Drug and Alcohol

Loperamide: Do People Actually Abuse Imodium, an Over-The-Counter Drug?

Loperamide, better known as Imodium, is an over-the-counter medication that can also be abused. Learn more about loperamide abuse in our blog.

Loperamide: Abuse Potential, Uses, Side Effects, and More

Table of Contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

March 7, 2024

The Edge Treatment Center

Loperamide, also known as Imodium, is a common medicine used to treat diarrhea. Even though it's not usually habit-forming, there's still a chance you might misuse Loperamide. In this article, we'll discuss Loperamide - its abuse potential, side effects to watch out for, and its interactions with other medications.

We'll break down how Loperamide works to ease your symptoms and give you tips on using it effectively. Whether you're dealing with a one-time issue or managing a chronic condition, we aim to arm you with the knowledge to use Loperamide safely and confidently.

What Is Loperamide?

Loperamide, widely known by brand names like Imodium or Pepto Diarrhea Control, is a go-to medication for stopping diarrhea in its tracks. It's part of a group called antidiarrheals, designed to ease those frequent, inconvenient trips to the bathroom that come with diarrhea.

How Loperamide Works

When diarrhea turns your day upside down, Loperamide steps in to slow things down inside your gut. It targets your intestines, the part of your body that absorbs water and nutrients, helping to absorb more liquid and make your stool firmer. This means you'll find relief and make fewer bathroom visits.

Available over the counter for mild cases, Loperamide is easy to get when you need it. But remember, if your symptoms hang around or get worse, it's time to see a doctor for advice on the best way to use it. While it's great at easing symptoms, Loperamide doesn't cure the root cause of diarrhea.

Is Loperamide a Controlled Substance?

Loperamide is not classified as a controlled substance in most countries. Despite its non-restricted status, Loperamide carries a risk of misuse and abuse, especially when consumed in doses far exceeding the recommended amounts or for purposes other than its intended medical use. At high doses, Loperamide can mimic the effects of opioids, which has led to instances of abuse.

Recognizing the potential for misuse, regulatory bodies, including the U.S. Food and Drug Administration (FDA), have taken proactive measures. These include limiting the quantities of Loperamide available for purchase and modifying packaging to deter abuse. Such steps aim to strike a balance between maintaining Loperamide's accessibility for those who rely on its therapeutic benefits and preventing its exploitation.

These regulations underscore the importance of using Loperamide responsibly and as directed, ensuring it remains a safe and effective treatment for those in need.

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What Is the Abuse Potential for Loperamide?

Loperamide, primarily used for short-term treatment of diarrhea, is generally not classified as highly addictive, particularly when used according to prescription guidelines. Unlike more potent opioids such as morphine or oxycodone, it does not induce significant euphoria or intense psychological dependence.

However, as a member of the opioid medication family, Loperamide can interact with the body's opioid receptors. At exceedingly high doses or when misused, Loperamide has the capability to produce opioid-like effects and cross the blood-brain barrier, leading to effects on the central nervous system.

Instances of Loperamide misuse and abuse have been documented, especially among individuals attempting to self-manage opioid withdrawal symptoms or seeking to achieve euphoric states. Known as "Loperamide abuse," this excessive use is dangerous and can result in serious health risks.

How To Tell If Someone Is Abusing Loperamide

Misusing loperamide beyond its medical necessity or prescribed duration can lead to significant concerns. Recognizing the signs of misuse is key to understanding and addressing potential abuse:

Preoccupation with Loperamide

Spending much of the day focused on loperamide, including thoughts of acquiring more, its effects, and planning usage.

Inability to Cease Use

Persistent consumption of the medication despite attempts to stop.

Misrepresentation for Prescriptions

Fabricating symptoms to obtain loperamide prescriptions from healthcare providers.

Extended Use Beyond Need

Continuing to take loperamide after the medical need has ceased or beyond the recommended timeframe.

Increasing Dosage for Effect

Gradually requiring higher doses of the drug to experience the desired effects.

Seeking Euphoria Through Substitution

Using loperamide as an alternative to opioids for its euphoric effects or to mimic a high.

Noticeable Lifestyle Changes

Observing drastic shifts in physical appearance, personal hygiene, and overall behavior.

If you suspect someone is abusing loperamide, approach the situation with kindness and concern. Offer your support and encourage them to seek professional help. Remember, acknowledging the problem is the first step toward recovery.

What Is Loperamide Used For?

Loperamide has multiple uses. They include:

Treat Acute Diarrhea

You can use Loperamide to quickly address symptoms of acute diarrhea caused by viral or bacterial infections, food poisoning, or medication side effects.

Manage Chronic Diarrhea

If you're dealing with long-lasting diarrhea related to conditions like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), Loperamide can offer relief.

Relieve Travelers' Diarrhea

When traveling to places with unfamiliar food and water sources, you can count on Loperamide to reduce the frequency and urgency of bowel movements.

Control Chemotherapy-Induced Diarrhea

If chemotherapy is causing you diarrhea, Loperamide can help manage these symptoms, improving your quality of life during treatment.

Manage Ileostomy Symptoms

For those with an ileostomy, Loperamide can help control bowel movements and reduce stool output, making life more comfortable.

Support Gastroenteritis Treatment

If you're suffering from gastroenteritis, or stomach flu, Loperamide can ease your symptoms and help get your bowel function back to normal.

Aid in Postoperative Diarrhea Management

After surgery, if you experience diarrhea due to anesthesia or changes in your digestive system, Loperamide can help you manage these symptoms and aid in your recovery.

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Loperamide Side Effects

Here are some of the most common side effects of using Loperamide.


You might experience constipation if Loperamide slows your bowel movements. This is more likely if you use it in higher doses or for longer than recommended.

Abdominal Discomfort

Loperamide can cause abdominal discomfort, bloating, or cramping. These symptoms are usually mild and temporary.

Nausea and Vomiting

Some people may feel nauseous or vomit after taking Loperamide. If these symptoms don't go away or get worse, you should seek medical help.

Dizziness or Drowsiness

Loperamide can make some individuals feel dizzy or drowsy. Be careful with activities that require alertness, like driving or using machinery, until you know how it affects you.

Dry Mouth

Occasionally, Loperamide can lead to a dry mouth, making you thirstier or making it hard to speak or swallow.

Allergic Reactions

Though rare, allergic reactions to Loperamide can happen. Symptoms like a rash, itching, swelling, severe dizziness, or trouble breathing require immediate medical attention.

Less Common Side Effects

Less common side effects of loperamide include:

Severe Constipation or Fecal Impaction

Taking too much Loperamide or using it for too long can lead to severe constipation or a blockage in your intestines.

Severe Allergic Reactions

Swelling of the face, lips, tongue, or throat, trouble breathing, and hives are signs of a severe allergic reaction.

Paralytic Ileus

This rare condition, where the intestines don't move as they should, can occur with high doses of Loperamide.

Cardiac Arrhythmias

Irregular heart rhythms may happen if Loperamide is taken in high doses or with other drugs that affect heart rhythm.

Central Nervous System Effects

High doses or misuse of Loperamide can cause confusion, disorientation, hallucinations, or mood changes.

Remember, while Loperamide is effective for diarrhea relief, knowing and monitoring for side effects is crucial for your health and safety.

Loperamide Interactions

Some medications, substances, or medical conditions can interact with Loperamide. To ensure the safe and effective use of Loperamide, be aware of these possible interactions.

Central Nervous System Depressants

Using Loperamide with other CNS depressants like opioids, sedatives, tranquilizers, or alcohol can increase effects such as sleepiness, dizziness, and poor coordination. It's wise to avoid or be cautious when using Loperamide with these substances.


Quinidine, a drug for heart rhythm problems, can stop Loperamide from breaking down in your body, leading to higher levels of Loperamide. This might cause irregular heartbeats, so it's best not to use them together.


Certain antibiotics, especially macrolides, can slow down the breakdown of Loperamide, raising its levels in your body and possibly leading to heart rhythm issues. If you're taking antibiotics, check with your doctor about using Loperamide.

P-Glycoprotein (P-Gp) Inhibitors

Drugs like verapamil, quinidine, and some antifungals inhibit P-gp, a protein that helps move substances out of cells and can increase Loperamide levels. If you're using these medications, you might need to adjust your Loperamide dose under medical supervision.

Medical Conditions

If you have liver disease or reduced liver function, Loperamide might break down more slowly in your body, raising the risk of higher drug levels and potential side effects. Be sure to discuss your health conditions with your doctor.

Other Medications

Loperamide can interact with various other medications, including those you can buy without a prescription and herbal supplements. Always inform your healthcare provider about all the medicines and supplements you're taking.

If you find yourself struggling with Loperamide misuse or if you need guidance on how to manage its side effects effectively, The Edge Treatment Center is here for you. We provide compassionate support and personalized care tailored to your specific needs, ensuring you navigate your recovery journey safely.

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Do you need advice about loperamide abuse? Reach out today.

What Are Loperamide Withdrawal Symptoms?

Withdrawal from Loperamide is uncommon but can happen if you use it in high doses or for a long time, especially if misused. Normally, Loperamide doesn't lead to withdrawal if you follow the prescribed amount. However, misusing it can cause dependence and withdrawal symptoms once you stop.

Common withdrawal symptoms include:

  • Stomach Issues: You might have stomach cramps, diarrhea, nausea, or vomiting.

  • Pain: Body aches and muscle pain are possible.

  • Mood Changes: You could feel anxious, restless, or irritable.

  • Sleep Problems: Stopping Loperamide might make it hard to sleep.

  • Cravings: There might be a strong desire to take the medication again.

Overcoming The Hold of Addiction

The Edge Treatment Center focuses on outpatient recovery, offering personalized plans for those dealing with Loperamide misuse and other addictions. Our flexible programs fit your lifestyle, allowing you to balance treatment with daily responsibilities.

Key Benefits:

  • Flexible Scheduling: Fit treatment around your life, not the other way around.

  • Stay Connected: Our device-friendly policy keeps you in touch with your support network.

  • Family Support: We involve your loved ones through counseling and support sessions.

  • Tailored Care: Receive personalized treatment from our expert clinicians, addressing both addiction and mental health needs.

  • 24/7 Support: Access our medical staff and support services anytime, ensuring you're fully supported every step of the way.

Join us at The Edge Treatment Center for treatment options that empower your journey to recovery, helping you lead a life free from addiction. Contact The Edge today to learn more.

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