Imodium and Opiate Withdrawal

Medically reviewed by Darren Hein, PharmD on January 4, 2017Written by Christine Case-Lo

Introduction

Addiction to prescription opiate drugs is a growing problem in the United States. Withdrawal can be unpleasant and difficult. Symptoms such as diarrhea, muscle aches, runny nose, sweating, chills, and nausea can be intense.

Anyone going through withdrawal should consider the help of a doctor or treatment center. Doctors can prescribe medications such as clonidine and buprenorphine that can help make withdrawal symptoms less intense.

Still, over-the-counter medications such as Imodium can help. Imodium can be used to help relieve diarrhea whether you’re in a treatment program or going through withdrawal at home. Find out how this common over-the-counter drug or its prescription version loperamide could help you through opiate withdrawal.

About opiate withdrawal

Opiate withdrawal occurs when you stop taking an opiate medication after developing a physical dependence on the drug. Anyone taking an opiate can become dependent on it. This includes people taking prescription medication for pain as well as people taking an illegal drug to get high.

Withdrawal symptoms can vary and are often the opposite of the opiate’s side effects. For instance, a common side effect of opiate use is constipation. During withdrawal, you might have diarrhea instead. Along those same lines, you might experience anxiety instead of depression, excessive sweating instead of dry skin, or dilated pupils instead of constricted pupils.

As you go through withdrawal, constipation from the opioid goes away and bowel movement returns quickly. This can lead to severe diarrhea and cramping that can last for a few days up to a few weeks. Dehydration due to diarrhea and vomiting is a serious risk in withdrawal. In severe cases of dehydration, you might need to go to the hospital. Therefore, it’s important to treat any diarrhea right away.

How Imodium works

Imodium helps prevent and treat diarrhea by slowing down digestion and the movement of your intestines. Loperamide, the active ingredient in Imodium, is an opiate receptor agonist. That means it’s a type of opiate. It works by affecting proteins called opioid receptors found in cells in your gastrointestinal tract. It signals these opioid receptors to keep working. This balances your digestive system to keep you from having diarrhea or constipation.

Unlike other opiates, however, loperamide doesn’t cross the blood-brain barrier into your brain or spinal column. Therefore, it doesn’t cause a high or relieve pain like other opiates can. To cause those effects, a drug has to reach the brain.

Imodium effects and overdose

Some people use Imodium to try to relieve other withdrawal symptoms besides diarrhea. No clinical studies have been done on using Imodium for this purpose. There is no data showing that large doses of Imodium can treat these symptoms.

Scientists also know that Imodium doesn’t cross the blood-brain barrier. As a result, Imodium can’t have a direct effect on withdrawal symptoms controlled through the central nervous system, such as pain, sweating, crying, and yawning.

Taking too much of the drug can also be dangerous. Imodium doses up to 60 mg can cause nausea and vomiting. Taking more than that can lead to overdose, which can cause serious health problems, such as:

  • liver damage
  • urinary retention
  • paralytic ileus (stoppage of the intestine)
  • slowed breathing
  • slowed heart rate
  • heart arrhythmia
  • heart attack
  • death

FDA warning

In 2016, the Food and Drug Administration (FDA) issued a warning stating that high doses of Imodium can cause severe heart problems such as heart arrhythmias and heart attack. High doses can even lead to death. Don’t take more Imodium than the package instructions recommend. And if you have a prescription for loperamide, don’t take more than your doctor has prescribed.

Using Imodium properly

It’s important to take Imodium according to the recommended dosage. At the time this article was written, the recommended adult dosage of Imodium was as follows:

  • Take two caplets or softgels or 30 mL of the liquid after the first loose stool.
  • Then, take one caplet or softgel or 15 mL of the liquid after each later loose stool.
  • Don’t take more than four caplets or softgels or 60 mL of the liquid in 24 hours.

Be sure to limit your use to two days and to check the package label for complete dosage information. If you want to use the medication for longer, talk to your doctor first.

Talk with your doctor

At the right doses, Imodium is safe to use for treatment of diarrhea caused by opiate withdrawal. Keep in mind that it must be used in the recommended doses and for the recommended amount of time.

When going through opiate withdrawal, you may have more questions about diarrhea, Imodium, or withdrawal in general. Don’t hesitate to ask your doctor. Some questions you could ask include:

  • Is Imodium a good choice for treating my diarrhea caused by withdrawal?
  • How long can I safely take Imodium?
  • What dosage would work for me?
  • Are there other over-the-counter or prescription medications I can take to help ease withdrawal symptoms?
  • Can you recommend an opiate addiction treatment center?
CMS Id: 71452