Questran and Loperamide?

[gmcarthur]

Hello All,

I was recently prescribed Questran for IBS. Previously I had been treated for IBD after a colonoscopy revealed crohns (T/Ilium) and after bouts of steroids, pentasa and non-treatment a second colonoscopy revealed no crohns but I was still exhibiting symptoms aligned with the disease, so in a last ditched attempt my GI suggested the problem was malabsorbtion of bile acids and prescribed colestyramine - they seem to be working very well at limiting my attacks but every so often I have 'grumbling bowels' and loose motions.

My question is: When I get these attacks am I ok to take Loperamide as well as the Questran?

All suggestions / advice accepted gratefully.

Thank you
Gary

[PHARMAC1ST]

I am aware that loperamide is contra indicated in crohns disease. As far as i can remember drugs such as hyoscine or mebeverine are prefered over anti-motility because loperamide, etc can actually exacerbate the condition.

However i have heard of doctors recommending loperamide for patients who have crohns disease to stop their bouts of diarrhoea.

When taking questron, if you are taking other medication then it should be taken either 1 hour before or 4-6 hours after administering questron. loperamide binds to receptors in gut wall reducing peristalasis (wave like contractions). The questron may bind to loperamide in the GI tract and therefore may reduce its efficacy in treating the diarrhoea.