Anti-Diarrhea Drug Loperamide Linked To Opioid Addiction Deaths And FDA Wants It To Stop

Kevin D. LilesAP Images

When you head off on vacation, the chances are that you will pack an over-the-counter anti-diarrheal drug in your luggage. Nothing ruins a vacation more than being unable to venture more than 10-yards from the nearest bathroom for fear that diarrhea will strike. Popular anti-diarrhea drugs, like Imodium, contain an active ingredient called Loperamide, which helps to combat diarrhea by slowing down movement in the gut. This cuts down the number of bowel movements and makes the stool less watery. Loperamide is also used to treat those who have ongoing loose bowel symptoms due to conditions like irritable bowel syndrome.

As reported by the National Institute for Health and Care Excellence [NICE] Loperamide is a perfectly safe drug when the manufacturer’s guidance is properly followed. Nice does, however, warn that large doses of Loperamide can cause cardiac arrest, liver failure, and death when Loperamide is abused.

As reported by USA Today last year, opioid addicts have been using Loperamide in huge doses to get high. The recommended maximum daily dose for Loperamide is 16 milligrams per day, with a normal dose being 8-10 milligrams in any 24-hour period. According to reports, some opioid addicts are using up to 200 milligrams of Loperamide per day because large doses can produce a high similar to heroin use.

Loperamide abuse has become so widespread that it now sometimes referred to as “the poor man’s methadone.” Like Methadone large quantities of Loperamide are being used by some addicts to mimic the effect of opioids or to help to relieve the symptoms of heroin withdrawal.

Loperamide Imodium FDA Opioid Warning
Featured image credit: J. Scott ApplewhiteAP Images

As reported by the Washington Post, the Food and Drug Administration have become so concerned by Loperamide abuse that they have formally asked manufacturers to help to reduce abuse by changing the way they package over-the-counter medicines containing Loperamide. FDA Commissioner Scott Gottlieb said yesterday that it was taking the action because abuse of Loperamide is “adding to the death toll of the nation’s opioid epidemic.”

The FDA wants Loperamide manufacturers to reduce the number of doses in a package to just eight 2-milligram capsules, enough for two days of anti-diarrhea treatment. They would also like manufacturers to introduce “blister packs” that have to be unpeeled to access each dose.

As with all licensed pharmaceutical products, the message on Loperamide is a simple one. Stick to the manufacturer’s guidance on dosages, don’t self-medicate, and if in doubt consult a medical professional.