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Last Updated: April 5, 2025

CLINICAL TRIALS PROFILE FOR LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE


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All Clinical Trials for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE

Trial IDTitleStatusSponsorPhaseStart DateSummary
NCT04186936 ↗ A Study of Combination Caplet With Loperamide Hydrochloride and Simethicone, and Imodium Express Tablets-lyophilizate Coadministered With Espumisan Capsule in Healthy Volunteers Completed McNeil AB Phase 1 2019-12-05 The purpose of this study is to assess bioequivalence between a Combination caplet with loperamide hydrogen chloride (HCl) 2 milligram (mg) and simethicone 125 mg, and Imodium Express tablets-lyophilizate with loperamide HCl 2 mg (co-administered with Espumisan capsules with simethicone 40 mg), with respect to the single-dose pharmacokinetics of loperamide HCl. The maximum observed concentration (Cmax), and the area under the concentration-vs.-time curve until the last measurable concentration (AUC [0-t]) will be used to assess bioequivalence.
NCT02217982 ↗ Pilot Study to Assess Dimethyl Fumarate Related GI Symptom Mitigation Terminated Biogen Phase 4 2014-07-01 Single site, open label, randomized design in patients with relapsing forms of Multiple Sclerosis. At the Screening Visit, the patient will be given a diary containing the MAGIS scale to be completed once a day for the first two weeks while on Dimethyl Fumarate (DMF), including the titration period. After two weeks or if a patient experiences 3 or more consecutive days of GI symptoms in any category of ≥3.5, the patient will return for a Baseline Visit. The MAGIS diary will be reviewed by the coordinator. Any patient who has reported an average MAGIS score of greater than or equal to 3.5 in at least one of the key categories will be randomized to a standard therapy or treatment arm. Patients who report a MAGIS of less than 3.5 during this period will be terminated from the study at this visit. Patients with an average reported MAGIS of greater than 6.5 at Baseline will be placed in the treatment arm. Patients who are randomized to the treatment arm will be instructed to take 125 mg simethicone and one tablespoon of a high fat food (peanut butter) 10 minutes prior to each DMF dose. If the average MAGIS score is greater than 3.5 in the diarrhea category they will also be instructed to take 2 mg loperamide three times daily. Patients randomized to the standard therapy arm will be instructed to follow the normal dosing regimen for DMF with a food bolus of their choice prior to dosing. If severe symptoms (MAGIS >6.5) are noted at any time post randomization in any MAGIS category, crossover to the treatment arm will be allowed. Both groups will be asked to rate their GI symptoms over the past 24 hours using the MAGIS scale once daily. Both treatment arms will be observed for 6 weeks. MAGIS will be recorded once daily. Patients will return to the clinic at Week 3 and Week 6/End of Treatment for diary and compliance review. After Week 6, patients will be instructed to return to a standard therapy. MAGIS will be recorded for one more week and collected at Week 7/End of Study.
NCT02217982 ↗ Pilot Study to Assess Dimethyl Fumarate Related GI Symptom Mitigation Terminated Rocky Mountain MS Research Group, LLC Phase 4 2014-07-01 Single site, open label, randomized design in patients with relapsing forms of Multiple Sclerosis. At the Screening Visit, the patient will be given a diary containing the MAGIS scale to be completed once a day for the first two weeks while on Dimethyl Fumarate (DMF), including the titration period. After two weeks or if a patient experiences 3 or more consecutive days of GI symptoms in any category of ≥3.5, the patient will return for a Baseline Visit. The MAGIS diary will be reviewed by the coordinator. Any patient who has reported an average MAGIS score of greater than or equal to 3.5 in at least one of the key categories will be randomized to a standard therapy or treatment arm. Patients who report a MAGIS of less than 3.5 during this period will be terminated from the study at this visit. Patients with an average reported MAGIS of greater than 6.5 at Baseline will be placed in the treatment arm. Patients who are randomized to the treatment arm will be instructed to take 125 mg simethicone and one tablespoon of a high fat food (peanut butter) 10 minutes prior to each DMF dose. If the average MAGIS score is greater than 3.5 in the diarrhea category they will also be instructed to take 2 mg loperamide three times daily. Patients randomized to the standard therapy arm will be instructed to follow the normal dosing regimen for DMF with a food bolus of their choice prior to dosing. If severe symptoms (MAGIS >6.5) are noted at any time post randomization in any MAGIS category, crossover to the treatment arm will be allowed. Both groups will be asked to rate their GI symptoms over the past 24 hours using the MAGIS scale once daily. Both treatment arms will be observed for 6 weeks. MAGIS will be recorded once daily. Patients will return to the clinic at Week 3 and Week 6/End of Treatment for diary and compliance review. After Week 6, patients will be instructed to return to a standard therapy. MAGIS will be recorded for one more week and collected at Week 7/End of Study.
NCT00685607 ↗ Study to Determine the Best Way to Measure How Quickly the Drug Can Give Relief From Sudden Diarrhea Completed Johnson & Johnson Consumer and Personal Products Worldwide Phase 4 2008-10-01 For six hours following drug administration, subjects will rate the severity of specific symptoms. At the end of the six hour study, subjects will rate the overall effectiveness of the product.
NCT02340481 ↗ Efficacy and Safety Study of Loperamide Hydrochloride/Simethicone Chewable Tablet in Treatment of Acute Diarrhea With Abdominal Discomfort and Flatulence Completed Xian-Janssen Pharmaceutical Ltd. Phase 3 2005-07-01 The purpose of this study is to evaluate the efficacy and safety of combined loperamide hydrochloride and simethicone compared to loperamide hydrochloride monotherapy in treating acute diarrhea associated with abdominal discomfort caused by gastrointestinal gas accumulation.
NCT00778115 ↗ Bioequivalence Study of Loperamide Hydrochloride 2 mg and Simethicone 125 mg Tablet Under Fasting Conditions Completed Ranbaxy Laboratories Limited N/A 2004-11-01 The objective of this study is to compare the relative bioavailability of Loperamide HCl 2 mg and simethicone 125 mg tablets (Ranbaxy) with that of Imodium® Advanced caplets (McNeil) in healthy subjects under fasting condition
>Trial ID>Title>Status>Phase>Start Date>Summary
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Clinical Trial Conditions for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE

Condition Name

2210-0.200.20.40.60.811.21.41.61.822.2DiarrheaHealthyRelapsing Remitting Multiple Sclerosis[disabled in preview]
Condition Name for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Intervention Trials
Diarrhea 2
Healthy 2
Relapsing Remitting Multiple Sclerosis 1
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Condition MeSH

21110-0.200.20.40.60.811.21.41.61.822.2DiarrheaMultiple SclerosisFlatulenceMultiple Sclerosis, Relapsing-Remitting[disabled in preview]
Condition MeSH for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Intervention Trials
Diarrhea 2
Multiple Sclerosis 1
Flatulence 1
Multiple Sclerosis, Relapsing-Remitting 1
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Clinical Trial Locations for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE

Trials by Country

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Trials by Country for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Location Trials
United States 2
China 1
Mexico 1
Russian Federation 1
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Trials by US State

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Trials by US State for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Location Trials
Utah 1
Missouri 1
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Clinical Trial Progress for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE

Clinical Trial Phase

40.0%20.0%20.0%20.0%00.911.11.21.31.41.51.61.71.81.922.1Phase 4Phase 3Phase 1[disabled in preview]
Clinical Trial Phase for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Clinical Trial Phase Trials
Phase 4 2
Phase 3 1
Phase 1 1
[disabled in preview] 1
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Clinical Trial Status

80.0%20.0%000.511.522.533.54CompletedTerminated[disabled in preview]
Clinical Trial Status for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Clinical Trial Phase Trials
Completed 4
Terminated 1
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Clinical Trial Sponsors for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE

Sponsor Name

trials0112233Johnson & Johnson Consumer and Personal Products WorldwideRanbaxy Laboratories LimitedBiogen[disabled in preview]
Sponsor Name for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Sponsor Trials
Johnson & Johnson Consumer and Personal Products Worldwide 1
Ranbaxy Laboratories Limited 1
Biogen 1
[disabled in preview] 3
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Sponsor Type

83.3%16.7%0-0.500.511.522.533.544.555.5IndustryOther[disabled in preview]
Sponsor Type for LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE
Sponsor Trials
Industry 5
Other 1
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Loperamide Hydrochloride and Simethicone: Clinical Trials, Market Analysis, and Projections

Introduction

Loperamide hydrochloride and simethicone is a combination drug widely used for the treatment of acute nonspecific diarrhea and associated gas-related abdominal discomfort. This article will delve into the clinical trials, market analysis, and future projections for this medication.

Mechanism of Action

Loperamide hydrochloride works by binding to the opiate receptors in the gut wall, inhibiting the release of acetylcholine and prostaglandins, which reduces propulsive peristalsis and increases intestinal transit time. This action enhances the resorption of water and electrolytes, thereby reducing fecal output and frequency, and improving stool consistency. Simethicone, an inert surface-active agent, relieves symptoms associated with gas, such as fullness, pressure, and bloating, by making it easier to pass gas through the digestive tract[2][4].

Clinical Trials

Efficacy and Tolerability

A randomized, double-blind, placebo-controlled clinical trial compared the efficacy and tolerability of a loperamide/simethicone (LOP/SIM) combination product with loperamide (LOP) alone, simethicone (SIM) alone, and placebo. The results showed that LOP/SIM was well-tolerated and more efficacious than LOP alone, SIM alone, or placebo for acute nonspecific diarrhea and gas-related abdominal discomfort. The median time to last unformed stool and the time to complete relief of gas-related abdominal discomfort were significantly shorter in the LOP/SIM group compared to the other groups[1][5].

Specific Outcomes

  • Time to Last Unformed Stool: The median time for LOP/SIM was 7.6 hours, significantly shorter than LOP (11.5 hours), SIM (26.0 hours), and placebo (29.4 hours)[1].
  • Relief of Gas-Related Abdominal Discomfort: LOP/SIM-treated patients experienced a shorter time to complete relief compared to those receiving either ingredient alone or placebo[1].

Market Analysis

Current Market Status

The market for loperamide, particularly for chemotherapy-induced diarrhea (CID), is significant. Loperamide is recommended in current treatment guidelines due to its effective reduction in fecal incontinence, frequency of bowel movements, and stool weight[3].

Market Forecast

A comprehensive market assessment report forecasts the sales of loperamide for CID in the seven major markets (the United States, Germany, France, Italy, Spain, the United Kingdom, and Japan) from 2024 to 2032. The report includes detailed market size analysis, regulatory milestones, and research and development activities. It also covers the competitive landscape, including both marketed therapies and late-stage emerging therapies for CID[3].

Regional Market Analysis

  • United States: The market size for loperamide in the U.S. is expected to grow, driven by the increasing incidence of chemotherapy-induced diarrhea.
  • EU4 and UK: Similar growth is anticipated in Germany, France, Italy, Spain, and the UK, reflecting the broader European market trends.
  • Japan: The Japanese market is also expected to see significant growth, aligned with global trends in the treatment of CID[3].

Projections and Future Outlook

Market Size Projections

The report projects that the loperamide market for CID will continue to expand, driven by increasing demand for effective treatments. The forecasted sales data from 2024 to 2032 indicate a steady growth trajectory, reflecting the drug's efficacy and the growing need for managing chemotherapy-induced diarrhea[3].

Regulatory Milestones

The report highlights key regulatory milestones and other developmental activities, including ongoing clinical trials and patent information. These factors are crucial for understanding the future market dynamics and potential competition[3].

Competitive Landscape

The competitive landscape includes both existing therapies and emerging treatments for CID. Loperamide's position in this landscape is strong due to its proven efficacy and safety profile. However, the report also notes the presence of late-stage emerging therapies that could potentially impact the market share of loperamide in the future[3].

Key Takeaways

  • Efficacy: Loperamide/simethicone combination is more efficacious than loperamide alone, simethicone alone, or placebo for acute nonspecific diarrhea and gas-related abdominal discomfort.
  • Market Growth: The market for loperamide, especially for CID, is projected to grow significantly from 2024 to 2032 across major markets.
  • Regulatory and Developmental Activities: Ongoing clinical trials, regulatory milestones, and patent information are crucial for the future market outlook.
  • Competitive Landscape: Loperamide remains a strong player, but emerging therapies could impact its market share.

FAQs

What is the primary mechanism of action of loperamide hydrochloride?

Loperamide hydrochloride works by binding to opiate receptors in the gut wall, inhibiting the release of acetylcholine and prostaglandins, which reduces gut motility and enhances water and electrolyte resorption[2].

How does simethicone contribute to the relief of diarrhea symptoms?

Simethicone relieves symptoms associated with gas by making it easier to pass gas through the digestive tract, thereby reducing fullness, pressure, and bloating[4].

What are the key findings from clinical trials comparing loperamide/simethicone with loperamide alone, simethicone alone, and placebo?

Clinical trials have shown that the loperamide/simethicone combination is more efficacious and well-tolerated than loperamide alone, simethicone alone, or placebo for acute nonspecific diarrhea and gas-related abdominal discomfort[1][5].

What is the projected market growth for loperamide in the treatment of chemotherapy-induced diarrhea?

The market for loperamide in treating CID is expected to grow significantly from 2024 to 2032 across major markets, including the United States, EU4, the UK, and Japan[3].

What are the potential challenges for loperamide in the future market?

Emerging therapies for CID could potentially impact the market share of loperamide. However, its proven efficacy and safety profile position it strongly in the current market landscape[3].

Sources

  1. Randomized, double-blind, placebo-controlled clinical trial of loperamide plus simethicone versus loperamide alone and simethicone alone in the treatment of acute diarrhea with gas-related abdominal discomfort. PubMed.
  2. IMODIUM® Complete (Loperamide Hydrochloride and Simethicone) Product Monograph. Health Canada.
  3. Loperamide for Chemotherapy-Induced Diarrhea Research 2024: Market Size, Forecast, and Market Insight - 2032. ResearchAndMarkets.com.
  4. Loperamide; Simethicone oral tablets. Cleveland Clinic.
  5. Loperamide and Simethicone journal articles from PubMed. Unbound Medicine.

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