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Anti-Diarrheal Disease Interactions

There are 4 disease interactions with Anti-Diarrheal (loperamide).

Major

Antiperistaltic agents (applies to Anti-Diarrheal) infectious diarrhea

Major Potential Hazard, High plausibility. Applicable conditions: Infectious Diarrhea/Enterocolitis/Gastroenteritis

The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.

References

  1. Brown JW "Toxic megacolon associated with loperamide therapy." JAMA 241 (1979): 501-2
  2. Walley T, Milson D "Loperamide related toxic megacolon in Clostridium difficile colitis." Postgrad Med J 66 (1990): 582
  3. "Product Information. Imodium (loperamide)." Janssen Pharmaceuticals PROD (2001):
  4. Marshall WF Jr, Rosenthal P, Merritt RJ "Atropine therapy and paralytic ileus in an infant." J Pediatr Gastroenterol Nutr 9 (1989): 532-4
  5. "Lomotil for diarrhea in children." Med Lett Drugs Ther 17 (1975): 104
  6. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
View all 6 references
Moderate

Antiperistaltic agents (applies to Anti-Diarrheal) fluid/electrolytes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Dehydration

Diarrhea can cause severe dehydration and electrolyte imbalance. Fluid accumulation within the GI track due to antiperistaltic-associated decrease in peristalsis can further aggravate dehydration and electrolyte imbalance. Antiperistaltic agents should be administered cautiously in patients with electrolyte imbalance and rehydration and electrolyte replacement should be initiated prior to initiation of therapy.

References

  1. "Product Information. Imodium (loperamide)." Janssen Pharmaceuticals PROD (2001):
  2. "Product Information. Kaopectate (attapulgite)." Pharmacia and Upjohn PROD (2001):
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals PROD (2001):
Moderate

Antiperistaltic agents (applies to Anti-Diarrheal) hepatic/renal dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Therapy with antiperistaltic agents should be administered with extreme caution in patients with hepatorenal disease or abnormal liver enzymes. Antiperistaltic agents are metabolized by the liver (diphenoxylate to an active form) and primarily excreted in the feces. Hepatic coma can be precipitated.

References

  1. "Product Information. Imodium (loperamide)." Janssen Pharmaceuticals PROD (2001):
  2. "Product Information. Kaopectate (attapulgite)." Pharmacia and Upjohn PROD (2001):
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals PROD (2001):
Moderate

Antiperistaltic agents (applies to Anti-Diarrheal) toxic megacolon

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Inflammatory Bowel Disease

Decreased intestinal motility and prolonged transit time have resulted in toxic megacolon in patients with acute ulcerative colitis. Paralytic ileus has also occurred. Antiperistaltic agent GI motility and prolongs transit time and therapy should be administered cautiously in these patients.

References

  1. "Product Information. Imodium (loperamide)." Janssen Pharmaceuticals PROD (2001):
  2. "Product Information. Kaopectate (attapulgite)." Pharmacia and Upjohn PROD (2001):
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals PROD (2001):
  4. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
View all 4 references

Anti-Diarrheal drug interactions

There are 343 drug interactions with Anti-Diarrheal (loperamide).

Anti-Diarrheal alcohol/food interactions

There is 1 alcohol/food interaction with Anti-Diarrheal (loperamide).

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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