Immodium - long term use & Withdrawal symptoms

Immodium (loperamide HCL) is classified as a synthetic opioid related to meperidine and fentanyl which are piperidine derivatives. The reason it relieves diarrhea is due to binding of mU opioid receptors in the gut which slows peristalsis thus allowing fecal matter to compact and lose water through reabsorption via the large intestine and it inhibits the gastrocolic reflex. Loperamide does cross the blood-brain barrier, but it is immediately pumped out into the non-CNS circulation by the action of P-glycoprotein. Loperamide prior to it's release was found to suppress withdrawal symptoms in morphine habituated primates. Certain drugs like cimetidine (an H2 receptor antagonist which acts on cytochrome P450 which decreases metabolism of competing substances like loperamide thus significantly increasing blood serum levels sometimes ending in a fatal overdose) and quinidine which are inhibitors of P-glycoprotein or PPI's (Proton Pump Inhibitors) can make the CNS vulnerable to opiate agonism from loperamide. and thus all the associated effects (habituation, respiratory depression, drowsiness). A mild withdrawal syndrome has been observed in studies of various laboratory animals following long-term use.

Thank you some common sense at last, just come off it after 6yrs an feeling much different your post heped by the way I was tole by my doctor it had no side effects BULL S***

The active ingredient in Immodium is loperamide. Loperamide works by binding to gut wall opioid receptors which inhibits peristalsis (or slows down the movement in your GI tract). loperamide by itself does not cross the blood brain barrier so you probably never felt any euphoria from the Immodium. Unfortunately, since it does attach to opioid receptors, you can still have symptoms of physical withdrawal. Try lowering the dose gradually over a few weeks instead of just stopping it all at once. This may help lessen the withdrawal symptoms. Hope this helps!

I see people had suggested the Costco Brand-which is considerably less than Immodium.

If you're not close to a Costco, chances are you're close to a Sams Club. I'm just chiming in to say Sam's has their own brand as well ("generic" version of Immodium)& 350 tabs, same ingredients as Immodium  for about the same ($6). VS. the cost of Immodium @ 24 tabs for $12-13

Brooke, try adding fiber to your diet - I promise you it will really help. There is a product I like with flax seed and fiber - it's called Nopalina Flax Seed - I used to take Immodium every day but this has helped me so much. You can sprinkle it on your food just as you would spices but after the food is cooked - sprinkle about a teaspoon at first to see how well you tolerate it and you can add more as you go. I wish I had known about this sooner. I don't know how it works but it really does!

you're wrong Kate. and a little arrogant. there are glycoprotein receptors at the bbb which can be overwhelmed by a high enough dose of loperamide. what these folks are describing is real. i was a biochem major a couple decades ago before becoming a physician & addiction specialist. a little humility young lady would serve you well.

U people are addicted to ASS medicine lol. Just do smack it's not as embarrassing as saying I'm an Imodium junkie or going to the store and cleaning out their supply.

Another physician here. Yes, Kate you are wrong. The BBB is not that hard to overwhelm if you take a higher dose than recommended. Loperamide addiction is becoming an increasingly greater problem as folks use it more to quell the symptoms of opiate withdrawal. Best wishes in your studies. A little humility goes a long way.

Hello Ms. Brooke,

Your problem is very common for people who used Imodium (or generic name Lorperamide). I would suggest that you go to your PC provider or at least talk to your Pharmacist. Imodium is used to decrease the amount of bowel movements or spasms in the GI system. So in essence you are actually allowing what ever bug that you have to take up shop in your gut. If you have any other side affects like bleeding or fowl smelling stool...go to the doctor ASAP. I have always been a proponent of a good quality probiotic eg. Nature's Bounty Ultra strength Probiotic 10 or even some of the ones available at GNC. Make sure that they have multiple bacteria strains and a high level of at least 10, 20 billion live cultures. The best thing to probably consider is getting the GI system back to a more natural flora. I wouldn't recommend 8 Imodium pills a day. I think one or two is more the norm. It is very difficult to eat foods nowadays with out fructose or extremely high sugar levels... It is best to let your doctor know what you are experiencing.

I have taken immodium for 27 years. It used to be when I took it, it would last me a couple of days. I am now up to 10 per day, if needed. I had once been told by a gastrointronologist to stay away from immodium. She said it has made my colon like that of an 80 year old woman and at the time I was 50. When I went off immodium, I had no side affects. But, after a year off, I went back because I couldn't deal with the diarrhea. My problem occurred from a motorcycle accident in 1988. Well, that' what I say, because they had removed 12 inches of my intestines and I never had diarrhea before. Doctors say it itsn't from the removal of some of my intestines, because they left that little flap between the large and small intestines. So, I live with what I have and take immodium.

YOU should not give advice when YOU don't know what YOU are talking about. Loperamide DOES cross the BBB in small amounts and if you take enough it WILL cause opiate effects and taken long enough, opiate withdrawals. I have taken it for over a year now and I can assure you that when I try to stop I go through horrible withdrawals and have to take it to stop them. Oh, I have no bowel issues either. Never have my whole life. I initially took it for withdrawals off of tramadol that the dr. had me on for fibromyalgia but lost my insurance and so lost the ability to afford going to the dr. anymore and had to cold turkey off the med. When I read online about people using loperamide for withdrawals off of opiates, I tried it. I took ten 2 mg pills and after about two or three hours I realized all my symptoms had vanished and I felt like I had taken my tramadol. Some people's body chemistry is different than others and they CAN get opiate effects off of loperamide. I know firsthand, and yes, I get diarrhea if I try to stop taking it. Remember I have not had any bowel issues in my life. It's just a withdrawal symptom from stopping loperamide, or any opiate for that matter. So please don't tell people things you don't really understand or have little firsthand knowledge of.

Adhesions from an appendectomy tied my bowel up and it was gangrenous by the time the 2nd opinion doctor (who saved my life) operated. I was 25 years old. The awful IBS like symptoms that followed were something I had to put up with according to the doctors. Imodium was only available via a doctor's Rx back in the 70s. I am now retired and in my late 60s. Lopermide gave me the ability to leave the house, work a full time job, have a social life and do a bit of travelling. On bad weeks I would take it daily to be able to get to work, but I think the most I ever took in one day was 6 tablets. If that did not solve the problem then something else (like a touch of food poisoning) was going on and I shouldn't be taking the imodium anyway.  I'm retired now and seldom go out so I really don't need to take it even if my system is acting up a bit. I always keep it in my purse just in case and if I travel I dose up to prevent problems. I have always had to have a pretty restrictive diet that consists of a lot of soluable fibers like rice and oatmeal. Fish and chicken, a little cheese, lots of yogurt, cooked vegetables and a few fruits. I can't do fats, beans, hot spicy, or overly large meals. Home-made chicken-veg soup poured over rice or just tuna and rice were "healing meals" for me. For young folks my advice would be to learn what foods your individual system tolerates, what your triggers are, and if you need to take imodium to live a functional life, then be sensible and follow the package directions (nowhere in them does it state you can take 30 pills a day). I've lived a lifetime with IBS and I've now and then been through all the described symptoms of depression, pain and isolation that the condition can generate. You can't "buy into" this condition and let it rule you. Control your diet, exercise daily and take the imodium just enough to let you live a life that is more interesting than being all wrapped up in your IBS.

You can get imodium really inexpensively if you buy the generic kind at Walgreens or Costco.

I too have been suffering, yes suffering using loperamide to get off of suboxone. Now I keep switching to poppy seed tea to try and stave off the loperamide withdrawal, but then when I stop the poppy tea I go right back loperamide again! Like a freaking merry go round of hell! I have been off of the lopes, I am now almost 4 days off and it has been hell. I have some freaking lopes in the bathroom, and it is taking all my will power to not take some. My latest stats are kind like this. On Thursday of a random week took 72 pills within 24 hours, after being off of them for 11 days while using poppy tea. Then Monday 40 pills, Tuesday 20, Wednesday 10, Thursday 5. By Friday the withdrawal was so bad I caved and took 55 pills. So then sat, sun, mon nothing. I have had a few comfort meds. Seroquel 25mg try to take as few as I can, flexeril, fioricet but no good because the caffeine makes me too irritable, and lastly I had 20mg of valium that I spilt up over 3 days. It basically is the restlessness and chest pressure/anxiety that is driving me nutso, not to mention I can't sleep! I would do anything for an ambien or two let me tell you. If you are going to lopes make sure you do a small amount no more than 30 pills and taper over 5 days. If you keep taking it you are i a world of hurt. I have withdrawn from methadone and it is worse, but this comes clothes, just from the sheer agitation and RLS and duration as well, I am sooo depressed, so exhausted because I was trying to do a low carb diet, so no comfort eating! The only major symptoms I have his restless limbs and sever I mean sever aggitation, and depression, anxiety.

I Was addicted to immodium for 5 years i recently stopped as my bowel collapse and lead to a hernia had emerceny surgery i have not took it for 5 weeks just poo normal now let nature take course