Anti-Diarrhea Medicine Abuse Leads To FDA Warning

The Food and Drug Administration is warning the public that taking extreme doses of over-the-counter anti-diarrhea medicine such as Imodium can have very serious effects and possibly be fatal. The warning, sent Tuesday, comes amid a string of deaths resulting from people taking too much of the medicine, which they're using as a substitute for powerful opioids and other painkillers.

Since the FDA approved loperamide, the active ingredient in the medicine, in 1976, the administration says it has received 48 reports of serious heart problems stemming from its use, including 10 deaths. More than half of those reports have come since 2010. But those are only self-reported cases, the FDA says, "so there are likely additional cases about which we are unaware."

In most of the cases, the FDA said, people were taking much more of the drug than recommended in an attempt to get high.

One study said that calls to poison centers related to loperamide abuse increased by 71 percent from 2011 through 2014. The New York Times reported that 12 cases of extreme illness or death have been linked to loperamide use over the last 18 months.

Otherwise, data on the problem is nearly nonexistent since the issue is so new.

"Loperamide's accessibility, low cost, over-the-counter legal status and lack of social stigma all contribute to its potential for abuse," William Eggleston, a toxicologist at SUNY Upstate Medical Center, said in a statement announcing a recent study of his on the topic.

Patch has reached out to Eggleston and SUNY Upstate Medical Center for more information.

Loperamide can produce a cheap high in very large doses. It can also cause serious heart problems that can be deadly.

The drug itself is an opioid that works by "slowing down the movement of the gut," according to WebMD. "This decreases the number of bowel movements and makes the stool less watery."

In recommended doses — no more than 8 mg per day over the counter and 16 when prescribed by a doctor — it is relatively harmless and is a common savior for people traveling in foreign countries or who just ate something that didn't sit well with them.

It's also dirt cheap.

Brand-name Imodium is available for $11 for 40 2-mg tablets. Generic store-brand loperamide can be bought for as little as $9 for 400 2-mg tablets.

It costs next to nothing for an opioid-like high. But that high could be deadly.

In large doses — the FDA did not say specifically how large — loperamide can cause serious heart problems such as an irregular heartbeat, which can be fatal. A study published last month detailed two cases in New York of people who attempted to self-treat their opioid addiction by taking anti-diarrhea medicine and died.

But, again, loperamide is a perfectly safe drug used to treat a common problem, if used correctly. Here are some steps the FDA says you can take to stay safe:

• Only take the recommended dosages — 8 mg per day over the counter or up to 16 when prescribed by a doctor.
• Stop taking the medicine if your diarrhea lasts more than two days.
• If anyone taking loperamide experiences fainting, an irregular heartbeat or unresponsiveness, seek medical help immediately.

Click here to read more from the FDA.