Editing Loperamide (section)

===Contraindications===
Treatment should be avoided in the presence of high [[fever]] or if the [[dysentery|stool is bloody]]. Treatment is not recommended for people who could have negative effects from rebound [[constipation]]. If suspicion exists of diarrhea associated with organisms that can penetrate the intestinal walls, such as [[Escherichia coli O157:H7|''E. coli ''O157:H7]] or ''[[Salmonella]]'', loperamide is [[contraindicated]] as a primary treatment.<ref name=drugs.com/> Loperamide treatment is not used in symptomatic ''[[Clostridium difficile colitis|C. difficile]]'' infections, as it increases the risk of toxin retention and precipitation of toxic megacolon.

Loperamide should be administered with caution to people with [[liver failure]] due to reduced [[first-pass metabolism]].<ref>{{ cite web | title = rxlist.com | year = 2005 | url = http://www.rxlist.com/imodium-drug/indications-dosage.htm | url-status = live | archive-url = https://web.archive.org/web/20121127021744/http://www.rxlist.com/imodium-drug/indications-dosage.htm | archive-date = 27 November 2012 | df = dmy-all }}</ref> Additionally, caution should be used when treating people with advanced [[HIV/AIDS]], as cases of both viral and bacterial toxic megacolon have been reported. If abdominal distension is noted, therapy with loperamide should be discontinued.<ref name=accessdata.fda.gov>{{cite web|url=http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory|title=Drugs@FDA: FDA Approved Drug Products|publisher=U.S. [[Food and Drug Administration]] (FDA)|access-date=14 May 2016|url-status=dead|archive-url=https://web.archive.org/web/20160506041852/http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory|archive-date=6 May 2016}}</ref>