Fever loperamide

Loperamide should not be used in patients with fever or dysentery. 

In initial studies, up to 35% of patients experienced severe diarrhea. Adoption of an intensive loperamide (see Chapter 38) regimen (4 mg of loperamide starting at the onset of any loose stool beginning more than a few hours after receiving therapy, followed by 2 mg every 2 hours) has effectively reduced this incidence by more than half. However, once severe diarrhea does occur, standard doses of antidiarrheal agents tend to be ineffective, although the diarrhea episode generally resolves within a week and, unless associated with fever and neutropenia, is rarely fatal. 

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