Loperamide

The need-to-know information about Loperamide (Imodium)

Loperamide

Pearls and Fun Nuggets

1. Loperamide is related to morphine šŸ’‰ It’s an opioid-receptor agonistĀ and acts on theĀ Ī¼-opioid receptorsĀ in theĀ myenteric plexusĀ of the large intestine. It works likeĀ morphine, decreasing the activity of the myenteric plexus, which decreases the tone of the longitudinal and circularĀ smooth musclesĀ of the intestinal wall.[31][32]

2. It’s also sometimes paired with anti-flatulent medications šŸ‘Œ In the late 1980s, before the US patent expired on 30 January 1990,[49]Ā McNeil company started to developĀ Imodium AdvancedĀ containing loperamide andĀ simethiconeĀ for treating bothĀ diarrheaĀ andĀ gas. In March 1997, the company patented such combination.[53]Ā The drug was approved in June 1997, by the FDA as Imodium Multi-Symptom Relief in the form of a chewable tablet.[54]

3. Loperamide used to be a controlled substance šŸ’ŠWhen originally approved for medical use in the United States, loperamide was considered a narcotic and was put into Schedule II of the Controlled Substances Act 1970. It was transferred to Schedule V on 17 July 1977, and then decontrolled on 3 November 1982.[42]

4. Be careful taking it with other antimotility drugs ā˜When combined with other antimotility drugs, the risk of constipation is increased. These drugs include other opioids, antihistamines, antipsychotics, and anticholinergics.Ā 

Ā 

Patient Perspectives

“I have IBS and had a bad flare up. 4 weeks of tests and constant diarrhea, they finally confirmed there was no infection so allowed me to take Immodium. I chose the plus comfort as I also have stomach pains. Followed instructions and took 2, I don’t mean to be crude, but I am elated to say that the next day I managed a normal BM for the first time in a month! Not noticed any help with the stomach pains/bloating but has definitely helped the flare up!”

Ā 

“If I eat meat, spicy foods, or dairy products, especially if it is later in the day, I sometimes get acute diarrhea at night. This is sometimes accompanied by pain that is bad enough to double me over. Imodium has always stopped the diarrhea, and the pain that I get with it, and almost always within two doses. As the bottle suggests, I take two pills after the first loose stool, and one after any subsequent loose stool. Although other medicines (such as Pepto-Bismal / Kaopectate) can also be helpful, whenever I sense that these symptoms are starting, I think of Imodium right away, because I know there is a very high probability that it will make the period of discomfort be as short as possible.”

Ā 

“I felt better about 3 hours after taking 2 tablets. Still have a slight problem though but will be taking one more twice a day and I expect to feel much better then.”

Brandon Simpson, PA-C
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