What Is the Work of Loperamide Hydrochloride
Imodium is a brand-name, over-the-counter (OTC) medication that's used to treat diarrhea. Because it's OTC, you don't need a prescription from your doctor to purchase Imodium.
With diarrhea, you have loose or watery stools that occur more often than normal. Imodium can be used to treat both:
- Acute (short-term) diarrhea. This type of diarrhea lasts up to a few days. And it's most often caused by a stomach bug or food poisoning. Typically, Imodium is used for acute diarrhea.
- Chronic (ongoing) diarrhea. This type of diarrhea lasts for more than 4 weeks. And it's usually related to long-term bowel conditions, such as irritable bowel syndrome (IBS) or Crohn's disease. For chronic diarrhea, Imodium should only be used if it's recommended by your doctor.
Drug details
Imodium is available in four different products, which all contain the drug loperamide. Loperamide is an antimotility drug. This means it slows down movements in your intestine and helps to control diarrhea.
Here's a summary of the differences between available Imodium products:
* Simethicone is called an antiflatulent drug. It reduces symptoms of excess gas that can occur with diarrhea, such as cramps and bloating.
Effectiveness
For information on the effectiveness of Imodium, see the "Imodium for diarrhea" section below.
Imodium A-D, which contains the active drug loperamide, is available as a generic drug. Generic loperamide is available as a prescription and over-the-counter (OTC) medication.
Imodium Multi-Symptom Relief, which contains the active drugs loperamide and simethicone, is also available as a generic drug.
A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.
In some cases, the brand-name drug and the generic version may come in different forms and strengths.
Imodium is a brand-name, over-the-counter (OTC) medication that's used to treat diarrhea. Because it's OTC, you don't need a prescription from your doctor to purchase Imodium.
However, in certain situations, it's not appropriate to self-treat diarrhea with Imodium. For instance, you should seek medical care from a doctor if you or your child has:
- bloody or black stools
- mucus in your stools
- diarrhea that started during or after taking antibiotics
- a fever with the diarrhea
- diarrhea that's lasted longer than 2 days
- episodes of diarrhea that have happened for more than 2 weeks
- diarrhea that's related to a long-term bowel condition, such as irritable bowel syndrome (IBS), ulcerative colitis, or Crohn's disease
- problems with how well your liver works
- an abnormal heart rhythm
- ever had an allergic reaction to Imodium or loperamide
In addition, if you're pregnant or breastfeeding, you should call your doctor before using over-the-counter (OTC) drugs, including Imodium.
If needed, your doctor may order certain tests to determine the cause of your diarrhea. In some cases, your doctor may recommend using Imodium. But in other cases, they may recommend different ways to treat your diarrhea.
The following information describes the recommended dosages for using Imodium to self-treat acute (short-term) diarrhea. If you're interested in using Imodium for chronic (ongoing) diarrhea, talk with your doctor first.
Also, don't take more than the recommended dosage of Imodium for your condition. And don't take more Imodium than the maximum recommended dose within 24 hours.
If your diarrhea isn't controlled after 48 hours of Imodium treatment, see your doctor.
Drug forms and strengths
Imodium, which is taken by mouth, is available in these four products:
- Imodium A-D caplets. These pills are capsule-shaped tablets that contain 2 milligrams (mg) of loperamide.
- Imodium A-D softgels. These pills are liquid-filled capsules that contain 2 mg of loperamide.
- Imodium A-D oral solution. This liquid contains 1 mg of loperamide per 7.5 milliliter (mL) of solution.
- Imodium Multi-Symptom Relief caplets. These pills are capsule-shaped tablets that contain 2 mg of loperamide and 125 mg of simethicone.
Dosage for Imodium A-D
The recommended dosage of Imodium A-D to treat diarrhea varies based on the form of Imodium A-D you're using. Recommended dosages for adults and children ages 12 years and older are as follows.
- Imodium A-D caplets:
- Take two caplets after your first loose stool.
- Then take one caplet after each loose stool that follows. But don't take more than four caplets within 24 hours.
- Imodium A-D softgels:
- Take two softgels after your first loose stool.
- Then take one softgel after each loose stool that follows. But don't take more than four softgels within 24 hours.
- Imodium A-D oral solution
- Take 30 mL of solution after your first loose stool.
- Then take an additional 15 mL after each loose stool that follows. But don't take more than 60 mL within 24 hours.
For dosage information for children younger than 12 years of age, see the section below called "Pediatric dosage."
Dosage for Imodium Multi-Symptom Relief
Imodium Multi-Symptom Relief is used to treat diarrhea that occurs with cramps, bloating, and gas.
The recommended dosage for adults and children ages 12 years and older is as follows:
- Take two caplets after your first loose stool.
- Then take one caplet after each loose stool that follows. But don't take more than four caplets within 24 hours.
For dosage information for children younger than 12 years of age, see the section below called "Pediatric dosage."
Pediatric dosage
Ideally, Imodium dosage for a child should be based on their body weight. But if you don't know how much the child weighs, you can base their dosage on their age instead.
Below, we describe recommended dosages of Imodium for children. Keep in mind that children who have trouble swallowing tablets may find it easier to take the liquid form of Imodium.
Children's dosage of Imodium A-D
Imodium A-D is used to treat diarrhea. Recommended dosages of this drug for children are explained below.
Children's dosage of Imodium A-D caplets
The recommended dosages of Imodium A-D caplets in children are as follows:
- For children ages 12 years and older, the recommended dosage of Imodium A-D caplets is the same as that for adults. See the "Dosage for Imodium A-D" section above for details.
- For children weighing 60 to 95 pounds* (lb) or who are ages 9 through 11 years:
- Give one caplet after their first loose stool.
- Then give half of a caplet after each loose stool that follows. However, no more than three caplets should be given within 24 hours.
- For children weighing 48 to 59 lb or who are ages 6 through 8 years:
- Give one caplet after their first loose stool.
- Then give half of a caplet after each loose stool that follows. However, no more than two caplets should be given within 24 hours.
- For children weighing 34 to 47 lb or who are ages 2 through 5 years:
- See your doctor before giving Imodium A-D caplets.
- For children weighing up to 33 lb or who are younger than 2 years of age:
- Do not give Imodium A-D caplets. Instead, see your doctor for treatment options.
* One pound is equal to about 2.2 kilograms (kg).
Children's dosage of Imodium A-D oral solution
The recommended dosages of Imodium A-D oral solution in children are as follows:
- For children ages 12 years and older, the recommended dosage of Imodium A-D oral solution is the same as that for adults. See the "Dosage for Imodium A-D" section above for details.
- For children weighing 60 to 95 lb* or who are ages 9 through 11 years:
- Give 15 mL after their first loose stool.
- Then give 7.5 mL after each loose stool that follows. However, no more than 45 mL should be given within 24 hours.
- For children weighing 48 to 59 lb, or who are ages 6 through 8 years:
- Give 15 mL after their first loose stool.
- Then give 7.5 mL after each loose stool that follows. However, no more than 30 mL should be given within 24 hours.
- For children weighing 34 to 47 lb or who are ages 2 through 5 years:
- See your doctor before giving Imodium A-D oral solution.
- For children weighing up to 33 lb, or who are younger than 2 years of age:
- Do not give Imodium A-D oral solution. Instead, see your doctor for treatment options.
* One pound is equal to about 2.2 kilograms (kg).
Children's dosage of Imodium A-D softgels
The recommended dosages of Imodium A-D softgels in children are as follows:
- For children ages 12 years and older:
- Give two softgels after their first loose stool.
- Then give one softgel after each loose stool that follows. However, no more than four softgels should be given within 24 hours.
- For children under the age of 12 years old:
- Do not give Imodium A-D softgels. Instead, see your doctor for treatment options.
Children's dosage of Imodium Multi-Symptom Relief
Imodium Multi-Symptom Relief is used to treat diarrhea that occurs with cramps, bloating, and gas.
Recommended dosages of this drug for children are as follows:
- For children ages 12 years and older, the recommended dosage of Imodium Multi-Symptom Relief is the same as that for adults. See the "Dosage for Imodium Multi-Symptom Relief" section above for details.
- For children weighing 60 to 95 lb* or who are ages 9 through 11 years:
- Give one caplet after the first loose stool.
- Then give half of a caplet after each loose stool that follows. However, no more than three caplets should be given within 24 hours.
- For children weighing 48 to 59 lb or who are ages 6 through 8 years:
- Give one caplet after the first loose stool.
- Then give half of a caplet after each loose stool that follows. However, no more than two caplets should be given within 24 hours.
- For children weighing 34 to 47 lb or who are ages 2 through 5 years:
- See your doctor before giving Imodium Multi-Symptom Relief.
- For children weighing up to 33 lb or who are younger than 2 years of age:
- Do not give Imodium Multi-Symptom Relief. Instead, see your doctor for treatment options.
* One pound is equal to about 2.2 kilograms (kg).
What if I miss a dose?
If you forget to take a dose of Imodium after having a loose stool, take the drug if you have another loose stool. But don't take a double dose of Imodium to make up for the missed dose.
Will I need to use this drug long term?
No, you won't take Imodium long term, unless you've been instructed to do so by your doctor. Imodium is typically used to treat acute (short-term) diarrhea. However, doctors do occasionally prescribe the drug to help control chronic (ongoing) diarrhea.
Unless recommended otherwise by your doctor, you should stop taking Imodium as soon as your diarrhea resolves. But if your diarrhea doesn't get better within 2 days of starting Imodium, see your doctor.
And don't take Imodium for longer than 48 hours unless directed by your doctor.
Imodium can be used to treat diarrhea in kids. But not all Imodium products are suitable for children. In addition, children ages 2 to 5 years should only take Imodium if it's recommended by a doctor. And Imodium shouldn't be used at all in children younger than 2 years old.
Imodium products that may be used in children are as follows:
In any case, if your child continues to have diarrhea after 2 days of Imodium treatment, they should see a doctor right away.
Dehydration in children with diarrhea
In children, diarrhea can quickly lead to serious dehydration (low fluid level). So if a child has diarrhea, it's important to make sure the child drinks plenty of fluids.
To help prevent dehydration, have your child sip on fluids throughout the day, especially after having a bowel movement. It's also a good idea to have them drink a rehydration solution. These solutions contain electrolytes, such as sodium and potassium, which can be lost through diarrhea.
Ask your pharmacist to recommend a suitable rehydration product and the best amount to have your child drink. Avoid giving your child sugary drinks, such as fruit juices or sports drinks, as these can worsen diarrhea.
The Food and Drug Administration (FDA) approves over-the-counter (OTC) drugs, such as Imodium, for self-treatment of certain conditions. Because Imodium is OTC, you don't need a prescription from your doctor to purchase it.
Imodium A-D and Imodium Multi-Symptom Relief are both used to treat diarrhea. Imodium Multi-Symptom Relief is also used to relieve cramps, bloating, and gas that can occur with diarrhea.
Both Imodium A-D and Imodium Multi-Symptom Relief can be used to treat acute (short-term) diarrhea, such as:
- Diarrhea from food poisoning. Food poisoning is caused by consuming a food or drink that's contaminated with bacteria, viruses, or parasites. Common bacterial causes of food poisoning include Salmonella , Campylobacter , and E. coli. In addition, traveler's diarrhea is typically caused by food poisoning. You can self-treat diarrhea that's caused by food poisoning with Imodium. But make sure you know when to seek medical care. See the "When to seek medical care" section above for details.
- Diarrhea from the stomach flu. "Stomach flu" is a commonly used term for viral gastroenteritis. This condition is caused by a viral infection in your stomach and intestines. And it's highly contagious, which means it passes easily from person to person. Norovirus and rotavirus are common causes of the stomach flu. You can self-treat diarrhea from the stomach flu with Imodium. But make sure you know when to seek medical care. See the "When to seek medical care" section above for details.
- Menstrual diarrhea. Menstrual diarrhea is diarrhea that occurs before or during menstruation. This condition is caused by changes in hormone levels. You can self-treat menstrual diarrhea with Imodium. But make sure you know when to seek medical care. See the "When to seek medical care" section above for details.
- Diarrhea from opioid withdrawal. Misuse of opioid drugs, including morphine, oxycodone, and heroin, can often lead to constipation. If you're dependent on opioid drugs, when you stop using them, you can have withdrawal symptoms that include diarrhea. (With dependence, your body needs the drugs in order for you to feel normal.) Imodium can be used to treat diarrhea that's related to opioid withdrawal. But ideally, Imodium should be part of a complete treatment program to help with opioid withdrawal. If you want to take Imodium for this use, talk with your doctor first.
- Diarrhea from stress or anxiety. For some people, feelings of stress or anxiety can trigger episodes of diarrhea. You can self-treat this type of diarrhea with Imodium. But make sure you know when to seek medical care. See the "When to seek medical care" section above for details.
- Diarrhea from IBS-D. IBS-D refers to irritable bowel syndrome (IBS) with a main symptom of diarrhea. IBS is a common condition that's due to a problem with your bowel function. It causes symptoms such as abdominal pain, cramping, bloating, constipation, and diarrhea. If you think your diarrhea might be related to IBS, you should see your doctor. You can use Imodium to treat IBS-D, but only if it's recommended by your doctor.
In addition, both Imodium A-D and Imodium Multi-Symptom Relief can be used to treat chronic (ongoing) diarrhea. This type of diarrhea lasts more than 4 weeks, and it's usually related to long-term bowel conditions These conditions include irritable bowel syndrome (IBS) and Crohn's disease. However, for chronic diarrhea, Imodium should only be used if it's recommended by your doctor.
Imodium works quickly to control diarrhea, helping you to have firmer stools and less frequent bowel movements.
Imodium's effectiveness for diarrhea
Imodium is an effective and widely used treatment for diarrhea. In fact, guidelines from the American College of Gastroenterology recommend Imodium for treating both acute and chronic diarrhea.
Imodium is a brand-name, over-the-counter (OTC) medication that's used to treat diarrhea.
In addition to the uses discussed above in the "Imodium for diarrhea" section, you may wonder if Imodium is used for certain other conditions. Below is information on other possible uses for Imodium that may not be appropriate.
Imodium for nausea or vomiting (not an appropriate use)
You shouldn't take Imodium for nausea or vomiting. The drug won't help treat these conditions.
Imodium for gas (not an appropriate use)
You shouldn't take Imodium for gas alone. However, gas can sometimes occur with diarrhea, bloating, abdominal pain, discomfort, or cramps. And Imodium Multi-Symptom Relief can be used for gas that's associated with diarrhea.
Imodium for stomach pain (not an appropriate use)
You shouldn't take Imodium for stomach (belly) pain alone. Stomach pain can sometimes occur with diarrhea. Taking Imodium to treat diarrhea may help stomach pain that's related to diarrhea. However, if your stomach pain isn't related to diarrhea, taking Imodium could worsen your pain.
Imodium for upset stomach (not an appropriate use)
You shouldn't take Imodium for an upset stomach alone. However, upset stomach or indigestion can sometimes occur with diarrhea. And taking Imodium to treat diarrhea can help upset stomach that's related to diarrhea.
Imodium for C. diff (may not be an appropriate use)
"C. diff" refers to a type of bacteria called Clostridium difficile. This bacteria can sometimes cause severe diarrhea in people who are taking antibiotics.
Antibiotics kill the bacteria that's found naturally in your gut. This allows other bacteria to grow and cause infection. Gut infections caused by C. diff can lead to severe and life threatening diarrhea.
Antimotility drugs, such as Imodium, typically aren't used to treat diarrhea related to C. diff. This is because the drugs can make this condition worse. However, if a C. diff infection is treated with an antibiotic, current guidelines suggest that Imodium could be used for related diarrhea. But these guidelines mention that no studies are available to confirm the safety of this treatment option.
If you're interested in taking Imodium for diarrhea that's related to C. diff, talk with your doctor.
Imodium is used to treat diarrhea. In some cases, you may need to take Imodium with other treatments. Below, we describe some other possible treatments that may be used with Imodium.
If you have questions about using other treatments with Imodium, talk with your doctor or pharmacist.
Imodium with rehydration solutions
When treating diarrhea, it's important to make sure that you're getting plenty of fluids.
Diarrhea causes you to lose more fluid and electrolytes than usual. (Electrolytes are salts, such as sodium and potassium.) And you'll need to replace these substances in your body to avoid dehydration (low fluid level).
Children and older people are particularly at risk for dehydration with diarrhea.
Drinking a rehydration solution is a good way to replace fluids and electrolytes lost through diarrhea. Rehydration solutions are drinks that contain both glucose (sugar) and electrolytes. You can buy these drinks at drugstores and grocery stores.
The American College of Gastroenterology recommends rehydration solutions for anyone with watery diarrhea that's severe. But they especially recommend these drinks for children and older people with diarrhea.
Imodium with antibiotics
If you have traveler's diarrhea or certain other gut infections that cause diarrhea, your doctor may prescribe antibiotics for you to take with Imodium.
For instance, traveler's diarrhea is typically caused by ingesting foods or drinks that are contaminated with bacteria. Antibiotics can help treat the infection that's caused by these bacteria. And Imodium can help shorten the amount of time that you have diarrhea.
Imodium A-D and Imodium Multi-Symptom Relief are both used to treat diarrhea. In addition, Imodium Multi-Symptom Relief treats gas, cramps, and bloating that can occur with diarrhea.
What happens with diarrhea
With diarrhea, you pass loose or watery stools much more often than usual. The most common cause of diarrhea is an infection in your digestive system called gastroenteritis. This infection can be caused by bacteria, viruses, or parasites.
Other causes of diarrhea include:
- hormone changes
- stress
- anxiety
- problems with how your bowel functions, such as irritable bowel syndrome (IBS)
With diarrhea, the muscular contractions in your intestine that move food through it become faster than usual. So food moves through your system much more quickly than normal. In addition, there's less time for your intestine to absorb water from your food. This leads to frequent watery bowel movements.
The fast contractions in your intestine can also lead to a buildup of gas. And this can cause symptoms such as cramps, bloating, and pressure in your belly.
What Imodium does
Imodium products all contain the antimotility drug loperamide, which helps to control diarrhea.
The drug works by slowing down the muscular contractions in your intestine. This slows the movement of food through your intestine. And it allows more time for water to be reabsorbed back into your body. This is how Imodium use leads to firmer stools and fewer bowel movements.
What Imodium Multi-Symptom Relief does
In addition to loperamide, Imodium Multi-Symptom Relief contains the antiflatulent drug simethicone. This drug reduces symptoms of gas. It works by causing small bubbles of gas that are trapped in your intestines to merge into larger bubbles. These larger bubbles are more easily expelled from your body.
How long does it take for Imodium to work?
Imodium typically starts to control diarrhea within 1 hour after you've taken the first dose.
How long does Imodium stay in your system?
After you stop taking Imodium, it takes about 11 hours for the level of Imodium in your body to be reduced by half. After this amount of time, Imodium will have less and less of an effect on controlling your diarrhea.
It typically takes about 2 to 3 days for the drug to be fully removed from your body.
Here are answers to some frequently asked questions about Imodium.
Can Imodium make you feel 'high'?
No, taking Imodium at the recommended dosage to treat diarrhea won't make you feel "high." At this dosage, Imodium doesn't affect your brain. Instead, it only works inside your intestine.
However, Imodium's chemical structure is similar to that of opioids, such as morphine and heroin. If it's misused and taken in extremely large doses, Imodium can affect your brain. And if it enters your brain, it may make you feel high.
Some people misuse Imodium in this way to make themselves feel high. But you shouldn't misuse Imodium, because doing so can have serious effects on your heart. (See the following question for more details).
If you have questions about how Imodium may affect you, talk with your doctor or pharmacist.
Is misusing Imodium dangerous?
Yes, misusing Imodium can be very dangerous. (Misuse is also sometimes called abuse.)
In fact, misusing Imodium can cause serious heart problems, such as an irregular heartbeat or heart attack. It can also cause loss of consciousness and slow, weak breathing. And it can sometimes even lead to death.
Because of these risks, you should never take more Imodium than the dosage that's recommended on the product labeling or by your doctor. If you have questions about the correct dosage for you, ask your doctor or pharmacist.
What should I do if I'm still having diarrhea after taking Imodium?
If you're still having diarrhea after your first dose of Imodium, take another dose after each loose stool that follows. But only take doses up to the maximum daily dose. For more information about this, see the "Imodium dosage" section above.
If you still have diarrhea after using Imodium for 2 days (48 hours), see your doctor. Your doctor may order certain tests to see what's causing your diarrhea. And they may recommend a treatment other than Imodium, depending on the results of those tests.
Will I be able to poop after I take Imodium?
Yes, you should be able to. Imodium slows down the contractions in your intestine so that you pass firmer stools less often. But usually, the drug doesn't completely stop you from having bowel movements.
According to Imodium's manufacturer, in clinical studies constipation occurred in less than 3% of people who took the drug. To read more about constipation with Imodium, see the "Imodium side effects" section below.
If you're concerned about not having bowel movements while you're taking Imodium, talk with your doctor or pharmacist.
Is Imodium safe to use?
Yes, Imodium is generally considered to be a very safe drug when it's taken correctly. (This means it's taken according to the instructions on its product label or as instructed by your doctor.)
To read about the possible side effects of Imodium, see the "Imodium side effects" section below.
You should take Imodium as recommended on its product label or as instructed by your doctor or pharmacist.
Imodium comes in the following products, which are each taken by mouth:
- Imodium A-D caplets, which are capsule-shaped tablets
- Imodium A-D softgels, which are liquid-filled capsules
- Imodium A-D oral solution, which is a liquid
- Imodium Multi-Symptom Relief caplets, which are capsule-shaped tablets
When to take
How often you'll take Imodium depends on whether you're treating diarrhea that's acute (short term) or chronic (ongoing).
Taking Imodium for acute diarrhea
To treat acute diarrhea, you'll take Imodium after your first loose stool. Then you'll take Imodium after each loose stool that follows. But don't take more than the maximum daily dose of this drug. (For information about this, see the "Imodium dosage" section above.)
If your diarrhea doesn't improve within 2 days of starting Imodium, stop taking it and see your doctor.
And if your diarrhea clears up with Imodium, but you get another episode of diarrhea soon after, you can take Imodium again. But if you keep having episodes of diarrhea for more than 2 weeks, you should see your doctor. They can check to see what's causing your diarrhea.
Taking Imodium for chronic diarrhea
Sometimes doctors prescribe Imodium to treat chronic diarrhea. In this case, they might recommend either:
- taking Imodium for episodes of diarrhea over a long-term basis
- taking Imodium every day to help prevent episodes of diarrhea
In either case, don't take more than the maximum daily dose of this drug. (For information about this, see the "Imodium dosage" section above.)
Taking Imodium every day
You should take Imodium every day only if your doctor recommends doing so. Taking Imodium every day is generally considered safe. However, using this drug daily may increase your risk for side effects, particularly constipation.
To learn more about this, see the "Imodium side effects" section below.
Taking Imodium with food
Imodium A-D caplets, softgels, and oral solution can be taken either with or without food.
However, Imodium Multi-Symptom Relief caplets should be taken on an empty stomach. This means they should be taken at least 1 hour before you eat food or 2 hours after you've eaten food.
Can Imodium be crushed, split, or chewed?
Imodium A-D caplets and Imodium Multi-Symptom Relief caplets can be split in half along their score line. But you shouldn't crush or chew these caplets.
Imodium A-D softgels should be swallowed whole. This form of Imodium shouldn't be split, crushed, or chewed.
If you have trouble swallowing Imodium pills, you may find it easier to take Imodium A-D oral solution.
Imodium can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Imodium. These lists don't include all possible side effects.
For more information on the possible side effects of Imodium, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you've had with Imodium, you can do so through MedWatch.
Mild side effects
Mild side effects of Imodium can include:*
- constipation†
- headache
- nausea and vomiting
- dizziness
- sleepiness†
- dry mouth
- abdominal (belly) pain
- indigestion
Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don't go away, talk with your doctor or pharmacist.
* This is a partial list of mild side effects from Imodium. To learn about other mild side effects, talk with your doctor or pharmacist, or view the prescribing information for loperamide, the active ingredient in Imodium.
† This mild side effect is explained in the "Side effect details" section below.
Serious side effects
Serious side effects from Imodium are rare, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you're having a medical emergency.
Serious side effects and their symptoms can include:
- Paralytic ileus (reduced movement in your intestine that causes a buildup of food and can lead to a blockage in your intestine). Symptoms can include:
- abdominal (belly) swelling
- feeling full or bloated
- abdominal cramping or pain
- constipation
- nausea and vomiting
- Allergic reaction.*
* This serious side effect is explained in the "Side effect details" section below.
Side effects in children
Imodium side effects are similar for both children and adults. See the side effect lists above for more information.
Side effect details
You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here's some detail on certain side effects this drug may or may not cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Imodium. But it's not known how often this occurs in people using Imodium.
Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing (warmth, swelling, or redness in your skin)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
Call your doctor right away if you have a severe allergic reaction to Imodium. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you're having a medical emergency.
Constipation
Some people have constipation after taking Imodium. In fact, it's one of the more common side effects of this drug. Imodium slows down the movement of food through your intestine, helping you to pass firmer stools less often. While this action reduces diarrhea, it may also lead to constipation in some people.
According to the drug's manufacturer, in clinical studies constipation occurred in less than 3% of people who took Imodium.
If you have constipation with Imodium, stop taking the drug. Constipation may last for a few days after you take Imodium, but it typically goes away on its own. And drinking plenty of water can help ease constipation.
However, if you have constipation that doesn't improve after a few days, see your doctor. On rare occasions, constipation can be a symptom of a serious side effect called paralytic ileus. With this condition, the movement in your intestines slows down so much that food builds up inside your intestine. And this can lead to a dangerous obstruction (blockage) in your intestine.
If you have constipation with abdominal (belly) swelling or bulging, or severe abdominal pain, stop taking Imodium. And see your doctor right away. These symptoms may indicate paralytic ileus.
Sleepiness
Imodium can make some people feel sleepy or tired. The drug can also cause dizziness. But it's not known how often these side effects occur with Imodium use.
If you feel sleepy, tired, or dizzy with Imodium, don't drive or operate machines. And if you have concerns about these symptoms with Imodium use, talk with your doctor or pharmacist.
Changes in stool color (not a side effect)
Taking Imodium won't cause the color of your stools to change.
If you have red or black stools, it's likely that you have blood in your stool. Typically, having blood in your stool suggests there's a problem inside your stomach or intestines.
If you have red or black stools, stop taking Imodium and see your doctor right away. They'll check to see what's causing the color change in your stool. And they can recommend appropriate treatment for your condition.
Blood pressure changes (not a side effect)
Imodium doesn't affect your blood pressure. The drug can sometimes cause dizziness, but this isn't related to blood pressure changes.
However, keep in mind that Imodium is used to treat diarrhea. And if you become dehydrated (have a low fluid level) from diarrhea, you may develop low blood pressure.
To help avoid dehydration while you have diarrhea, it's important to drink plenty of fluids. You can also drink a rehydration solution. These drinks contain glucose (sugar) and electrolytes, such as sodium and potassium. Rehydration solutions help to replace fluids and electrolytes in your body that you can lose through diarrhea.
If you feel dizzy or think you may be getting dehydrated while you're taking Imodium, call your doctor. They can recommend ways to help improve your condition.
Other drugs are available that can treat diarrhea. Some may be a better fit for you than others. If you're interested in finding an alternative to Imodium, talk with your doctor or pharmacist. They can tell you about other medications that may work well for you.
Examples of other drugs that may be used to treat diarrhea include:
- bismuth subsalicylate (Pepto-Bismol, Kaopectate)
- diphenoxylate and atropine (Lomotil)
You may wonder how Imodium compares with other medications that are used for diarrhea. Here we look at how Imodium and Lomotil are alike and different.
Ingredients
Imodium comes as two products:
- Imodium A-D, which contains the active drug loperamide.
- Imodium Multi-Symptom Relief, which contains two active drugs: loperamide and simethicone.
Lomotil also contains two active drugs: diphenoxylate and atropine.
Uses
Both Imodium and Lomotil are used to treat diarrhea. But they're used in different ways. For instance:
- Imodium A-D is used to treat diarrhea.
- Imodium Multi-Symptom Relief is used to treat diarrhea along with gas, bloating, and cramps.
- Lomotil is used as an add-on treatment for diarrhea that's not controlled with other medications.
Imodium is used in adults and children ages 2 years and older. However, children ages 2 to 5 years old should only be given Imodium if it's recommended by a doctor.
Lomotil is used in adults and children ages 13 years and older.
Drug availability
Imodium is an over-the-counter (OTC) medication. Because it's OTC, you don't need a prescription from your doctor to purchase Imodium.
Lomotil, on the other hand, is only available by prescription. So you'll need to have a prescription from your doctor to purchase Lomotil.
Drug forms and administration
Imodium comes in the following forms, which are each taken by mouth:
- Imodium A-D caplets (capsule-shaped tablets)
- Imodium A-D softgels (liquid-filled capsules)
- Imodium A-D oral solution (liquid)
- Imodium Multi-Symptom Relief caplets
Lomotil comes as tablets that are taken by mouth.
Side effects and risks
Imodium and Lomotil both can cause some similar side effects, but some different ones as well. Below are examples of these side effects.
Mild side effects
This list contains up to 10 of the most common mild side effects that can occur with Imodium, with Lomotil, or with both drugs (when they're taken individually).
- Can occur with Imodium:
- constipation
- Can occur with Lomotil:
- itchy skin
- Can occur with both Imodium and Lomotil:
- headache
- nausea and vomiting
- dizziness
- sleepiness
- dry mouth
- abdominal (belly) pain
- indigestion
Serious side effects
These lists contain examples of serious side effects that can occur with Imodium, with Lomotil, or with both drugs (when taken individually).
- Can occur with Imodium:
- few unique serious side effects
- Can occur with Lomotil :
- poisoning from atropine (an ingredient in Lomotil)
- opioid-like side effects from diphenoxylate (an ingredient in Lomotil), such as respiratory depression (weak, slowed breathing) and coma
- mood changes, such as depression or euphoria (extreme happiness)
- hallucinations (seeing or hearing something that's not real)
- Can occur with both Imodium and Lomotil :
- serious allergic reaction
- paralytic ileus (reduced movement in your intestine that causes a buildup of food and can lead to a blockage in your intestine)
Effectiveness
The only condition both Imodium and Lomotil are used to treat is diarrhea.
These drugs haven't been directly compared in clinical studies. But separate studies have found both Imodium and Lomotil to be effective for treating diarrhea.
Costs
According to estimates on WellRx.com, Lomotil generally costs more than Imodium. But the actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
Imodium and Lomotil are both brand-name drugs, but generic forms of each are available. The generic form of Imodium is called loperamide. The generic form of Lomotil is called diphenoxylate/atropine.
A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.
Like Lomotil (discussed above), other medications are prescribed for similar uses as Imodium. Here we look at how Imodium and Kaopectate are alike and different.
Ingredients
Imodium comes as two products:
- Imodium A-D, which contains the active drug loperamide.
- Imodium Multi-Symptom Relief, which contains two active drugs: loperamide and simethicone.
Kaopectate contains the active drug bismuth subsalicylate.
Uses
Both Imodium and Kaopectate are used to treat diarrhea. But they're used in different ways. For instance:
- Imodium A-D is used to treat diarrhea.
- Imodium Multi-Symptom Relief is used to treat diarrhea along with gas, bloating, and cramps.
- Kaopectate is used to relieve diarrhea and upset stomach, including symptoms of nausea, gas, heartburn, and indigestion.
Imodium is used in adults and children ages 2 years and older. However, children ages 2 to 5 years old should only be given Imodium if it's recommended by a doctor.
Kaopectate is used in adults and children ages 12 years and older. Children younger than 12 years of age should only be given Kaopectate if it's recommended by a doctor.
Drug availability
Both Imodium and Kaopectate are over-the-counter (OTC) medications. Because they're OTC, you don't need a prescription from your doctor in order to purchase either drug.
Drug forms and administration
Imodium comes in the following forms that are taken by mouth:
- Imodium A-D caplets (capsule-shaped tablets)
- Imodium A-D softgels (liquid-filled capsules)
- Imodium A-D oral solution (liquid)
- Imodium Multi-Symptom Relief caplets
Kaopectate comes as a tablet and a liquid that are both taken by mouth.
Side effects and risks
Imodium and Kaopectate can cause some similar side effects, but some different ones as well. Below are examples of these side effects.
Mild side effects
These lists contain up to 10 of the most common mild side effects that can occur with Imodium or with Kaopectate.
- Can occur with Imodium:
- constipation
- headache
- dizziness
- sleepiness
- dry mouth
- abdominal (belly) pain
- indigestion
- nausea and vomiting
- Can occur with Kaopectate :
- temporary dark-colored or black discoloration of stools or tongue that's harmless
- Can occur with Imodium and Kaopectate:
- no shared mild side effects
Serious side effects
These lists contain examples of serious side effects that can occur with Imodium, with Kaopectate, or with both Imodium and Kaopectate (when taken individually).
- Can occur with Imodium:
- paralytic ileus (reduced movement in your intestine that causes a buildup of food and can lead to a blockage in your intestine)
- Can occur with Kaopectate :
- Reye's syndrome (a rare disease affecting the brain and liver), in children and teenagers
- ringing in your ears or hearing loss
- Can occur with both Imodium and Kaopectate :
- serious allergic reaction
Effectiveness
Imodium and Kaopectate have different uses, but they're both used to treat diarrhea.
These drugs haven't been directly compared in clinical studies. However, one 1990 clinical study compared the use of Imodium A-D with that of Pepto-Bismol. (Pepto-Bismol contains the same active drug as Kaopectate does, bismuth subsalicylate.)
In this study, Imodium controlled diarrhea faster and more effectively than did Pepto-Bismol.
In addition, both Imodium and bismuth subsalicylate are recommended in the American Journal of Gastroenterology (ACG) guidelines for treating acute (short-term) diarrhea.
Costs
According to estimates on WellRx.com, Imodium and Kaopectate generally cost about the same. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
Imodium and Kaopectate are both brand-name drugs. And generic forms of both drug are available. The generic form of Imodium is called loperamide. The generic form of Kaopectate is called bismuth subsalicylate.
A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.
There's not enough information available from human and animal studies to know if Imodium is safe to take during pregnancy.
If you're pregnant or think you could be pregnant, talk with your doctor before using Imodium. Also, if you're planning a pregnancy, ask your doctor before taking Imodium. They can discuss with you the risks and benefits of using this drug during pregnancy.
It's not known if Imodium is safe to take during pregnancy. If you're sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you're using Imodium.
For more information about taking Imodium during pregnancy, see the "Imodium and pregnancy" section above.
Imodium may pass into human breast milk in small amounts. But it's not known if it's safe to take this drug while breastfeeding.
If you're breastfeeding, talk with your doctor about the risks and benefits of taking Imodium.
Imodium isn't known to interact with alcohol. However, if you get certain side effects with Imodium, drinking alcohol will likely increase these side effects. These include sleepiness or dizziness.
In addition, it's generally recommended that you avoid drinking alcohol while you have diarrhea, which Imodium is used to treat. Drinking alcohol while you have diarrhea could make your symptoms worse.
Imodium can interact with several other medications.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.
Imodium and other medications
Below are examples of medications that can interact with Imodium. This section doesn't contain all the drugs that may interact with Imodium.
Before taking Imodium, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions what drugs you shouldn't take with Imodium, ask your doctor or pharmacist.
Imodium and medications that can cause an abnormal heart rhythm
Certain medications can cause an abnormal heart rhythm, called a prolonged QT interval. Taking Imodium with these medications could raise your risk for an irregular heartbeat.
Examples of medications that can raise the risk of an irregular heartbeat with Imodium include:
- certain antibiotics, such as:
- clarithromycin
- ciprofloxacin (Cipro)
- moxifloxacin
- certain drugs to treat irregular heartbeats, such as:
- amiodarone (Pacerone)
- quinidine
- procainamide
- sotalol (Sotylize, Betapace, Betapace AF, Sorine)
- disopyramide (Norpace)
- certain antipsychotic drugs, such as:
- pimozide (Orap)
- haloperidol
- quetiapine (Seroquel, Seroquel XR)
- ziprasidone (Geodon)
- methadone, which is used for opioid dependence
If you take any of these medications, check with your doctor before taking Imodium.
Imodium and opioids
Opioids (also called opiates) include pain-relieving medications such as oxycodone and morphine. But opioids also include illegal drugs such as heroin.
Imodium has a chemical structure that's similar to that of opioid medications. However, Imodium doesn't affect your brain when it's taken at the dosage recommended for diarrhea. So it doesn't have the same effects on your body as opioids do.
But both Imodium and opioids can cause side effects such as constipation and sleepiness. So taking Imodium with opioids could raise your risk for these side effects.
In addition, if Imodium is misused (taken in higher doses than are recommended for diarrhea), it can enter your brain. In this case, taking Imodium with opioids could lead to symptoms of opioid overdose, such as loss of consciousness and respiratory depression (slow, weak breathing).
In general, you shouldn't misuse Imodium, because doing so can have serious effects on your heart. And misusing Imodium can be especially dangerous if you're also taking opioids.
Imodium and medications that can increase levels of Imodium
Taking Imodium with certain medications can increase the level of Imodium in your body. And this could raise your risk for side effects from Imodium. (For more information about side effects of Imodium, see the "Imodium side effects" section above.)
Examples of medications that can increase the blood level of Imodium include:
- itraconazole (Sporanox), an antifungal drug
- gemfibrozil (Lopid), a lipid-lowering drug
- ritonavir (Norvir), an HIV drug
If you take any of these medications, check with your doctor before taking Imodium.
Imodium and herbs and supplements
There aren't any herbs or supplements that have been specifically reported to interact with Imodium. However, you should still check with your doctor or pharmacist before using any of these products while taking Imodium.
Imodium and foods
There aren't any foods that have been specifically reported to interact with Imodium. If you have any questions about eating certain foods with Imodium, talk with your doctor.
Taking too much Imodium can lead to serious heart problems, such as irregular heartbeat or heart attack. It can also cause loss of consciousness and respiratory depression (slow, weak breathing). And it can sometimes even lead to death.
Do not take more Imodium than is recommended in the product label or instructed by your doctor.
What to do in case you take too much Imodium
If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.
The expiration date for Imodium will be printed on the product packaging. The expiration date helps guarantee that the medication is effective during this time.
You may wonder if you can take expired Imodium. The
If you have unused medication that's gone past its expiration date, talk with your pharmacist about whether you might still be able to use it.
Storage
How long a medication remains good can depend on many factors, including how and where you store the medication.
Imodium should be stored at room temperature (68°F to 77°F/20°C to 25°C). It should be kept in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.
Disposal
If you no longer need to take Imodium and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.
This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.
As with all medications, the cost of Imodium can vary. To find current prices for Imodium products in your area, check out WellRx.com.
The cost you find on WellRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.
Although Imodium is an over-the-counter (OTC) drug, in some cases a doctor may prescribe it. If your doctor prescribes Imodium for you, you can ask your insurance provider if they will cover the drug.
Before approving coverage for Imodium, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.
If you're not sure if you'll need to get prior authorization for Imodium, contact your insurance company.
Financial and insurance assistance
If you need financial support to pay for Imodium, help may be available.
Johnson & Johnson, the manufacturer of Imodium, offers coupons that may help lower the cost of Imodium. For more information and to find out if you're eligible for support, visit the program website. You can also talk with your doctor or pharmacist to see if there are others ways to save on this medication.
Generic version
Imodium is available in a generic form called loperamide. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of loperamide compares to the cost of Imodium, visit WellRx.com.
If your doctor has prescribed Imodium and you're interested in using loperamide instead, talk with your doctor. They may have a preference for one version or the other. You'll also need to check your insurance plan, as it may only cover one or the other.
Imodium may not be right for you if you have certain medical conditions or other factors affecting your health. These include:
- Irritable bowel syndrome (IBS). You should only take Imodium for diarrhea that's related to IBS if this is recommended by your doctor. That's because Imodium can make some symptoms of IBS worse. For example, bloating and constipation may be worsened. Your doctor will recommend if it's safe for you to use Imodium for IBS depending on your pattern of IBS symptoms.
- Inflammatory bowel disease. If you have inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, takingImodium can sometimes cause a serious condition called megacolon. (With megacolon, your colon swells and expands.) You should only take Imodium for inflammatory bowel disease if recommended by your doctor. In addition, Imodium should not be used during acute flare-ups of ulcerative colitis symptoms.
- Liver problems. Imodium is broken down by your liver. If you have a problem with how well your liver works, Imodium could build up in your body, raising your risk for side effects. If you have a liver problem, you should only take Imodium if recommended by your doctor.
- An abnormal heart rhythm. Taking more than the recommended dose of Imodium can cause serious heart problems, including irregular heartbeat and heart attack. If you have an abnormal heart rhythm, you could have a higher risk for these problems. So if you have an abnormal heart rhythm, you should only take Imodium if recommended by your doctor.
- Allergic reaction. If you've ever had an allergic reaction to Imodium or any of its ingredients, or to generic loperamide, you shouldn't take Imodium. Ask your doctor or pharmacist what other medications are better options for you.
- Pregnancy. It's not known if Imodium is safe to take during pregnancy. For more information, see the "Imodium and pregnancy" section above.
- Breastfeeding. It's not known if Imodium is safe to take while breastfeeding. For more information, see the "Imodium and breastfeeding" section above.
If you have any of the conditions listed above, talk with your doctor before taking Imodium.
Note: For more information about the potential negative effects of Imodium, see the "Imodium side effects" section above.
The following information is provided for clinicians and other healthcare professionals.
Indications
Imodium A-D is used to treat diarrhea, including traveler's diarrhea. Specifically:
- Imodium A-D oral solution is suitable for adults and children ages 6 years and older, and children ages 2 to 5 years if recommended by a doctor.
- Imodium A-D caplets are suitable for adults and children ages 6 years and older, and children ages 2 to 5 years if recommended by a doctor.
- Imodium A-D softgels are suitable for adults and children ages 12 years and older.
Imodium Multi-Symptom Relief is used to treat diarrhea with symptoms of gas, cramping, and bloating. Specifically:
- Imodium Multi Symptom Relief caplets are suitable for adults and children ages 6 years and older, and children ages 2 to 5 years if recommended by a doctor.
Administration
Imodium products are all taken by mouth.
Mechanism of action
Imodium A-D and Imodium Multi-Symptom Relief both contain the antimotility drug loperamide.
Loperamide is an opioid agonist that binds to opioid receptors in the gut wall. This action reduces peristalsis, increases intestinal transit time, and increases reabsorption of water and electrolytes from the intestinal contents into the bloodstream. Taking loperamide results in firmer stools that are passed less frequently.
Imodium Multi-Symptom Relief also contains the antiflatulent drug simethicone. Simethicone is an anti-foaming agent that reduces the surface tension of gas bubbles, causing small bubbles to merge together. These larger bubbles are more easily expelled to relieve symptoms of cramping, bloating, and discomfort.
Pharmacokinetics and metabolism
Loperamide is well absorbed from the gut after oral administration; however, bioavailability is only 0.3% due to extensive first-pass metabolism.
Simethicone is not absorbed after oral administration.
Loperamide primarily undergoes hepatic metabolism through CYP3A4 and CYP2C8. It's excreted in the bile and subsequently the feces.
Loperamide has a half-life of approximately 11 hours.
Contraindications
Imodium A-D and Imodium Multi-Symptom Relief are contraindicated in children under 2 years old and in people with:
- hypersensitivity to any ingredient
- acute dysentery
- bacterial enterocolitis that is caused by invasive organisms such as Salmonella, Shigella, and Campylobacter
- acute ulcerative colitis
- pseudomembranous colitis (including Clostridium difficile infection) that is related to using broad-spectrum antibiotics
Misuse, withdrawal, and dependence
Imodium is a mu opioid agonist. At the recommended dosages for diarrhea, Imodium does not cross the blood brain barrier or produce a centrally acting opioid effect. However, when taken in extremely high doses, Imodium can enter the central nervous system and produce euphoria. Imodium is sometimes misused for this effect.
Misuse of Imodium can lead to prolonged QT interval, Torsades de Pointes, or other ventricular arrhythmias, and heart attack. It can also lead to other symptoms of opioid overdose, such as CNS and respiratory depression.
Misuse of Imodium can lead to dependence on the drug and withdrawal symptoms after stopping the drug.
Storage
Store Imodium at room temperature (68°F to 77°F/20°C to 25°C).
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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Source: https://www.medicalnewstoday.com/articles/imodium