A recent study by Rutgers University found that overdosing on loperamide—a non-prescription, over-the-counter diarrhea medication, has increased nationwide in recent years. Published in the journal Clinical Toxicology, the study found increasing evidence in which patients with opioid use disorder will misuse loperamide to prevent and self-treat withdrawal symptoms. Some patients were also revealed to take high doses of loperamide to establish similar effects of taking heroin, fentanyl or oxycodone.
When used appropriately, loperamide is a safe and effective treatment for diarrhea – but when misused in large doses, it is more toxic to the heart than other opioids, which are classified under the federal policy as controlled dangerous substances. Credit: Rutgers University
Loperamide is inexpensive, can be bought in large quantities online and in retail stores, and is undetectable on routine drug tests. "When used appropriately, loperamide is a safe and effective treatment for diarrhea -- but when misused in large doses, it is more toxic to the heart than other opioids which are classified under federal policy as controlled dangerous substances," says senior author Diane Calello, who is also the executive and medical director of the New Jersey Poison Control Center at Rutgers University Medical School. "Overdose deaths occur not because patients stop breathing, as with other opioids, but due to irregular heartbeat and cardiac arrest."
Learn more about Loperamide as an anti-diarrheal drug:
The study reviewed reported cases of patients with loperamide exposure in a national registry. The patients that reported misuse of loperamide, taking in about 50 to 100 two-milligram pills per day, were mostly young Caucasian men and women.
"Possible ways of restricting loperamide misuse include limiting the daily or monthly amount an individual could purchase, requiring retailers to keep personal information about customers, requiring photo identification for purchase and placing medication behind the counter," stated Calello. "Most importantly, consumers need to understand the very real danger of taking this medication in excessive doses."
Source: Rutgers University