title: Loperamide, the "Poor Man's Methadone": Brief Review.
abstract: Loperamide is widely available as an inexpensive, over-the-counter remedy commonly used for management of diarrhea. Although an opioid, at therapeutic doses it acts primarily on the gastrointestinal tissues; however, larger than recommended amounts facilitate central nervous system (CNS) penetration. Such high doses of loperamide have recently gained popularity among users of opioids to manage withdrawal symptomatology and, less frequently, to achieve psychoactive effects. Chronic loperamide use can result in development of tolerance and, upon abrupt cessation of use, withdrawal. With increasing prevalence of use, side-effects are noted, one particularly being life-threatening cardiac arrhythmias. Users are often not forthcoming and routine drug screens do not detect loperamide, so providers need to be alert to such practices in order to recognize intoxication, be able to screen for use, and facilitate entry into treatment.
authors.affiliation: a Resident Physician, Department of Psychiatric Medicine, Brody School of Medicine , East Carolina University , Greenville , NC , USA.
authors.forename: Cornel N
authors.initials: CN
authors.lastname: Stanciu
authors.affiliation: a Resident Physician, Department of Psychiatric Medicine, Brody School of Medicine , East Carolina University , Greenville , NC , USA.
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Gnanasegaram
mesh_terms: D000930:Antidiarrheals / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004361:Drug Tolerance; D006801:Humans; D008139:Loperamide / Q000008:administration & dosage / Q000009:adverse effects*; D015813:Substance Abuse Detection / Q000379:methods; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*
chemical_list: D000930:Antidiarrheals; D008139:Loperamide
keywords: Cardiotoxicity; imodium; loperamide; opioid intoxication; opioid withdrawal