Imodium is a useful over-the-counter drug for diarrhea that can be toxic to the heart in high doses and have long-term risks.

Article at a Glance:

  • Imodium is the brand name for loperamide, an over-the-counter drug for diarrhea.
  • Imodium is not an opioid and does not readily cross into the brain but instead works on opioid receptors in the gut.
  • Some people misuse Imodium in an attempt to get high or treat opioid withdrawal symptoms.
  • High doses of Imodium can cause potentially fatal cardiac side effects.

Imodium Side Effects

Imodium, the brand name for loperamide, is an over-the-counter medication used to treat diarrhea. Although loperamide is not considered to be an opioid, it works on opioid receptors in the gut to slow down intestinal movement. The result is fewer bowel movements and less watery stool. Unless directed by a physician, Imodium isn’t intended to treat long-term or chronic diarrhea. Side effects are possible, even when someone uses Imodium as directed or intended. Although some side effects are common and expected, a person who is abusing Imodium may have more serious side effects.

Imodium Common Side Effects

When taking Imodium at normal therapeutic doses, Imodium is generally well-tolerated. Most side effects are mild, and few are expected. The common side effects of a therapeutic Imodium dose are:

  • Dizziness
  • Constipation
  • Abdominal cramps
  • Nausea

Imodium Major Side Effects and Overdose

With Imodium misuse, side effects can be more severe. Because Imodium does not readily cross the blood-brain barrier, high doses are required to achieve psychoactive effects like euphoria. This can lead to dangerous cardiac side effects like:

  • Fainting
  • Rapid heartbeat or irregular heartbeat
  • Unresponsiveness

Because of its impact on electrical conduction within the heart, an Imodium overdose can be fatal in severe cases.

Imodium Long-Term Side Effects

Long-term side effects of Imodium use are unclear. Because Imodium is intended as a short-term medication to treat diarrhea, its long-term effects have not been extensively studied. This is especially true when discussing the high doses of the drug that are sometimes misused. Only a few case reports exist about long-term Imodium use, with some people experiencing heart damage while others did not.

Signs of Imodium Abuse

Imodium abuse is a problem in the United States. In 2019, the FDA limited Imodium’s package size and total doses per package for this reason. While some people misuse Imodium to control diarrhea, others misuse it in an attempt to ward off opioid withdrawal symptoms or get high. When a person begins to become dependent on a drug like Imodium, certain signs can emerge. These can be physical, psychological or behavioral.

Behavioral Signs of Abuse

Someone struggling with Imodium use may start showing certain signs as they descend into addiction. Many behavioral symptoms are common to multiple substances and are not specific to a certain drug. Substance abuse symptoms include:

  • Acting socially withdrawn
  • Avoiding family or friends
  • Spending an abnormal amount of time with new friends
  • Losing interest in things that once gave pleasure
  • Having problems sleeping or sleeping at strange times
  • Forgetting appointments
  • Missing deadlines
  • Experiencing problems at work or school
  • Having problems with family
  • Acting recklessly
  • Having legal problems

Physical Signs of Abuse

Although Imodium is generally well-tolerated, physical symptoms can occur when a person abuses the drug. These include:

Although all signs of abuse mean that addiction should be addressed, physical signs of Imodium abuse can be signs of toxicity, which can be fatal in some cases. You should seek emergency medical attention immediately if you or a loved one show physical signs of Imodium abuse.

Psychological Signs of Abuse

Psychological signs of abuse can also manifest when someone starts struggling with Imodium. Some symptoms include mood swings and irritability.

Find the Help You Need

Just because a drug like Imodium is over-the-counter does not mean that it is safe or that you cannot become addicted to it. If you or a loved one struggles with Imodium misuse, you don’t have to struggle alone. Our experts at The Recovery Village can help you begin an Imodium-free life with treatment options that can work well for your situation.

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

U.S. Food and Drug Administration. “FDA limits packaging for anti-diarrhea m[…]o encourage safe use.” September 20, 2019. Accessed December 20, 2020. “Loperamide.” July 3, 2020. Accessed December 20, 2020.

Zarghami, Mehran; Rezapour, Maryam. “Loperamide Dependency: A Case Report.” Addiction & Health, January 2017. Accessed December 20, 2020.

National Institute on Drug Abuse. “Commonly Used Drug Charts.” August 20, 2020. Accessed December 20, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.