Loperamide – Frequently Asked Questions

What is Loperamide?

Loperamide hydrochloride, sold under the brand name as Imodium, is an over-the-counter drug used to treat diarrhea. It works by slowing down the contractions in the intestines, effectively relieving symptoms of diarrhea. It has also been increasingly used by people suffering from opioid addiction and dependence to treat their withdrawal symptoms.

Loperamide - Frequently Asked Questions
While loperamide is considered to be safe to use for most people, it should be avoided by people with certain conditions. If you have a fever you should avoid taking loperamide. People with bloody stools should also avoid loperamide. It is generally considered to be safe for women who are pregnant but doctors recommend that women who are nursing should also avoid taking loperamide. Loperamide can result in adverse reactions in people who may have been exposed to salmonella or E. coli.
When taken in the proper dosage, side effects of loperamide are mostly mild and are not very common. They include constipation, dizziness, nausea and abdominal cramps.
Yes, loperamide is actually an opioid. However, it is different than most opioids in that it does not usually pass through the blood-brain barrier. That means that loperamide has no effect on the opioid receptors in the brain, which is how other opioids achieve their pain-relieving and euphoric properties. Loperamide, instead, acts on opioid receptors in the digestive system to slow down the intestines, effectively relieving symptoms of diarrhea.
Loperamide is not currently scheduled as a controlled substance by the DEA. However, due to recent abuse of the drug and reports of overdoses, the FDA has recommended that its sale should be restricted. Loperamide may soon be sold in packages containing smaller amounts or eventually moved behind the counter, much like pseudoephedrine was after it became popular in the production of methamphetamine.
When taken in standard doses, loperamide will not result in a high since it does not work on the opioid receptors in the brain. There have, however, been anecdotal reports of people getting high when they take very large doses of loperamide. High amounts of loperamide may overwhelm the system and allow the drug to cross the blood-brain barrier, where it can bind to the opioid receptors in the brain and cause effects similar to those of other opioids.
Many people have attempted to use loperamide to manage their opioid withdrawal symptoms. However, in the same way that loperamide is misused for euphoric effects, people suffering from opioid addiction would need to take dangerously large amounts of loperamide to treat their withdrawal symptoms. Loperamide is not an acceptable or safe substitute for other opioid replacement therapies.
It is possible to overdose on loperamide. People who are using the drug for recreational purposes or to manage their opioid withdrawal symptoms take massive amounts of loperamide which can lead to heart complications. Disruption of the heart’s rhythm can lead to unconsciousness and even death.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.