Imodium increases blood pressure

Too much loperamide harms the heart

Fast and reliable help - that's what patients expect from diarrhea medication. Loperamide fulfills exactly these requirements. But an overdose of the drug causes life-threatening cardiac dysfunction.

During the holiday season, many holidaymakers buy loperamide (Imodium®) for their first-aid kit. The drug suppresses bowel movements. As a result, it acts unbeatably quickly against diarrhea. Chemically, loperamide is related to morphine. However, it lacks the euphoric effect. It is therefore available without a prescription. But: "Without a prescription does not mean harmless," emphasizes Prof. Dr. Martin Schulz, chairman of the drug commission.

Life-threatening cardiac disorder after overdose

If loperamide is abused or accidentally overdosed, it can be life-threatening, ”warns Prof. Schulz. According to the American Food and Drug Administration (FDA), ten people have died of cardiac arrest following a loperamide overdose in the past forty years. Another 31 were cared for in the intensive care unit with cardiac arrhythmias, according to the American Medicines Agency. In view of the available data, heart patients should only take the drug after consulting their doctor.

Pay attention to the correct dosage

The body breaks down higher amounts of loperamide more slowly, resulting in poisoning. That is why the correct dosage is crucial. At the beginning of treatment, patients take two capsules with 2 mg loperamide once. They swallow another capsule after each other unformed stool. It is important that you do not exceed the maximum daily amount of 6 capsules. If the symptoms do not improve after 48 hours, a doctor should be consulted.

Additional medication increases the risk

Loperamide is unsuitable for patients with inflammatory bowel diseases as well as febrile or antibiotic-related diarrhea. Some drugs increase the effects of loperamide. They include the cholesterol-lowering drug gemfibrozil, the antibiotic chlarithromycin and the antifungal drug itraconazole. Prof. Schulz therefore recommends in principle: "Anyone who takes loperamide should ask the pharmacy about possible interactions."

Alternatives for loperamide

Heart patients are best looking for an alternative to loperamide. Vaprino® and tannin-containing drugs such as Uzara® reduce the amount of fluid released into the intestine. Tannacomp® also has a disinfectant effect. In addition, like the probiotic drugs Perocur® and Perenterol®, it is suitable for the prevention of diarrheal diseases. All of the drugs mentioned have the advantage over loperamide that they do not close the stomach. As a result, the poisons, viruses or bacteria that cause disease get out of the body more quickly.

Source: Federal Association of German Pharmacists' Associations, Arznei-Telegram


Susanne Schmid / Arznei-Telegram / Federal Association of German Pharmacists' Associations | last changed on at 16:26

Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.