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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I take Imodium to control diarrhea . I am 81

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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3571 Questions

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Posted on Fri, 25 Jan 2019 in Medicines and Side Effects
Question: I take Imodium to control diarrhea. I am 81 years of age. My condition started 14 months ago. I took this med intermittently at first but it cold not give me reliable relief until I began taking it once a day and I have done this for ten days now with the reliable relief I was seeking. My question is about the Imodium: I have heard it has an opioid-related feature whose effect is to slow down the digestive process. I think this is true, based upon my recent experience and the results have been satisfactory. But I am concerned about the opioid? Is this likely to become addictive? I think the med does make me sleepy, but I also take a medicatition called fesoterodine to control urine and this may also contribute to the sleepiness. My chief concern is the opioid. Is it in this med? Is It dangerous for long term use as I plan to do.
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Answered by Dr. Panagiotis Zografakis 1 hour later
Brief Answer:
there is potential for addiction

Detailed Answer:
Hello,

there is some potential for abuse of imodium because loperamide indeed has some opioid abilities. Thankfully its low absorption by the gastrointestinal tract and its removal from the central nervous system due to the presence of a special transporter reduces its psychoactive effects. At high doses though it may indeed cause opioid-like euphoria and addiction.

It may cause sleepiness and other similar symptoms (like dizziness and fatigue).

It's not appropriate for long term management of diarrhea as it does not treat the cause. It only reduces the motility of the intestines, therefore reducing the diarrhea. If the diarrhea has not stopped after a few days then continuing the use of loperamide is not a good option. If you intend to use it from time to time then it's OK. Using it every day may reduce your symptoms but the cause won't be discovered and treated.

Regarding your concerns about addiction, it would be difficult to occur with the recommended doses. You're going to need many pills to start experiencing the psychoactive effects. A normal patient who only needs imodium to relieve diarrhea will never take enough pills to get into danger for addiction.

I wouldn't consider loperamide a dangerous drug for the average patient. It would be better given for a short time though. A constipated patient should investigate the cause of constipation.

I hope I've answered your question. Please let me know if you need further assistance.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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