Loperamide abuse, addiction & recovery

Side effects of Imodium (Loperamide) include but are not limited to vomiting, dizziness, nausea, constipation, skin rash, abdominal bloating, pain, and constipation.

Imodium (Loperamide) typically slows down the digestive system to stop diarrhea within a half hour to an hour resulting in relieve relieving from symptoms, but this can depend on the individual.

It is not recommended to take more than four capsules, or more than 60mL of liquid Imodium, in a 24-hour timespan.  It is also not recommended that the medication be taken for longer than 48 hours. However, it is best to consult with a physician to determine dosage and length of use.

The amount of time Imodium stays in your system depends on multiple factors, such as the dosage, age, weight and how long it is taken. On average, Imodium half-life is approximately 11 hours but can range between 9 and 14 hours.  Half-life is the amount of time it takes for 50% (or half) of a drug’s active substance to be metabolized in your body. That means that the concentration of it in the body is cut to half the original dosage at around 11 hours after the initial intake.

Loperamide, the active ingredient in Imodium, can produce a high and act as an opioid, however it does not easily cross the blood brain barrier. The blood brain barrier is a highly selective, semipermeable border of cells that prevent many chemicals in the bloodstream from crossing into the brain and affecting the central nervous system (CSN).  Its purpose is to protect the brain and CNS from toxins while allowing necessary nutrients.   Although Loperamide, at recommended dosages does not cross the blood brain barrier or result in euphoria or analgesia, at very large doses it can overcome the protective mechanism in the blood-brain barrier and effect the CNS causing a typical opioid overdose triad: central nervous system depression, respiratory depression, and constriction of the pupil.

The U.S. Food and Drug Administration deemed no more than 8 mg per day (typically 4 capsules) for over-the-counter use of Loperamide, however, when prescribed by a medical professional, the dosage sometimes goes up to a maximum of 16 mg.

The University of Pittsburgh’s Medical Center has reported seeing a 167% increase in calls between 2015 and 2017 which related to loperamide overdose and observed more deaths related to overdose.  Loperamide can be an alternative for those who struggle with opioid addiction (including Oxycontin or Vicodin addiction), as it is a less costly and easier to obtain.

Overdose of Loperamide has also resulted in cardiac arrest in multiple cases. In 2016, the Federal Drug Administration brought attention to the dangerous effects of Loperamide. Heart-related issues have been reported in those who used high dosages of the drug, therefore more education and information for medical professionals has been released to prevent high dosages of Loperamide from being prescribed by physicians.

Because someone experiencing a loperamide overdose may develop central nervous system depression, after acute toxicity is treated, extra observation of the patient is necessary for at least 48 hours. Naloxone may be administered for a Loperamide overdose, however, Loperamide can stay in the system longer than 1-3 hours, which is the average time for Naloxone’s effectiveness in treating an overdose. Within the 48 hours timespan, it is essential that patient’s vital signs are monitored as there is risk for respiratory failure and dehydration. Another treatment for Loperamide overdose is the administration of activated charcoal, more commonly known as “pumping of the stomach”, which is a process that removes excess drugs or alcohol from the stomach.

Diarrhea is a common and significant side effect of opioid withdrawal. Therefore, Imodium (Loperamide) may be prescribed to address the diarrhea and prevent dangerous dehydration.

Imodium (Loperamide) is sometimes inappropriately used by individuals self-medicating opiate withdrawal symptoms other than diarrhea.  Imodium (Loperamide) is an opioid-receptor agonist that acts on the μ-opioid receptors in the large intestine.  At very high doses, Imodium will cross the blood-brain barrier and impact the opioid receptors in the brain.  This allows the individual to taper the impact of their opioid dependence withdrawal, however, it is a dangerous procedure.

Addiction treatment at Recovery Centers of America consists of a medically monitored detox as part of inpatient addiction treatment. Dependence and addiction on any opioid should be treated by medical professionals who can prescribe medications to make the withdrawal safer and more comfortable.

After the detox process, treatment will include one- on- one therapy and group therapy sessions, relapse prevention skill development, and various services that may help sustain recovery such as mindful meditation, seminars on healthy lifestyle techniques, and ways to maintain meaningful connections during the recovery process.

Once inpatient treatment is complete, Recovery Centers of America will assess the patient for outpatient treatment, a step down from inpatient, which is highly recommended for maintaining recovery after a 30-day inpatient program. RCA stays by our patients’ side every step of the way throughout their treatment and the recovery process. We also encourage patients to make connections with others in recovery in their local area by getting involved in their local RCA Alumni association.

If you or someone you know may be struggling with a loperamide addiction, please reach out to us by calling 1-800-RECOVERY.

• https://immodium.com
• https://medlineplus.gov/druginfo/meds/a682280.html
• https://pharmacy.utexas.edu/news/fatalities-due-megadoses-common-anti-diarrheal-medication
• https://addictionresource.com/drugs/imodium/mechanism-of-action/
• https://missouripoisoncenter.org/loperamide-an-unexpected-drug-of-abuse/
• https://www.healthline.com/health/imodium-and-opiate-withdrawal#dosage
• https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-serious-heart-problems-high-doses-antidiarrheal
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6663275/
• https://www.forbes.com/sites/brucelee/2018/03/31/another-overdose-of-an-anti-diarrhea-drug-this-time-a-death-from-loperamide/?sh=4368017e4202
• https://www.deachronicles.com/2019/09/fda-approves-new-packaging-for-poor-mans-methadone/
• https://www.fda.gov/drugs/drug-safety-and-availability/fda-limits-packaging-anti-diarrhea-medicine-loperamide-imodium-encourage-safe-use