Is It Safe to Take Imodium Regularly?

Get the Facts About a Common Diarrhea Treatment

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Imodium (loperamide) is often the go-to treatment for diarrhea, but is it safe? How much can you take without worrying that you have taken too much? Let's take a look at what Imodium can do for you and whether or not it carries any safety risks.

Benefits 

Imodium is a medication that is effective in reducing the symptoms of diarrhea.

Specifically, Imodium works in the following ways:

  • Reduces the speed and frequency of colon contractions.
  • Reduces the secretion of fluid within the large intestine.
  • Increases the absorption of fluids and electrolytes into the intestinal tract.
  • Increases the transit time of stool through the colon.
  • Increases muscle tone in the anal sphincter, thus reducing the chances of a soiling accident.
  • May have no or only a limited effect in terms of reducing abdominal pain.

Dosage

For best results, follow the dosing information on the medication packaging. In order to reduce the risk of the Imodium working too well and providing you with a new problem — namely, that of constipation — it is recommended that you start with a small dose, perhaps limiting yourself to 1 to 2 mg over the course of a day. A more typical dose of Imodium is to take 2 mg, twice a day.

If necessary, you can increase the amount of Imodium that you take. The most you should ever take in a day is 8 mg unless your doctor advises you otherwise.

Be sure to drink lots of water while taking Imodium.

Keep in mind that Imodium will be at its highest level of effectiveness approximately 16 to 24 hours after you take it.

Note: Do not take Imodium if you see any sign of rectal bleeding or blood in your stool. Also, avoid it if you are running a fever or have any other signs of a bacterial infection such as C. diff, salmonella, or E. coli.

With a bacterial infection, you don't want to slow down the bowel because you want to help the body eliminate the infectious agent as quickly as possible.

Common Side Effects

Imodium tends to be well-tolerated and to cause minimal side effects. This is because it works primarily within the large intestine. Very little of the medication enters the bloodstream and it does not cross the blood-brain barrier, thus there is no risk of addiction.

When side effects do occur, they tend to be only digestive in nature:

  • Abdominal pain or cramping
  • Bloating
  • Constipation
  • Nausea
  • Vomiting

In 2016, the FDA issued a warning regarding the misuse of Imodium. This involves the increased risk of serious heart problems from very high dosages and interactions with other medications. The warning was primarily triggered by people self-treating opioid withdrawal symptoms with high amounts of Imodium.

Children

Imodium is generally seen as a safe, effective remedy for the treatment of diarrhea in children over the age of 6. However, it is always a good idea to check with your child's doctor before giving them any medication, even if it is available over the counter.

Imodium would not be recommended for a child who is dehydrated, malnourished or experiencing bloody diarrhea.

Pregnancy

If you are pregnant, you should not use any medication without first getting approval from your physician. One small study identified a possible link between the use of Imodium in early pregnancy and several fetal risk factors. These include hypospadias (a urethra birth defect concerning the opening of the penis), large baby size, and a higher rate of Cesarean births.

Inflammatory Bowel Disease

People who suffer from an inflammatory bowel disease (IBD) should not take Imodium without permission from their doctor. The use of antidiarrheal medications such as Imodium places IBD patients at risk for the development of toxic megacolon, a potentially life-threatening disorder.

The Bottom Line

Except for precautions taken with young children, pregnant women, and those with IBD, Imodium is considered to be a relatively safe, well-tolerated option for dealing with diarrhea. As the medication only acts on the digestive tract, there appears to be little risk associated with long-term or frequent use.

If you find that you need to take Imodium on a more frequent basis, be sure to discuss your symptoms and your dosage with your doctor.

Sources:

Ford A, et.al. American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation. American Journal of Gastroenterology. 2014;109:S2-S26. doi:10.1038/ajg.2014.187.

Kallen B, Nilsson E, Otterblad Olausson P. Maternal use of loperamide in early pregnancy and delivery outcome. Acta Paediatrica. 2008:541-545.

Lacy B, et.al. New and Emerging Treatment Options for Irritable Bowel Syndrome. Gastroenterology & Hepatology. 2015;11:1–19.

Lee K. Pharmacologic Agents for Chronic Diarrhea. Intestinal Research. 2015;13:306–312. doi:10.5217/ir.2015.13.4.306.

U.S. Food & Drug Administration. Loperamide (Imodium): Drug Safety Communication - Serious Heart Problems With High Doses From Abuse and Misuse. 2016.

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