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Imodium (loperamide) Disease Interactions

There are 4 disease interactions with Imodium (loperamide):

Major

Antiperistaltic agents (Includes Imodium) ↔ infectious diarrhea

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

Antiperistaltic agents (Includes Imodium) ↔ fluid/electrolytes

Moderate Potential Hazard, Moderate plausibility. Applies to: 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. Kaopectate (attapulgite)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  3. "Product Information. Imodium (loperamide)." Janssen Pharmaceutica, Titusville, NJ.
Moderate

Antiperistaltic agents (Includes Imodium) ↔ hepatic/renal dysfunction

Moderate Potential Hazard, Moderate plausibility. Applies to: Renal Dysfunction, 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 Pharmaceutica, Titusville, NJ.
  2. "Product Information. Kaopectate (attapulgite)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
Moderate

Antiperistaltic agents (Includes Imodium) ↔ toxic megacolon

Moderate Potential Hazard, Moderate plausibility. Applies to: 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. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  2. "Product Information. Imodium (loperamide)." Janssen Pharmaceutica, Titusville, NJ.
  3. "Product Information. Kaopectate (attapulgite)." Pharmacia and Upjohn, Kalamazoo, MI.
  4. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
View all 4 references

Imodium (loperamide) drug interactions

There are 312 drug interactions with Imodium (loperamide)

Imodium (loperamide) alcohol/food interactions

There is 1 alcohol/food interaction with Imodium (loperamide)

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.