Loperamide/imodium

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Dee Randall - 19 Mar 2005 18:20 GMT

Hello,
A family member who has had diarrhea for a couple of months and was
diagnosed with colon cancer within the last week has been taking imodium 2mg
TABLETS for at least two months daily without controlling the diarrhea.

However, when a doctor prescribed loperamide 2 mg CAPSULES and the family
member mentioned that it was a narcotic prescription and this family member
used once - two tablets - within the last 24 hours - and said that this
prescription had controlled the diarrhea, we are wondering if there is,
indeed, a difference between what the doctor prescribes and the OTC.

I have tried on-line to see if there is any difference between the
prescription (capsule) and the OTC (tablet) and can find none.
I have noted that Imodium A-D does contain the word 'opiate.'

Does anyone know if there is a difference in the OTC (tablet) and a
prescription (capsule).
Thanks so much.
Dee

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RWP - 19 Mar 2005 19:28 GMT

> Hello,
> A family member who has had diarrhoea for a couple of months and was
[quoted text clipped - 16 lines]
> Thanks so much.
> Dee

At least in the UK Imodium is marketed as a capsule and as a tablet. Both
contain 2mg of Loperamide. In addition, the tablets contain an ingredient
that arguably stops cramping too.

Loperamide binds to the opiate receptor in the gut wall, reducing propulsive
peristalsis and increasing intestinal transit time. Loperamide is well
absorbed from the gut, but is almost completely extracted and metabolised by
the liver where it is conjugated and excreted via the bile. Due to its high
affinity for the gut wall and its high first pass metabolism, very little
loperamide reaches the systemic circulation

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Andy - 20 Mar 2005 17:36 GMT

> > Hello,
> > A family member who has had diarrhoea for a couple of months and was
[quoted text clipped - 27 lines]
> affinity for the gut wall and its high first pass metabolism, very little
> loperamide reaches the systemic circulation

Whilst 85% of Loperamide can be found in the gut some does cross the blood
brain barrier, because of this a 'may cause drowsiness' message has to be
included in the packaging. Also beware of taking with tagamet or zantac as
this will help the loperamide cross the blood brain barrier.
andy

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getsumonya - 19 Mar 2005 19:29 GMT

You may be confusing loperamide with
Lomotil.
Lomotil is a tablet used for diarrhea.
It is a CIV controlled substance because it contains diphenoxylate.

Brad

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Dee Randall - 19 Mar 2005 21:35 GMT

> You may be confusing loperamide with
> Lomotil.
> Lomotil is a tablet used for diarrhea.
> It is a CIV controlled substance because it contains diphenoxylate.
>
> Brad

Thanks, Brad. No, It is loperamide, as on the prescription and OTC Imodium
package.
Dee

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Ralph Deubner - 19 Mar 2005 22:34 GMT

In Germany the difference between the OTC and the prescricptive "variation"
of loperamide ist the number of single units in one package. The single dose
is 2mg in every case, but in the OTC packages the number of tablets or
capsules is limited in that way, that you get a two-days-dose in the
package, not more. If you diarrhea lasts longer than two days it is
recommended to ask a doctor anyway.

Ralph

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