Skip to main content

Can you take Flibanserin with Loperamide?

1 drug interaction and 11 additional warnings found for the following 2 drugs:

Add/remove drugs

Drug interactions

Major drug interactions

Major:

loperamide flibanserin

Applies to: loperamide and flibanserin

Flibanserin may significantly increase the blood levels of loperamide. This can lead to serious and potentially fatal complications such as irregular heart rhythm and cardiac arrest, especially if you use more than the recommended doses of loperamide.

You may also be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

Do not exceed the dose and frequency or duration of use of loperamide recommended on the product label or prescribed by your doctor.

Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

flibanserin Food/Lifestyle

Applies to: flibanserin

Do not use alcohol too close to the dosing time of flibanserin. Doing so can cause excessive drowsiness and decreases in blood pressure, which may lead to:

  • dizziness
  • lightheadedness
  • fainting
  • accidental injury

What to do: Take flibanserin at bedtime to minimize the risk of these effects. It is recommended that you stop drinking alcohol at least two hours before taking flibanserin; otherwise, you should just skip the flibanserin dose that evening. Alcohol should not be consumed until at least the morning after taking flibanserin at bedtime.

Because grapefruit juice can significantly increase the blood levels of flibanserin, you should also avoid the consumption of grapefruit and grapefruit juice during treatment.

Talk to your healthcare provider if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate food/lifestyle interactions

Moderate:

loperamide Food/Lifestyle

Applies to: loperamide

Alcohol can increase the nervous system side effects of loperamide such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with loperamide.

Do not use more than the recommended dose of loperamide, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Disease interactions

9 potential interactions Applies to: 8 conditions, including Hypotension, Inflammatory Bowel Disease, Syncope, Liver Disease, and Dehydration.

Alcoholism

Major:

flibanserin

Flibanserin has a major potential interaction with Alcoholism.

The use of flibanserin is contraindicated along with the ingestion of alcohol, as it increases the risk of hypotension and syncope. It is important to assess the likelihood of the patient abstaining from alcohol, taking into account the current and past drinking behavior.

Dehydration

Moderate:

loperamide

Loperamide has a moderate potential interaction with 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.

Hypotension

Major:

flibanserin

Flibanserin has a major potential interaction with Hypotension.

The use of flibanserin can cause hypotension and syncope. The benefits and risks of therapy should be considered in patients with preexisting conditions that predispose to hypotension. Flibanserin should be used with caution in these patients.

Infectious Gastroenteritis

Major:

loperamide

Loperamide has a major potential interaction with Infectious 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.

Inflammatory Bowel Disease

Moderate:

loperamide

Loperamide has a moderate potential interaction with 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.

Liver Disease

Major:

flibanserin

Flibanserin has a major potential interaction with Liver Disease.

Flibanserin may accumulate in patients with hepatic impairment. Therapy with flibanserin is contraindicated in patients with compromised hepatic function.

Moderate:

loperamide

Loperamide has a moderate potential interaction with 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.

Renal Dysfunction

Moderate:

loperamide

Loperamide has a moderate potential interaction with Renal Dysfunction.

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.

Syncope

Major:

flibanserin

Flibanserin has a major potential interaction with Syncope.

The use of flibanserin can cause hypotension and syncope. The benefits and risks of therapy should be considered in patients with preexisting conditions that predispose to hypotension. Flibanserin should be used with caution in these patients.

More resources

flibanserin

A total of 517 drugs are known to interact with flibanserin.

loperamide

A total of 383 drugs are known to interact with 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.