Loperamide is marketed as an over the counter (OTC) antidiarrheal agent (Imodium) which may be sold in combination with atropine (Imodium-AD). Loperamide is an opioid and can be abused and cause dependence.
The risk of abusing Imodium-AD was thought to be low because the toxic side effects from the atropine would limit use.
A person who abuses loperamide:
(1) may take large doses for a period of time
(2) may present with opioid toxicity
(3) may present with cardiac conduction disorders (long QT interval, ventricular tachycardia)
(4) may present with catatonia, agitation or alterned mental status
(5) other anticholinergic side effects (fever, dry mouth, etc)
(6) may develop pancreatitis
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