High-dose loperamide in the treatment of 5-fluorouracil-induced diarrhea in colorectal cancer patients

Thirty-seven colorectal cancer patients with grade 1-4 diarrhea (NCICTC) ca used by chemotherapy with 5-FU-containing regimens, received oral loperamid e at the initial dose of 4 mg followed by 4 mg every a h (total dose 16 mg/ 24 h). Twenty-five patients (69%) were diarrhea-free and were considered to be treatment responders, Eight-four percent of the patients with grade 1 o r 2 diarrhea achieved a response, but only 52% of those with grade 3-4 diar rhea, These data seem to suggest that high-dose loperamide is effective in patients with moderate diarrhea and can be regarded as the treatment of cho ice, The patients with more severe diarrhea did not respond so well, and sh ould, perhaps, be,given first-line treatment with more effective drugs, suc h as somatostatin analogues (e.g., octreotide).