Brand name(s): Imodium, Anti-Diarrheal, Diamode, Imotil, K-Pek, Kao-Paverin, Maalox Anti-Diarrheal, Pepto-Bismol Diarrhea Control, Valu-Rite Anti Diarrheal

Generic names: loperamide

Preparations: tablet, liquid, capsule

Uses for IBS
Imodium, or loperamide, is an oral antidiarrheal agent. It is chemically related to opioids. It is used to treat acute nonspecific diarrhea as well as chronic diarrhea associated with inflammatory bowel disease (IBS). It has been endorsed by the American Gastroenterology Association for the management of IBS with diarrhea. It is also used to reduce the volume of discharge from ileostomies and to treat travelers’ diarrhea.

Loperamide slows motility by directly acting on the muscles of the intestinal wall. It also inhibits fluid and electrolyte secretion and increases water absorption. By increasing the transit time of the intestinal contents, loperamide reduces fecal volume, increases the bulk density and the viscosity of the feces, and decreases the loss of electrolytes and fluids from the body. Loperamide is chemically related to opioids, however, it does not exhibit analgesic or opiate-like effects, even at high doses. Tolerance to its antidiarrheal effect has not been observed, and it does not appear to produce physical dependence.

Children under 2 years old should not take loperamide. Precautions should be taken in young children and should be discontinued if there is no improvement of symptoms in 48 hours. Loperamide is safe in women who are pregnant or breastfeeding. Precautions should also be taken in the elderly.

People with paralytic ileus should not take loperamide. Also, people who experience bloating or who have dysentery, infectious diarrhea, or liver disease should use precaution when taking loperamide.

Moderate reactions may occur when loperamide is taken with quinidine (heart drug), saquinavir (HIV drug), and thyroid medications.

Adverse Reactions
Loperamide is generally well tolerated, and adverse reactions are usually self-limiting. The following have been reported during treatment: epigastric or abdominal pain, abdominal distension, constipation, drowsiness, dizziness, dry mouth, fatigue, headache, and nausea and vomiting.

Paralytic ileus occurs rarely and has occurred in cases of overdose, acute dysentery, or in children under 2 years old. Other adverse events that have been reported include hives, indigestion, flatulence, itching, and urinary retention.