HWN Suggests

Anti-diarrheal drug loperamide, a.k.a. Imodium, provides a novel — and deadly — way to get high

The recommended initial dose is 4mg (two capsules) followed by 2 mg (one capsule) after each unformed stool. Daily dose should not exceed 16mg (eight capsules)...

For the intestinally afflicted, loperamide — Imodium, as it’s more commonly known — is a godsend.

While diarrhea is certainly fodder for jokes, sight gags and childhood singalongs, it’ also serious: It accounts for 4 percent of all deaths, and 5 percent of health loss to disability, worldwide. After being approved by the U.S. Food and Drug Administration in 1976, Imodium quickly became the bestselling prescription anti-diarrheal medication in the United States during the 1980s, and in 1988, it was approved for…

read full article

Featured

  Travelers Diarrhea

Recent travelers to Mexico had significant symptom relief with bismuth subsalicylate (BSS) in a trial, though loperamide was favored vs BSS in travelers to Latin America. Loperamide was more efficacious than BSS for symptom duration. Loperamide plus antibiotics rapidly reduces the number of diarrheal stools. Loperamide should be given along with antibiotics to patients with TD.

 Imodium is an opioid

The drug marketed as Imodium, loperamide, has found a new, unintended use. While traditionally used for relieving diarrhea, some drug users are now turning to loperamide to either relieve the symptoms of opioid withdrawal, or achieve a high.

Articles of Interest

Don't leave home without this medicine

My go-to remedy for diarrhea is Immodium-AD® (loperamide). First introduced as a prescription medicine in 1976, loperamide has been available over the counter (OTC) for many years and has proven to be a VERY effective medicine for acute diarrhea.

Are anti-diarrheal medicines counterproductive?

Anti-diarrheal medications such as loperamide (Imodium) work by slowing down peristalsis, the wave-like contractions of the bowels. Bismuth subsalicylate (Pepto-Bismol) works by changing the balance of fluid in the intestines.

Are anti-diarrheal medicines counterproductive?

In other words, is it better to let a bug run its course and be done, than to take medication that might help you feel better in the short-term but could actually prolong problems?

Compare Imodium vs. Pepto-Bismol

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Coronary artery spasm after ingestion of Imodium (loperamide) in a 14-year-old boy

Imodium (loperamide) is an opioid receptor agonist that binds to opioid receptors in the gut wall reducing peristalsis (antimotility drug). Loperamide is indicated for the symptomatic relief of acute diarrhea and is generally considered very safe in adults. Its use in children, however, has been discouraged by the World Health Organization and the American Academy of Pediatrics owing to concerns over safety and efficacy in young children

High Dosages of Imodium May Lead to Heart Problems, FDA Says

Recent article reported on two deaths of people who sought to self-treat withdrawal symptoms from painkiller addiction by using Imodium.

Is it bad to take Imodium when you have diarrhea?

The recommended initial dose is 4mg (two capsules) followed by 2 mg (one capsule) after each unformed stool. Daily dose should not exceed 16mg (eight capsules). Clinical improvement is usually observed within 48 hours.

Long Term Use of Loperamide

Your specific question is about the use of loperamide and this is an extraordinarily safe drug with very few side effects. About the only problem you can get with loperamide is constipation and that usually means you are taking too much. In the UK loperamide comes in the form of capsules (Imodium) and I often tell patients to pull the capsule apart and the contents can then be divided into a half, a third or a quarter.

Resources

Imodium

IMODIUM products contain an active ingredient called Loperamide, which works to slow your system to its normal pace. This allows the body to start absorbing fluids and salts as it should, restoring the consistency of stools.

StatPearls

Loperamide is a highly lipophilic synthetic phenylpiperidine opioid. The peak plasma time is 4 to 5 hours, with a half-life of 7 to 19 hours. It has a low bioavailability of < 1% due to the first-pass metabolism.