peristalsis disorders, accompanied by congestion and related disorders.
• Severe form of liver failure, as well as kidney damage in acute and chronic form.
• Internal bleeding due to damage to the mucous membranes of the digestive tract.
• Breastfeeding period. If it is necessary to prescribe medication, you must stop feeding for the entire period of therapy.

The drug is prescribed with caution to women who suffer from diarrhea in the early stages of pregnancy.

The official instructions indicate that the drug does not have a negative effect on the development of the fetus and the mother’s body. Despite this, use is allowed only if the benefit of treatment outweighs the possible harm. The product is considered relatively safe for pregnant women.

If it is necessary to prescribe medication to patients in late pregnancy, the duration of treatment should be minimal. If any complications occur, you should immediately stop therapy.

Imodium during pregnancy can provoke various complications, even if all recommendations are followed. Women may report abdominal pain, flatulence and bloating. After taking several therapeutic doses, the condition worsens, peristalsis is significantly weakened or disappears, and the patient feels heaviness in the stomach.

Often, complications can lead to indigestion; symptoms are accompanied by nausea, vomiting and heartburn. Negative reactions occur not only when instructions are violated, but also when all rules of therapy are followed. The drug can also provoke an overdose, which is accompanied by severe headaches and dizziness, and a deterioration in general well-being.

If the patient has a tendency to allergic manifestations, the drug can lead to the appearance of a skin rash, severe itching and burning, and irritation. The condition worsens when symptoms persist for a long time.

In severe cases, treatment with tablets or capsules leads to the development of Quincke's edema. It is accompanied by swelling of the mucous membranes of the throat and the development of suffocation. In the absence of timely treatment, death is possible as a result of complete cessation of air supply to the lungs.

Any negative reactions that occur during treatment are considered a reason to stop it and consult a doctor.

Instructions for use of Imodium (Method and dosage)

The drug should be used only after consultation with a doctor. Only a specialist knows how to use Imodium, what it will help with in each specific case and how long it should be used. In the case of acute and chronic diarrhea, 2 capsules are usually used at the beginning of the course. Instructions for the use of Imodium for children over 6 years old indicate that in this case, as a rule, they are given one capsule per day.

For the purpose of maintenance therapy, the dosage is adjusted so that bowel movements occur 1-2 times a day. As a rule, it ranges from 1 to 6 capsules for adults. The maximum dosage is no more than 8 capsules. Children over 6 years old are given no more than 3 capsules.

For those taking Imodium tablets, the instructions for use advise that they should be placed on the tongue and allowed to dissolve for a few seconds, after which they should be swallowed without liquid.

In case of acute diarrhea, the initial dosage is 2 tablets for adults and 1 tablet for children over 6 years of age. If the drug works successfully, it is continued to be taken one tablet after each bowel movement in case of loose stools.

The initial daily dose for chronic diarrhea is 2 tablets for adults and 1 tablet for children. Then the dosage is adjusted individually so that the frequency of stool is 1-2 times a day. Every day an adult patient can take from 1 to 6 tablets. The maximum dose should not exceed 8 tablets. For children, dosages are calculated based on weight (3 tablets per 20 kg, but not more than 8 tablets).

If, in case of acute diarrhea, the effect of the drug is not observed for two days after use, its use should be stopped immediately and another medicine should be selected. When the patient begins to have normal stools or does not have them for 12 hours or more, the drug is also discontinued.

What are the side effects of Imodium?

Get emergency medical help right away if you have signs of any of the following reactions to loperamide:

• hives;
• labored breathing;
• swelling of the face or throat;
• fever;
• burning in the eyes;
• a red or purple skin rash that spreads throughout the body and causes pimples and flaking.

Be careful!

Stop using Imodium and call your doctor immediately if you experience these side effects:

• watery or bloody diarrhea;
• stomach pain or bloating;
• continued or worsening diarrhea;
• fast or racing heartbeat;
• shortness of breath and sudden dizziness.

Common side effects may include:

• constipation;
• dizziness, drowsiness;
• nausea;
• stomach cramps.

This is not a complete list of side effects of loperamide. Check with your doctor about all side effects of this drug and if any of them occur, stop using it and seek emergency medical help.

Overdose

In case of an overdose, symptoms of central nervous system depression may appear: stupor, drowsiness , loss of coordination, miosis , muscle hypertonicity , etc. In addition, urinary retention and a set of symptoms reminiscent of intestinal obstruction .

Children when taking the drug are more sensitive to the effects on the central nervous system.

Naloxone can be used as an antidote . It may need to be reapplied as Imodium lasts longer. To identify possible symptoms of overdose, the patient should be observed for two days. Treatment is symptomatic. Gastric lavage and the use of activated carbon .

Imodium Express tablets lyophilisate 2 mg No. 10

Compound

Active substance: loperamide hydrochloride - 2 mg. Excipients: gelatin - 5.863 mg, mannitol - 4.397 mg, aspartame - 0.75 mg, mint flavor - 0.3 mg, sodium bicarbonate - 0.375 mg, purified water - 136.315 mg (removed during lyophilization).

Pharmacokinetics

Suction

Most of loperamide is absorbed in the intestine, but due to active first-pass metabolism, systemic bioavailability is approximately 0.3%.

Distribution

The binding of loperamide to plasma proteins is 95%, mainly to albumin.

Metabolism

Loperamide is predominantly metabolized in the liver, conjugated and excreted in bile. Oxidative N-demethylation is the main route of metabolism of loperamide and is carried out primarily with the participation of an inhibitor of the CYP3A4 and CYP2C8 isoenzymes. Due to active first-pass metabolism, the concentration of unchanged loperamide in the blood plasma is negligible.

Preclinical data indicate that loperamide is a substrate of P-glycoprotein.

Removal

In humans, T1/2 of loperamide averages 11 hours, varying from 9 to 14 hours. Unchanged loperamide and its metabolites are excreted primarily in feces.

Pharmacokinetics in special groups of patients

Pharmacokinetic studies have not been conducted in children. The pharmacokinetics of loperamide and its interactions with other drugs are expected to be similar to those in adults.

Indications for use

• symptomatic treatment of acute and chronic diarrhea (allergic, emotional, medicinal, radiation origin, with changes in diet and quality food composition, with metabolic and absorption disorders);
• as an auxiliary drug for diarrhea of ​​infectious origin;
• for the purpose of regulating stool in patients with ileostomy.

Contraindications

• hypersensitivity to loperamide and/or other components of the drug;
• children under 6 years of age;
• phenylketonuria;
• I trimester of pregnancy;
• lactation period (breastfeeding).

Imodium® Express should not be used as primary therapy:

• in patients with acute dysentery, which is characterized by bloody stool and high fever;
• in patients with ulcerative colitis in the acute phase;
• in patients with bacterial enterocolitis caused by pathogenic microorganisms, incl. Salmonella spp., Shigella spp. and Campylobacter spp.);
• in patients with pseudomembranous colitis associated with broad-spectrum antibiotics.

Imodium® Express should not be used in cases where slowing down peristalsis is undesirable due to the possible risk of developing serious complications, incl. intestinal obstruction, megacolon and toxic megacolon. Imodium® Express should be discontinued immediately if constipation, bloating or intestinal obstruction occurs.

Use with caution in patients with impaired liver function due to slow first-pass metabolism.

Directions for use and doses

The drug is used orally. The tablet is placed on the tongue, it dissolves within a few seconds, after which it is swallowed with saliva, without washing down with water.

Adults and children over 6 years old

For acute diarrhea, the initial dose is 2 tablets. (4 mg) for adults and 1 tab. (2 mg) for children, then 1 tablet. (2 mg) after each bowel movement in case of loose stools.

For chronic diarrhea, the initial dose is 2 tablets. (4 mg)/day for adults and 1 tab. (2 mg) for children; then the initial dose should be adjusted so that the frequency of normal stool is 1-2 times a day, which is usually achieved with a maintenance dose of 1 to 6 tablets. (2–12 mg)/day.

The maximum daily dose should not exceed 6 tablets. (12 mg); the maximum daily dose in children is calculated based on body weight (3 tablets per 20 kg of child’s body weight), but should not exceed 6 tablets. (12 mg).

When stool normalizes or if there is no stool for more than 12 hours, the drug is discontinued.

Imodium® Express is not used in children under 6 years of age.

When treating elderly patients, no dose adjustment is required.

When treating patients with impaired renal function, no dose adjustment is required.

Although pharmacokinetic data are not available in patients with hepatic impairment, Imodium® Express should be used with caution in such patients due to slow first-pass metabolism.

Directions for use

Since lyophilisate tablets are quite fragile, they should not be pressed through the foil to avoid damage.

In order to remove a tablet from the blister, you must perform the following steps:

• take the foil by the edge and completely remove it from the cell in which the tablet is located;
• Gently press down from below and remove the tablet from the package.

Storage conditions

The drug should be stored in its original packaging out of the reach of children at a temperature of 15°C to 30°C.

Best before date

5 years. Do not use after the expiration date stated on the package.

special instructions

Treatment of diarrhea with Imodium® Express is symptomatic only. In cases where it is possible to establish the cause of diarrhea, appropriate therapy should be carried out.

In patients with diarrhea, especially children, loss of fluid and electrolytes may occur. In such cases, it is necessary to carry out appropriate replacement therapy (replenishment of fluid and electrolytes).

Imodium® Express lyophilisate tablets contain a source of phenylalanine. The drug is contraindicated for patients with phenylketonuria.

If there is no effect after 2 days of treatment, it is necessary to stop taking the drug, clarify the diagnosis and exclude the infectious origin of diarrhea.

Patients with AIDS taking Imodium® Express to treat diarrhea should stop taking the drug at the first sign of abdominal bloating or signs of intestinal obstruction. There have been isolated reports of constipation with an increased risk of developing toxic megacolon in patients with AIDS and infectious colitis of viral and bacterial etiology who were treated with loperamide.

Imodium® Express should be used with caution in patients with liver failure, because this may lead to CNS toxicity due to relative overdose.

Abuse or misuse of loperamide as an opioid substitute has been reported in individuals with opioid dependence.

QT prolongation and ventricular arrhythmias, including torsade de pointes (TdP), have been reported in association with loperamide overdose, in some cases fatal. Imodium® Express should not be used for an extended period of time without medical supervision, and patients should not exceed the recommended dose and/or recommended duration of treatment.

If the medicine has become unusable or has expired, do not throw it into wastewater or onto the street. Place the medication in a bag and place it in the trash. These measures will help protect the environment.

Description

Antidiarrheal drug.

Dosage form

Lyophilisate tablets are white or almost white, round; on one side of the tablet it is allowed to have a bulge in the center, an uneven rough surface and uneven thinned edges; on the other side there is a chamfer, surface roughness is allowed.

Use in children

Contraindicated in children under 6 years of age.

Action

Loperamide, by binding to opioid receptors in the intestinal wall, inhibits the release of acetylcholine and prostaglandins, thereby slowing down peristalsis and increasing the transit time of contents through the intestines. Increases the tone of the anal sphincter, thereby reducing fecal incontinence and the urge to defecate.

As a result of a clinical study, data were obtained that the antidiarrheal effect occurs within one hour after taking a single dose (4 mg).

Side effects

According to clinical studies

Adverse reactions observed in ≥1% of patients taking Imodium® Express for acute diarrhea: headache, constipation, flatulence, nausea, vomiting.

Adverse reactions observed in ≥1% of patients taking Imodium® Express for chronic diarrhea: dizziness, flatulence, constipation, nausea.

Based on post-marketing studies (spontaneous reports of adverse reactions and clinical or epidemiological studies)

The following adverse reactions were classified as follows: very common (≥10%), common (≥1% but <10%), uncommon (≥0.1% but <1%), rare (≥0.01% but <0.1%) and very rarely (<0.01%, including isolated reports).

From the immune system: rarely - hypersensitivity reactions, anaphylactic reactions, including anaphylactic shock, and anaphylactoid reactions.

From the nervous system: often - headache, dizziness; infrequently - drowsiness; rarely - loss of coordination, depression of consciousness, hypertonicity, loss of consciousness, stupor.

From the organ of vision: rarely - miosis.

From the gastrointestinal tract: often - constipation, nausea, flatulence; uncommon - abdominal pain, abdominal discomfort, dry mouth, pain in the epigastric region, vomiting, dyspepsia; rarely - bloating, intestinal obstruction (including paralytic ileus), megacolon (including toxic megacolon), glossalgia.

From the skin and subcutaneous tissues: infrequently - skin rash; rarely - angioedema, pruritus, urticaria, bullous rash, including Stevens-Johnson syndrome, toxic epidermal necrolysis and erythema multiforme.

From the kidneys and urinary tract: rarely - urinary retention.

General disorders: rarely - fatigue.

Use during pregnancy and breastfeeding

Imodium® Express is not recommended for use during pregnancy and breastfeeding.

In case of diarrhea during pregnancy or breastfeeding, consultation with your doctor is necessary to prescribe appropriate treatment.

Interaction

According to preclinical studies, loperamide is a substrate of P-glycoprotein. With the simultaneous use of loperamide (single dose of 16 mg) and quinidine or ritonavir, which are P-glycoprotein inhibitors, the concentration of loperamide in the blood plasma increased 2-3 times. The clinical significance of the described pharmacokinetic interaction with P-glycoprotein inhibitors when loperamide is used at recommended doses is unknown.

The simultaneous use of loperamide (single dose of 4 mg) and itraconazole, an inhibitor of the CYP3A4 isoenzyme and P-glycoprotein, led to an increase in the concentration of loperamide in the blood plasma by 3-4 times. In the same study, the use of the CYP2C8 isoenzyme inhibitor, gemfibrozil, led to an approximately 2-fold increase in plasma concentrations of loperamide.

When using a combination of itraconazole and gemfibrozil, the Cmax of loperamide in the blood plasma increased by 4 times, and the total concentration by 13 times. This increase was not associated with CNS effects as assessed by psychomotor tests (i.e., subjective sleepiness rating and digit substitution test).

The simultaneous use of loperamide (single dose of 16 mg) and ketoconazole, an inhibitor of CYP3A4 and P-glycoprotein, led to a fivefold increase in plasma concentrations of loperamide. This increase was not associated with an increase in pharmacodynamic effect assessed by pupil size.

With simultaneous oral administration of desmopressin, the concentration of desmopressin in the blood plasma increased 3-fold, probably due to a slowdown in gastrointestinal motility.

It is expected that drugs with similar pharmacological properties may increase the effect of loperamide, and drugs that increase the rate of passage through the gastrointestinal tract may decrease the effect of loperamide.

Overdose

Symptoms: in case of overdose (including relative overdose due to impaired liver function), urinary retention, paralytic intestinal obstruction, constipation, signs of central nervous system depression (respiratory depression, airway obstruction, vomiting with impaired consciousness, stupor, loss of coordination, drowsiness, miosis, muscle hypertonicity). Children and patients with impaired liver function may be more sensitive to the CNS effects of loperamide than adults.

QT interval and QRS complex prolongation and/or serious ventricular arrhythmias, including torsade de pointes (TdP) have been reported in individuals who have intentionally taken excessive doses (40 mg to 240 mg/day) of loperamide hydrochloride; cardiac arrest, fainting. Cases of death due to deliberate overdose have also been described.

Abuse, misuse and/or overdose of high doses of loperamide can lead to the clinical manifestation of Brugada syndrome.

Treatment: In case of overdose, ECG monitoring should be initiated to detect QT prolongation.

If symptoms of overdose occur, naloxone can be used as an antidote. Because the duration of action of loperamide is longer than that of naloxone (1-3 hours), repeated use of naloxone may be necessary. Therefore, it is necessary to carefully monitor the patient’s condition for at least 48 hours in order to timely detect signs of possible CNS depression.

Because overdose management is constantly changing, it is recommended that you contact a poison control center (if available) for the most current recommendations for overdose treatment.

Impact on the ability to drive vehicles and operate machinery

During treatment with Imodium® Express, you should refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions, because the drug may cause dizziness and other side effects that may affect these abilities.

Imodium analogs

Level 4 ATC code matches:
Loperamide

Loperamide Hydrochloride

Imodium Plus

Lopedium

The following analogues of Imodium can be found in the pharmacy chain:

• Lopedium;
• Loperamide;
• Loperamide Grindeks;
• Loperamide Hydrochloride;
• Stoperan;
• Imodium Lingual;
• Loperamide-Health.

All medications have their own application characteristics. Imodium analogues are not recommended for use without consulting a doctor. If the drug turns out to be ineffective, you need to consult a specialist before purchasing another replacement product.

The price of analogues, as a rule, is noticeably lower than the cost of Imodium.

Which is better - Imodium or Loperamide

The drug has many analogues.

Among them:

• Loperamide;
• Lopedium;
• Stoperan.

These drugs have the same active ingredient. The difference is in the cost, which for analogues is usually lower than for Imodium. It is believed that Imodium is more effective than its analogues.

If we compare Loperamide and Imodium, then Imodium is absorbed and absorbed faster. Therefore, the therapeutic effect will occur faster.

Reviews of Imodium

Reviews of Imodium can be found quite often on the Internet. Those who have tried this remedy characterize it as an effective drug. They report that the effect becomes noticeable quite quickly after the first use. Reviews of Imodium especially often praise the convenient form of release of the medicine - lozenges. There are virtually no side effects reported. Among the negative aspects, most reviews note only the inflated price of the drug. That's why many people prefer to look for analogues of this product.

IMODIUM® Express in complex therapy of poisoning

One of the indications for the use of the drug IMODIUM® Express is acute diarrhea associated with changes in the qualitative composition of food. The drug can also be used as part of adjuvant therapy for infectious diarrhea2. The medicine is available in the form of lozenges, which makes it convenient to use in any life situation:

• IMODIUM® Express does not need to be washed down with water;
• tablets dissolve in just a few seconds2;
• the product does not cause problems with swallowing, so it is easy to take for children2, the elderly, patients with neurological disorders and dysphagia;
• The tablets have a pleasant mint taste.

Up to contents

Imodium price, where to buy

These capsules and tablets for diarrhea are often recommended to be purchased in pharmacies. The price of Imodium in Moscow and other Russian cities in the form of capsules (6 pieces per pack) is approximately 160 rubles. In Ukraine, a similar product costs about 45 hryvnia.

Many, however, prefer Imodium anti-diarrhea tablets, which cost approximately 170 rubles. This form of release is considered more convenient.

Patients also often find out how much a given product costs in a pharmacy compared to its analogues. Their cost is noticeably lower, so many prefer to look for a replacement for Imodium.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Imodium Express lyophilized tablets 2 mg 10 pcs Catalent UK Swindon Zaidis Limited/Jansen-Cilag S.p.A.
  240 rub. order
• Imodium Express lyophilisate tablets 2 mg 6 pcs. Catalent UK Swindon Zaidis Limited / Janssen-Cilag

  166 RUR order

• Imodium Express lyophilized tablets 2 mg 20 pcs Catalent UK Swindon Zaidis Limited / Janssen-Cilag

  417 RUR order

Pharmacy Dialogue

• Imodium Express tablets 2mg No. 20 Catalen UK Swindon Encaps

  RUB 399 order

• Imodium Express tablets 2mg No. 6 Catalen UK Swindon Encaps

  RUB 154 order

• Imodium Express tablets 2mg No. 10 Catalen UK Swindon Encaps

  RUB 224 order

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Pharmacy24

• Imodium 2 mg No. 20 capsules Janssen-Silag, France
  96 UAH. order

PaniPharmacy

• Imodium capsule Imodium capsules 2 mg No. 6 France, Janssen-Cilag

  57 UAH order

• Imodium lingual tablets Imodium lingual tablets 2mg No. 6 UK

  59 UAH order

• Imodium capsule Imodium capsules 2 mg No. 20 France, Janssen-Cilag

  112 UAH order

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