Podcast #198: Imodium

Author: Aaron Lessen M.D.

Educational Pearls:

• Imodium (loperamide) is a mu-opioid receptor agonist. Traditionally, it is used as an anti-diarrheal. It is also abused recreationally for an opioid high and to self-treat opioid withdrawal.
• 40 or more pills are often ingested. People often co-ingest with cimetidine to potentiate the desired effects.
• Patients will present with opioid overdose symptoms (narrow pupils, respiratory depression).
• Narcan is effective in reversing an overdose of Imodium.
• Imodium prolongs QT and predisposes to Torsades, so monitor rhythm and then treat like any other opioid OD.

References: http://www.tandfonline.com/doi/abs/10.3109/15563650.2016.1159310