Imodium in Spain: Loperamide (Fortasec) and Diarrhoea

Imodium is sold in Spain, but the loperamide brand most pharmacies hand you is Fortasec. Both contain the same medicine, loperamide. It is available without a prescription for adults and children over 12 for short bouts of diarrhoea. Do not use it if you have a fever, blood in your stool, or for young children.

What is Imodium called in Spain?

In Spain the best-known loperamide brand is Fortasec. Imodium is also on sale, and so are Salvacolina and generic packs labelled loperamida. They all contain the same active ingredient. If you ask for "Imodium" and the pharmacy does not have it, ask for loperamida or Fortasec. Every Spanish medicine has an official leaflet in the AEMPS database (CIMA), which the pharmacist can print for you.

Loperamide is also found in combination products with simethicone, sold for diarrhoea with bloating and gas. Check the box so you know what you are taking.

Do you need a prescription for loperamide in Spain?

No. The standard loperamide packs are over-the-counter medicines in Spain, sold only in pharmacies. There is no limit on where you buy them, but a pharmacist will ask a few questions first: how long you have had diarrhoea, whether you have a fever, and whether there is blood. Those questions matter, as the next sections explain.

What does loperamide do?

Loperamide slows down the movement of the bowel. Stools become less frequent and less watery. That makes it useful when you need to be on a bus, a plane or in a meeting. It does not kill the virus or bacteria that caused the diarrhoea, and it does not replace the fluid you have lost. Think of it as a brake, not a cure.

When can you use it for traveller's diarrhoea?

Loperamide is reasonable for mild, watery traveller's diarrhoea in an otherwise healthy adult who has no fever and no blood in the stool. Take it together with plenty of fluids, follow the leaflet for how much and for how long, and stop as soon as your stools are formed again. If you are not better within two days, stop and get medical advice. Our traveller's diarrhoea page explains what a doctor assesses.

When should you NOT take loperamide?

• Fever, or feeling very unwell: this suggests an infection that needs a proper look.
• Blood or mucus in the stool, or black stools. Slowing the gut can make some bacterial infections worse.
• Severe belly pain or a swollen, hard abdomen.
• Children under 12. The over-the-counter packs are for adults and children over 12. For younger children, rehydration comes first and a doctor decides.
• Diarrhoea that started during or after antibiotics, which can be a bowel infection called C. difficile.
• A flare of ulcerative colitis or Crohn's disease, unless your specialist has said it is fine.
• Heart rhythm problems. The AEMPS and other agencies have warned that taking more loperamide than the leaflet allows can cause serious heart rhythm disorders. Never exceed the pack instructions.

Rehydration is the real treatment

Most diarrhoea in Spain, including traveller's diarrhoea, settles on its own in a few days. What makes people ill is dehydration. Spanish pharmacies sell oral rehydration sachets and ready-made bottles (suero oral or sales de rehidratación oral). They replace salt and sugar as well as water, which plain water does not. Sip small amounts often, especially after each loose stool. Eat light, salty food as soon as you feel like it. Avoid alcohol and very sugary drinks, which can make diarrhoea worse.

Do you need antibiotics?

Usually not. Most cases are viral or clear up without them. A doctor may consider antibiotics for traveller's diarrhoea with fever, blood, or when it is severe, after asking about your trip and your symptoms. In Spain antibiotics always need a prescription. Read our guide on traveller's diarrhoea prescriptions before a trip.

When to see a doctor

• Diarrhoea that lasts more than two or three days, or keeps coming back.
• Signs of dehydration: very dark urine, passing little urine, dizziness when you stand up, a dry mouth.
• You are over 65, pregnant, have diabetes, kidney disease or a weak immune system.
• You take medicines that depend on fluid balance, such as diuretics, blood-pressure tablets or lithium.
• A child or an older person who is drinking less than usual.

When to call 112

• Confusion, fainting, or a very fast heartbeat.
• No urine for many hours, or a baby with no wet nappies.
• Bloody diarrhoea with a high fever and severe belly pain.
• You cannot keep any fluid down.

Getting a medical assessment

If you are unsure whether loperamide is right for you, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read more about traveller's diarrhoea. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

Frequently asked questions

Sources

• AEMPS – CIMA: official medicine information (search "loperamida")
• NHS: Loperamide
• MedlinePlus: Loperamide
• Mayo Clinic: Traveler's diarrhea

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.