title: Notes from the Field: Cardiac Dysrhythmias After Loperamide Abuse - New York, 2008-2016.
abstract: Loperamide is an over-the-counter antidiarrheal with opioid-receptor agonist properties. Recommended over-the-counter doses (range = 2-8 mg daily) do not produce opioid effects in the central nervous system because of poor oral bioavailability and P-glycoprotein efflux* of the medication (1); recent reports suggest that large doses (50-300 mg) of loperamide produce euphoria, central nervous system depression, and cardiotoxicity (2-4). Abuse of loperamide for its euphoric effect or for self-treatment of opioid withdrawal is increasing (5). Cases of loperamide abuse reported to the Upstate New York Poison Center and New York City Poison Control Center were analyzed for demographic, exposure, clinical, and laboratory characteristics. Cases of intentional loperamide abuse reported to the National Poison Database System (NPDS) also were analyzed for demographic, dose, formulation, and outcome information.
authors.forename: William
authors.initials: W
authors.lastname: Eggleston
authors.forename: Jeanna M
authors.initials: JM
authors.lastname: Marraffa
authors.forename: Christine M
authors.initials: CM
authors.lastname: Stork
authors.forename: Maria
authors.initials: M
authors.lastname: Mercurio-Zappala
authors.forename: Mark K
authors.initials: MK
authors.lastname: Su
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Wightman
authors.forename: Karen R
authors.initials: KR
authors.lastname: Cummings
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Schier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008139:Loperamide / Q000633:toxicity*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011039:Poison Control Centers; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D008139:Loperamide