Loperamide No More, or A Public Service Announcement

ImageI am done being mad and am well on my way into recovery.

I am here to tell you, I took my last dose of loperamide about 48 hours ago. I had a really tough time with the last and final measly doses after tapering down over a couple of weeks. Seems stupid, but I came to believe it was just a psychological hold, those last few milligrams, so I finally just jumped and stopped taking them altogether. The withdrawals suck, but in truth, are mild compared to what it would have been like if; A: I was on something stronger like Vicodin, etc.; or B: If I’d not tapered off slowly. Right now, I don’t want to redose despite feeling like I’m going to crawl out of my skin, mainly because I don’t want to have to keep going through it over and over. At some point, I just need to say “enough is enough,” right? So I’m done and waiting for the day when my brain begins the process of healing my body. Tick tock. Tick tock.

So as I said, withdrawal sucks, but isn’t as bad as it could be. Of course, ask me again at 1am when I’m wide awake (AGAIN) and the sensation of crawling ants under my skin won’t let me sleep. But with the medications I’m on, I’m surviving.

I have changed over to the AA meetings as the NP had suggested and am (as of right now) doing okay with them. Life is still a daily struggle, but it helps knowing I have people on my side. Yes, I’m still seeing the square-jawed NP for my medication management. I tried looking into therapy, but this stupid ‘burg is about as dry as a bone when it comes to such things (for those of us under the glorious Medicare plan, that is). Until I get a car, I think talk therapy is gonna have to be put on the back burner. I accept that and look forward to the day when I have wheels again — which may be soon, I hope. Fingers crossed and a small prayer.


Now, because it’s bothering me that I haven’t done this yet, I present: A brief public service announcement on the hazards of loperamide misuse:


For anyone wanting to know about using loperamide for opioid withdrawal. Loperamide (brand name: Imodium) is NOT a viable replacement for any opioid/opiate drug — whether Vicodin, Heroin, Oxycontin, or whatever you prefer. If you require a replacement drug, you will need buprenorphine (brand name: Subutex or Suboxone) or methadone. Those drugs are safe and FDA approved for opioid withdrawal when prescribed by a licensed physician.

Loperamide is an atypically-acting opioid of the piperidine class, binding mostly to the mu opioid receptors in the gut and appears to act peripherally as well. It crosses the blood brain barrier in small amounts, immediately mediated out by a chemical called P-glycoprotein which your brain produces to protect you from the effects of the drug (even in high doses). It is true you won’t get high on it, but you may get a slight, warm fuzzy feeling in extremely high doses. So for those thinking there are no Central Nervous System (CNS) effects, I assure you, there are (pinned pupils being just one obvious sign). Loperamide, when taken in the recommended doses (2-4mg at the start of diarrhea symptoms, maximum 16mg per day), is considered safe and approved by the FDA; odds are are you won’t experience any problems if you are taking it as directed.

BUT…. for loperamide in higher “mega” doses, there is little-to-no actual scientific data available. Since prescription drug and opioid abuse has skyrocketed in the last few years, anecdotal evidence has become available due to the popularity of information sharing via internet boards, social media sites, personal websites, and YouTube videos — many of which promote the use of loperamide as a replacement or withdrawal drug for opioids.

Scientific data is scant at best. Recently, a white paper has been written about my experience (presented at a 2013 Toxicology conference) describing SEVERE cardiac effects from high doses of loperamide. Right now, the exact reason why it causes heart rhythm disturbances in such misuse/abuse situations is poorly understood because, as I mentioned, there’s very little scientific data available on the drug in high doses. (Personally, I think Loperamide may or may not have some kind of dose-dependent cumulative effect, perhaps within the cardiac muscle itself, but that’s just my opinion which, since I don’t actually have a PhD in biochemistry, doesn’t matter much anyway.)

All things considered, it has been suggested based on three known incidents in this one hospital, that those who abuse loperamide can develop deadly cardiac arrhythmias (in these specific cases, typically patient presents with syncope [fainting] and cardiac arrest due to ventricular tachycardia degenerating into polymorphic ventricular tachycardia, aka, Torsade de Pointes).

Getting shocked back to life with defibrillators dozens of times while wide awake and lucid for the experience is FAR worse than going through withdrawal, I assure you.

Like others, I’ve read the websites, online boards, and seen the Youtube videos where it is has become a popular recommendation — not only suggested but presented as fact that addicts could simply consume anywhere from a few dozen or a couple hundred loperamide tablets to help them through withdrawals. THIS IS A LIE. Well, sort of. It does work from the perspective that high dose loperamide does alleviate the physical symptoms of withdrawal. But at what price? Back when all this started, I did a lot of research before I started using the loperamide. I read bulletin boards, collected anectotal evidence, read PDRs, and researched a handful of white papers (what little I could find) and came to the conclusion that loperamide seemed like a fairly innocuous drug that could help prevent or at least alleviate my withdrawal symptoms as people were suggesting it. The way I saw it, since others had successfully used it in high doses, and nobody reported them dead, it seemed safe to “repurpose” the drug in that way. That’s how it all began.

Then I discovered the ugly truth: that loperamide, like any opioid, has a tolerance. Take it for a while, then the withdrawal symptoms start rearing their ugly heads. It became a “new” addiction (and one that didn’t get me high, either). I never took the time to withdraw from the loperamide — there was never time. It was never convenient. I always had some excuse. Then the dosage escalated up and up. Eventually, I got sick in a way that nobody would have expected. Not toxic megacolon. Not liver damage. Not even kidney damage. It was my heart — I was near death, eventually on life support, and doctors were baffled. Then I survived, and there were more cases. I was the proverbial canary in the coal mine.

I survived in no small part due to the fact that I was the only one brave enough to fess up that I was addicted to what most people think of as a diarrhea drug. I went to the ER and confessed what I was doing and exactly how much I was taking. I talked the doctors through it — what the drug was, how I knew what it did, why I was taking it. I was VERY lucky to be conscious for any of this. In one white paper I read recently, the patient was dead long before anyone could figure out what happened. My doctors learned because of me. How many others who came before me died because they showed up at the ER coming in and out of consciousness from a deadly arrhythmia and weren’t so forthcoming about their usage? Loperamide doesn’t show up on a normal tox. screen the way that, say, Vicodin would — so if the patient isn’t willing to admit to it, that patient could die. My doctors are now getting the word out to poison control centers around the country how to save people from loperamide overdose. Hopefully, we will save a few lives.

So — bottom line time. If you’re reading this because you’re thinking of taking high-dose loperamide, then seriously, don’t do it. Don’t go down the loperamide path like I did. It’s false hope. Ask for help. Go to your doctor and beg for help — it’s out there if you seek it. It’s not a perfect system, and withdrawing sucks no matter how you look at it, but if you can trust me for five seconds, believe me when I say using loperamide in high doses is not worth it. Opioid withdrawal won’t kill you, but that high-dose loperamide will.

And if, perchance, you are reading this because you are already addicted to loperamide, welcome to my world. There is help for you.

First of all, if you ever discover yourself getting dizzy, eyes unable to focus, or nauseous or vomiting an hour or couple hours after dosing (it feels a bit like the stomach flu) or worse, waking up gasping for air or passing out or fainting, call 911 and for God’s sake, confess! Tell them exactly what you’re taking. Take the bottle with you if you can. And tell them if you’re taking anything else or anything to potentate it (like quinine, grapefruit juice, or omeprazole — yes, you!) and tell them EXACTLY how much you took — don’t be shy. I was on 144 loperamide tablets a day when it happened to me. Another guy was over 300 at a time. Just be honest; your life literally depends on it.

ImageSecondly, if you’re not in crisis, talk to your doctor about getting off the loperamide. He/she might initially look at you like your nuts or tell you you’re exaggerating, but insist that they look it up and/or call the poison control center. At the risk of outing myself, I’m including the poison control center’s logo herein for informational and educational purposes only (my blog is absolutely NOT endorsed by them). Give that number to your doctor.

What to expect afterward? Withdrawal treatment from loperamide addiction will depend on the symptoms and a plan of action must be developed with your doctor. The number one thing they will likely want to do is get you off the high-dose loperamide immediately. My doctor has been treating my case like ordinary opioid withdrawal, but it hasn’t been easy because (as I mentioned) it isn’t an ordinary opioid. It acts peripherally, so I experience a lot of physical issues such as restless legs syndrome, and a surprising number of central nervous system-based symptoms such as depression, and severe insomnia and agitation. Yes, even with a slow taper. The medications help but do not eliminate the symptoms.

I should also emphasize that when I went through withdrawal this time, I chose to taper down from the drug against the advice of my doctors. I don’t recommend it. Eventually, I have managed to stop taking it, but not without sacrifice. Make no mistake: as I said, loperamide is similar to other opioids, but its withdrawal symptoms last considerably longer and are very devious and frustrating to deal with even with a slow taper. Individual experience may differ. But the most important thing is work a plan with your physician. This won’t be easy, so you’ll need help. Advocate for your own health!

If you’re insistent on detoxing off the loperamide yourself, expect a rough ride, and I wish you the best of luck. Take vitamins, drink plenty of water, and take lots of hot baths — you probably know the routine. Just leave the lope out of the equation this time.

Finally, if you are a doctor treating a patient who is experiencing v-tach due to loperamide abuse/misuse or who is addicted to loperamide and needs to get into a treatment program, please call the Poison Control number listed in the logo above immediately to discuss the case with the doctors on staff. They know (almost! ha!) as much as I do about it and will be able to guide you through developing an effective treatment plan for your patient.

One last time, with feeling: Yes, opioid withdrawal sucks. There are no two ways about it. But using loperamide is not a way out, it will  just making things worse. Opioid withdrawal won’t kill you, but that high-dose loperamide will.

Thank you for listening.



About madmargaret

Nursing student, Mac nerd, medical 'genius', recovering addict, singer, ex-actor, and all-around swell egg. Really!
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30 Responses to Loperamide No More, or A Public Service Announcement

  1. Anonymous says:

    I just want to thank you for putting the time in to educate people, giving your honest truth. I was addicted to it… no one believed me and it was hell to come off. While on it I made the mistake of not drinking enough fluids, leaving my muscles weak and beat up. My skin looks like scales. I have literally dried myself up from the inside out. I came clean to my doc after I was off it. I wanted her to know this addiction exist and she will eventually hear about it. When I was going through withdrawal my chest hurt so bad, was hard to take a deep breath, I did not understand why. I was up to 200 pills per day. I had to use Kratom to help me get off. Now Kratom can also be addictive… so I’m not condoning. Anyhow. Thank you.

    • madmargaret says:

      Glad to be of service! Stay in touch and please let me know how things go for you.

  2. Hello, I have been on Loperamide for 5 days now. To come off of a teariable Kratom habit.
    Day one 80mg lope
    Day two 80mg. lope
    Day three 74mg lope
    Day four 70 mg. lope
    Day five 64mg. lope. (today) This is how I have been taking it so far. My idea is to go down, no matter what. Now I used Kratom for years. I used to be able to easily, taper off of it. Well that was years ago. I put my Kratom in capsules, I recently got down to 4 capsules of kratom, about 9 grams a day. I took months tapering to that level. All that got me was sick 4 hours, sort of well for 4 hours, and so on. It was a brutel cycle. I decided to try Loperamide, to break the cycle. So here I am 5 days into it. Not feeling the best, but still able to function. Woke up last knight with puking and diareaha, at the same time. It was teariable. I ended up puking on my bedroom floor, trying to get to the bathroom. every since I started taking Loperamide, I have had diareaha. Some times wourse than others. II have some questions for you.
    1. Did you try and kick the same way I am, by reducing your loperamide use, during the withdrawal part, Like I am?
    2. Why did you increase your usage? Were you aware of its potential for addiction, when you did so?
    3. If you had been more educated on Loperamides potential for addiction, do you feel you could have slowly tappered, down?
    4. Did you try any kind of taper, and if so did you reach a place where you could hold, if things got bad, give it a few days, then continue your taper.
    5. With your experience and knowledge, what should be my next move? .

    • madmargaret says:

      Hi — Thanks for your comment. Hope I can answer your questions.
      1. I had quit using Vicodin and used the loperamide to alleviate the symptoms. I wasn’t trying to do both at once — that can cause precipitated withdrawal as well as other unexpected reactions.
      2. My usage increased because loperamide has a tolerance like any other opioid. I wasn’t interested in immediately tapering (dumb idea) and ended up being on it long enough that i experienced tolerance. And when that feeling of tolerance-related withdrawal returned (or what seemed like withdrawal-like symptoms), rather than quit, I increased the dosage. It was stupid, but that’s addict thinking for ya. I was not informed that loperamide was addictive; very little research was available at the time. Only now is the word getting out and research being done, in small part because I almost died from the stuff and my docs have been trying to educate other medical professionals about the danger.
      3. If I’d known how dangerous Loperamide can be, yes, I would have either never used it at all, or I would have tapered quickly after starting. Like I said, my research at the time led me to believe it was fairly innocuous — no idea what I was in for. That’s one of the reasons I’m trying to spread the word and educate through this blog.
      4. Yes, I tried tapering a couple of times. The last and successful taper (last year) was at a rate of about 10% every couple of days. It was still rough, so I ended up jumping from about 6 per day down to zero. I suffered the consequences of withdrawal symptoms, but I had meds from the doc (like Clonidine) to help with it. I highly recommend comfort drugs over opioid replacement.
      5. Regarding your next move, getting off the kratom and off the loperamide are obviously your best options, but how to get there is the question. You should not be experiencing that kind of diarrhea while on that much loperamide — BUT — to be fair, I don’t know that much about high dosage, long-term kratom use either. My best educated guess is that even though kratom is NOT a traditional opiate, there is likely some agonist/antagonist competition going on between the two drugs for the receptors. That can raise absolute havoc (like what you’re describing). Though it may not be your favorite idea, it might be best to get honest with a doctor and get some RXs for opiate withdrawal (like Clonidine, among others). Wasn’t my favorite idea either, but ultimately, it’s what worked to get me off the cycle.

      I hope that helps. More questions? Just ask. 🙂 Thanks — MM

    • madmargaret says:

      Another idea for where to go from here would be — it’s unclear whether you’re taking kratom simultaneously with the lope. If you are, cut out the kratom and use lope only and continue tapering as tolerated (10% every couple of days or so). That might be worth a try too. Take care — MM

      • roeschandco says:

        I worry loperamide may kill me. I have been on loperamide for nearly 4 years. My breathing is difficult and some other things too. How does it affect the heart?

  3. roeschandco says:

    In 2010 I started using loperamide as a temporary relief drug between my doctor prescribed oxycodone. I would usually run out of 90 pills (10 mg oxycodone) in less than 11 days. I experienced loperamide (internet) and was very comfortable using it as a withdrawal solution. It bailed me out for two weeks each month. Now that nearly 4 years slipped by my breathing has become more difficult, swollen chest and extreme weaknesses. Over the years I would only swallow 30 pills a day…Sometimes not for three days. After adding all that up, I must have gulped 30,000 of those green 2 mg pills. I wish I never got on drugs. Yes, a coworker presented oxycodone to me…but no…He did not put a gun to my head and force me either. I have to ween off loperamide and the clonidine isn’t working to well. Thanks for reading.

    • madmargaret says:

      Hi — and thanks for writing. I’m so sorry you have to go through this, and please don’t be ashamed. I’ve been there — addiction is a tricky, sneaky thing. If you are experiencing symptoms like what you describe, running into problems with difficult breathing, tightness in the chest, and weakness, I strongly recommend you see a physician right away. It’s a bit beyond my expertise — a doc can take your full medical history and can see the full scope of what’s going on much better than I can. They’ll take a history on you and run an EKG to see what’s going on with your heart (it’s painless, so don’t worry about that). Further testing might be necessary to see what else might be going on, but don’t be afraid. Save your life.

      High dose Loperamide effects the heart in a couple of different ways). First, it appears to slow the heart rate (causing bradycardia); second, it seems to effect the electrolytes including magnesium and calcium channels in such a way that can adversely effect rhythm and the timing of the heart’s beats (which cause arrhythmias); third, these two combined can lead to serious electrical conduction problems, lengthening something called the QTc time (basically, how long it takes your heart to reset after each beat), which can lead to cardiac arrest. It’s really nothing to fool around with, as I well know. I had to be cardioverted (zapped with the heart paddles) while wide awake and lucid for the experience over 28 times — virtually unheard of — because my heart kept stopping. I don’t recommend it. You’re going to need people with medical degrees to work this situation with you.

      Because not much is known about loperamide addiction, and some doctors may dismiss your concerns because they don’t know about it, you can refer your doctor to the Upstate Poison Control Center at 1-888-222-1222. They’re the folks who are truly ‘in the know’ about the drug and its effects and how to treat it. They saved my life and they know as much and more than I do about loperamide. Also, see the article on this site regarding the white papers that have been written on the subject (http://tinyurl.com/lkzltmv) which provides a lot of technical info docs can use to better understand the situation.

      With regard to the clonidine, there may be other factors at play here. Sometimes the initial dose is too low and needs to be increased, or there may be some other cardiac problems that are counteracting the efficacy of the drug. That’s why it’s so important to get a doc on board to help you.

      I know how scared you are, but please don’t be too afraid to seek help. PLEASE. You are not alone. You’re on the right track already by asking for help and trying to get the loperamide and opiate monkey off your back for good. Please hang in there and let me know how things go. See your doctor and give them the Poison Control Center number. It’ll be okay.

      (hugs) — MM

  4. 93KW says:

    Did you actually die? What are some of the symptoms i should look out for when dealing with a problem like this? I constantly check my heart beat because i’m paranoid like that and it’s always at a regular beat. But what are the feelings like when this happens? How does the heart beat? I take about 160 lope separated with two dose each day (now i’m cutting back big time due to learning this) although i used to take 200 a day. I was taking more than that till i finally realized it was getting bad and started cutting back; i’ve been working on it and trying to get down to about 20 a day. I got freaked out after my fingers started shaking uncontrollably, like tremors, or something. Did that ever happen to you? Some people speculate loperamide could trigger parkinson’s although there’s no evidence to back that up. I just don’t want to have cardiac arrest. And please give me tips on what to look out for if it does hit! Thank you.


    • madmargaret says:

      Yep I was actually dead. Dead sucks, I don’t recommend it. I wasn’t dead long, but dead enough so the doctors didn’t think I could be revived. I came to eventually, but yeah, I was one of those miracle code blues that should not have survived, but did. And I was revived 28 times (that I know of) by being zapped with the paddles — another experience I do NOT recommend.

      Symptoms were vague at first — a sense of altered consciousness, dizziness, a sense of warmth in my chest — I simply felt “funny” — then — nothing. But I’m alive and here to talk about it now.

      My heart was going into ventricular tachycardia (a type of irregular heart beat) which degenerated into torsades de pointes — a rare and fatal heart arrhythmia that most people don’t live to tell about. Loperamide appears to slow the heart rate and alters the timing of the heart beat which leads to arrhythmia and cardiac arrest. Combine that with a skipped heart beat (a PVC or premature ventricular contraction) and that sets off a fatal cascade.

      I have not seen reliable evidence that loperamide leads to Parkinsonian symptoms except in one study of fetal pigs whose blood-brain-barrier is immature. In people, it’s quite a different thing, but… little is known right now. The symptoms you describe are more likely related to the overdose (weird stuff happens at large doses!) but especially if you were using Tagamet or other such drugs to get the lope to cross into the brain in higher quantities, the outcome is less sure.

      As far as to what to look for. Any dizzy spells. Nausea. Vomiting. And if you find you’re passing out and awakening gasping for air (that’s what was happening to me at home) call 911, bring the loperamide bottle with you, and confess to the ER physicians EVERYTHING you are on. They will need ALL that information. The docs will want to call Poison Control 1-800-222-1222 and they can get answers from them as to how to proceed.

      Good luck with your taper — and stay strong. The sooner you’re off it, the better you’ll start feeling… eventually. 🙂

      Take care

  5. lellew says:

    Can you please email me? My husband has been taking large doses of loperamide for over two years. About 8 months after he began, i watched him die (clinical death, anyway). He was clinically dead for 8-9 minutes, in a coma for 3 days, then the Dr told us he had long QT and installed an ICD. We didn’t know why he’d had the cardiac arrest. He is now dealing with many symptoms, and of course it’s the loperamide! So now that I’ve discovered what’s wrong, I want to help him get well (I wanted to before but had no idea how). We went to his Dr today, and he wasn’t very nice. My husband has never been a drug user. This started because instead of weaning him off of pain meds, his Dr cut him off cold turkey. So anyway, the Dr said that all he has to do is cut down. What a brilliant man! Wow, why didn’t we think of that?? So I explained to him that the withdrawals are pretty uncomfortable, and that he needs something to help ameliorate the symptoms. He said “we don’t do that here” and referred him to some place for addictions. I don’t think that’s appropriate, someone who was just trying to keep from withdrawals after being left high and dry by his Dr shouldn’t have to just suffer it out and do the 12 steps! There’s a big difference between addiction and dependence! So anyway, it seems everyone around here has their heads up their butts and I don’t know where to turn, if there is anything you can think of, please letme know. Perhaps your Dr may have advice on how to find the right Dr around here, or something else. Anyway, if there’s anything you can do to help, my email is lellew7@gmail.com

    • madmargaret says:

      Hi Lellew,

      Sorry for the tardiness of my reply. I’ve been doing A LOT of other things and lost track of the blog for a while.

      A referral to an addiction specialist is, in fact, the right move. I understand you don’t agree that he has a addiction problem, but either way, it’s the right choice. Those people understand the ins and outs of both physical and mental dependence on drugs. It’s a very complex disorder. They’re the best choice for getting him through withdrawal.

      The medical system can be pretty frustrating, but go with the flow on this and I promise, you won’t regret it.

      Regarding the addiction/dependence thing, there actually isn’t much difference when it comes to opioids. Many things start for one reason yet continue for another. If he was using pain meds for a long time, then was cut off unexpectedly (this happens A LOT), then turned to high dose loperamide to get off it, used it for 8 months without stopping, ended up dead, was brought back to life yet wants to continue to use anyway, there is a reason for that. He is NOT in control of his usage. (I had to admit that myself!) And mentally, regardless of whether he or you think he’s addicted, sadly he is. Pain meds alter the brain biochemically — it’s not your choice — whether addicted before or not, he is now. And the best way to deal with that is, in fact, to deal with it. It’s not to say he’s some kind of hardcore gutter addict or anything, but without help, this could start all over again and will likely get worse. I went many, many years “in control” of my pain meds… until one day, one incident, one bad choice, and soon after I was in so deep I couldn’t see the forest for the trees. Do what you can NOW to make sure that doesn’t happen.

      12-step programs are actually a very healthy way of learning to deal with life. They get a bad rap. In fact, I’m not terribly fond of them myself for many reasons (mainly personality issues within the group itself), but… there is method to the madness. Even if he thinks he doesn’t really need it, there is sound reasoning for it. At its core, it’s almost a Buddhist approach to life. Acceptance. Charitable thinking. Altruism. Universal thinking. Spiritual healing. And most importantly (especially in recovery from an addictive substance) learning how to deal with life without drugs. Again, remember that his brain is altered now — like it or not — and we need to be sure that gets changed to a healthy, non-addictive approach, so this cycle doesn’t repeat itself. And he’ll need all the support he can get to do that. Now, 12-steps aren’t the only choice to do that; they’re just the most readily available. And they’re free.

      I hope that helps, and again, forgive me for being tardy in my reply.

      Please let me know how you guys are doing and if you’ve been able to get the help you need.

      Take care

      • Remake says:

        Hello Margaret,
        I need advice…desperately. However the means I got here, I am addicted to lortab. When 120/month of the 10s weren’t enough (I know that probably sounds like nothing) I wanted to get off of them. When I went to my doctor he encouraged NOT to get off of them. He said that what I need is more. He then gave me 150/month. So I went to my church leader (who is also a medical doctor) for advice. He agreed with my GP and said that if he could, he would write me a prescription for more. For whatever pain I may be in, I just wanted off of pills. So I went to the Internet and YouTube and came across the imodium. I went and got all the ingredients…rubyred grapefruit juice, tonic water, Tagamet, and imodium. I had NO idea of the downside…and I really thought I hit the jackpot. No withdrawals. Until I stopped. I could not believe the Imodium WDs. Depression like I have never known (suicide REALLY seemed logical). The back of my head burned like I was in a fire. Hot/cold flashes. So, it took me about 2 hours of this and I doped up. The most I ever took at one time was 40. I took it for about 6 weeks. I tried to taper, but I could never find my stable point to start. And there was never a schedule about when the WDs would come. I can go on, but I’m sure you know.
        I went back to my doctor and told him what I did. So he is totally onboard with helping me, but he is not well-versed on this addiction. I think he thinks I’m exaggerating. So, what I did was transition back to lortab. I know you’re against that, but I’ve been off imodium for 3 weeks now. I have also tried morphine to help. My lortab intake is now way greater than before. I’m taking 12-15/day. When I try to taper, the WDs still have the sensation of the Imodium WDs. I can tell the difference. I’m scared. What have I done??!! That was rhetorical, but my real questions are: my doctor will give me anything. My Clonidine is .1mg pills. Should I take more. Are there any other predictions I should ask for. Thank you so much for any advice. I’m very scared. If nothing else, I hope my experience added to all the others deter at least one person from trying this.

      • madmargaret says:

        Hi — sorry for the tardy response. Things have been really hectic here. My best advice is to be dead honest with your doctor. If the clonidine isn’t cutting it, tell him. More can be taken, but only if he says so. Hydroxyzine can be very helpful as well for anxiety and sleep (as well as Trazodone at night). Like I said, honesty with your doctor will be the best course of action. Getting off loperamide is VERY HARD — but you can do this!! And if you do it right, you only have to do it once. 🙂 My best wishes, and please keep in touch. — MM

  6. Hello, thank you for all of this information. I have a small suggestion, please realize that I have some visual impairments. The background (snow?) really makes it difficult to read your pages. Is there a way to turn it off? Thank you in advance. Rob

  7. Micheal Bopp says:

    Thank you for sharing. It has been a concern of my own recently and I hope I can manage similar things by myself. I was sure there would be a draw back to lope. It seems to do wonders for opiate “WD’s”. I am in my early stages of discovery for this remedy of some sort, maybe 2 months, but I appreciate your time of posting such information.

  8. nick clark says:

    Hi Margaret,
    I know this post is very old now, but I hope this message gets to you anyway. Thank you very much for the original post! I have been to this page many times in the last year to re-read what you said, and have determined that I cannot go this alone and need help. I have had 4 knee surgeries in the last 3 years, and each time was cut off from pain meds cold turkey. I would use loperamide each time for a few days, and always feel fine by the end of the week and stop using it. Then came the last 4 months or so. I realized that loperamide, along with something like Tagamet, would nearly get rid of my generalized depression and anxiety (not related to withdrawal/surgery/etc). I started taking 100mg loperamide along with Tagamet on occasions where I would need to interact with people. Basically to completely cover up my extreme social anxiety, I would take some a few hours before guests arrive or before heading to a holiday gathering, and be the most social, talkative, motivated person at the party. This would happen on a bi-monthly basis, very rarely more often. Then in the last 2 months, my depression has been much worse than ever. I started using loperamide about 3 times weekly, always with a day off in between, mostly because the effects for me seem to last well through the day after using. Now, when I stop using it for a few days to try to go cold turkey, I DO notice some very mild withdrawal symptoms, but nothing I could not deal with in the past. What I CANNOT deal with, is the EXTREME stomach pain!! I feel like there are razors in my gut! Two months ago I was diagnosed with Giardia, and took a script that seemed to fix it all up. Then it came back again, and again, and again. Always seemingly a few days after I try to stop using loperamide cold turkey. Did you ever deal with this extreme stomach pain? I thought for sure at first that the Docs were indeed correct about it being Giardia, but now I am worried. I cannot go more than 2 days without the lope because I fear for the horrible stomach pain. I have never gone above 100mg (50pills) and did not think that I had a problem until recently. Now that my knee is good enough to work, I feel as though I cant just stop using the loperamide and lose out on so much work time and lay in bed all day holding my stomach. Any help you can offer would be greatly appreciated! I plan to talk to my therapist about this issue for the first time this week. Take care!

  9. Kellie Warren says:

    Hey Margaret!! I commented on another blog of yours but I can’t remember where…lol You responded in a pretty timely manner and wished me well and wanted to know how I am doing. Well, here I am 5 weeks later after quitting taking the “high dose Lope” for 2 years, and I am hoping I am almost out of the “physical withdrawal HELL”!!! I was trying my best to detox myself at home but it became way too much for me to handle!!! So it was off to the ER I went. I was desperate. Upon my arrival to the ER, I was their first patient going through Imodium withdrawal. Long story short, Poison Control was called and after talking with them, I was put on a heart monitor, I was given an EKG, I had an extremely painful Blood Gas drawn. THAT SUCKED!!! I was put in a room in the ER that had a Crash Cart. I was monitored very closely and they admitted me to PICU. I was so sick and my heart rhythms were not what they wanted to see in a relatively healthy 40 year old woman. My QT rhythms were too long. My resting heart rate was in the low 40’s and when I would eventually drift off to sleep, my heart rate was dipping into the 30’s and alarms would start going off. Now that I am home, I am under the care of a Cardiologist for heart damage from taking 144 mgs. of Lope for as long as I did. I could have died but I didn’t ☺️ I’ve been told I’m lucky to be alive and I believe it after reading about people that weren’t so fortunate and died before they made it to the hospital. They never treated my symptoms, I had to kick it out…lol I was beyond miserable!!! I’m still not physically where I want to be energy wise so I don’t know if I’m out of those woods just yet since it’s only been 5 weeks or if it’s my heart. My Cardiologist said I may even need a Pacemaker if my heart’s QT rhythms don’t shorten up on their own!! Did you have any cardiac issues? It wasn’t mentioned anywhere that I read if you did. I’ll close for now, I just wanted to reach back out to you and leave another comment with my update ☺️

    • madmargaret says:

      Hi Kellie! Most patients I’ve talked to have a return to “normal” baseline cardiac status after loperamide withdrawal within a few weeks. The QT interval is the time it takes for the heart to depolarize and repolarize (basically how long it takes to run its electrical cycle). An abnormally long QT time can be a precursor to fatal heart arrhythmias which is likely why your cardiologist is concerned. Women tend to have slightly longer QT times than men do, so I’m sure your cardiologist is going to want to monitor you for a bit to see if it returns to normal, especially if they don’t know what your previous cardiac status was. Only you and he/she can make the decision as to whether or not to get a pacemaker — BUT — I caution against doing anything too soon. A conservative approach is best if you are asymptomatic (no symptoms).

      My cardiac condition returned to normal — my cardiologists use my strips to teach students what an ideal heart function should look like. And I never had to have a permanent pacemaker (I had a temporary one during my hospitalization though).

      That said, it IS possible that your QT interval was a bit long prior to the loperamide use, or that the loperamide exacerbated an existing condition you were otherwise unaware of. And now, because you’re seeking help for your heart, they can see that and treat it as needed. Again, that’s a decision for you and your doc to make. Sounds like he/she is doing the correct thing by taking a conservative approach and monitoring you.

      I’m so sorry you had to go through the withdrawal though (cause I know it sucks!!) but I’m VERY glad you did it with a medical team onboard to help you! It is a scary thing, I know, but stick with it. And do stay in touch! I want to know how you do!

      Have a great day!

      • Kellie Warren says:

        I couldn’t be more grateful for all of your helpful posts!! I’ve learned so much and I have actually helped inform other medical professionals during my stay in the ER and during my hospital stay. I actually had 2 doctors come and talk to me that we’re not assigned to my care wanting to learn more about Imodium abuse and what I’ve was experiencing. I hope I can help others in the future !!! I have a feeling this Loperamide abuse amongst fellow addicts will get worse before it gets better!! I hope that the FDA cracks down on how the Lope is packaged !!! All I know is the hell that I’ve just gone through, I’m never going back to that again!!! I’ve been keeping a journal of what I went through and how I was feeling so I can refer back to that when my “stinking thinking” tries to get the best of me!! Thanks again, Margaret!! I’ll be in touch ☺️

  10. Jason Williams says:

    Hello – I was taking Lope blissfully ignorant to it’s issues for around 2 years. After my first year I was having issues with syncope and went to the hospital and they found out my potassium was dangerously low. Not thinking it had anything to do with lope, I continued using (around 200mgs) everyday. As time went on and I became more aware of the issues I started getting very scared. At the beginning of this year I noticed my potassium would drop once or twice a month and I would have to go get it back up. Meanwhile I started tapering off. I’m down to 80-90mgs today and Im having a real hard time going lower. I have also since developed really bad anxiety issues knowing what I’m doing to my body. My last doctor visit I was informed i have high QTC but it was nothing to worry about now. Basically, what is your advice on trying to get below my dose now?

    • madmargaret says:

      Long QTc can be a serious concern… does the doc know it’s bc of the loperamide? You will need to push yourself to continue tapering your lope. I know the anxiety is bad. Get some hydroxyzine and clonidine, which may require a frank discussion with your doc. Those two drugs will ease your symptoms and make it more tolerable

    • madmargaret says:

      Serious kudos tho for tapering down as much as you have!! I have to congratulate you on that — it’s a big step! Also, a little hope for you, the cardiac effects of lope overdose tend to resolve themselves once it is out of your system. But ya gotta get there, kiddo. You CAN do this!! Keep your eyes on the prize. Keep in touch!

  11. Jason Williams says:

    I admitted all of this to a doctor during my last emergency visit and he basically said oh its not problem because of how immodium attaches to your gut. After I bombarded him with the issues it causes he either did not believe me or didn’t really care. I don’t have insurance and my area will not help anyone without insurance. Was considering going to suboxone to get off the lope immediately because of the cardiac metabolite but some of the offices i talked to damn near laughed at me because of what I was taking and offered no assistance. Ive been to almost every emergency room in a 50 mile radius trying to explain to them what i’m going through and all of them said I have nothing to worry about. Lope isnt dangerous and you cannot withdrawal from it. Even after telling them I was on 80-90 mg a day.

    Also noticed that I’ve been low on hemoglobin a lot. Lope seems to really mess up a lot of things in your body as far as vitamins…I’ve started taking a once a day mens + iron supplements + potassium supplements. During the WD’s I literally have to force myself to eat. It’s hell. I’m trying to convince myself that the lower I go with the lope the easier the WDs will be coming down. Sometimes I feel like this is all a mental game. I’ve gone through opiate withdrawals a few times in my life but those generally last 5-6 days. I couldnt imagine feeling like that for 4+ weeks 😡

    • madmargaret says:

      I am REALLY sorry that you went through that. The medical community at large is having trouble catching on regarding loperamide abuse. I just came back from a conference where people in the industry plan to address that very issue. Please do not let this discouraging experience prevent you from continuing to seek help. Start by contacting a local rehab facility or recovery center. (Don’t be scared! They can treat you on an outpatient basis not just inpatient.). Let them know what you’re taking, and, if they balk, encourage them to contact the poison control center to confirm that this is a real known problem with real consequences. In fact, give them the number of the Upstate Poison Control center at (315) 476-4766. They are the nexus for all things loperamide. Don’t give up! You’re doing great! Please keep in touch and let me know what happens.

  12. Jason Williams says:

    Also; Would it be in your opinion ill-advised to do any sort of exercise while tapering off immodium? Sometimes I feel like if my heart beat goes anywhere above resting I feel like I’m going to have a heart attack. Get really short of breath. Not sure if that is just from going so long inactive or if its dangerous because of the lope. Sooo many things I have to take into consideration :/

    • madmargaret says:

      Exercise is GREAT while tapering off loperamide! I have heard from a number of people that it helps tremendously and tends to shorten withdrawal. Like anything else, don’t overdo it, but getting out for some exercise is definitely ok. Remember you are used to your heart rate being very slow due to the imodium; any rise in heart rate is going to feel strange. However, if you experience any chest pain or discomfort extending down your left arm, don’t do it and get medical help.

  13. Jason Williams says:

    Hello Margaret….I would just like to keep you informed (mainly because I’m proud of myself) I am now 4 days clean of Loperamide and I can say I am never going back. My heart conditions have started to ease (The feeling of being low on potassium [shortness of breath, chest tightness, ability to walk more than 5 feet without feeling like i’m having a heart attack]). Also…I will admit the only way I have been able to do this thusfar is by researching & purchasing Kratom (I know, trading one for the other) But! I have a plan. My doses are very small, just enough to wither away the most severe of the withdrawal symptoms; the feeling uncomfortable in your own skin, the constant yawning, runny nose, twitching, insomnia. I do still have hot/cold flashes and occasional watery eyes but that is very manageable. Your posts on Loperamide are what first set my eyes upon a life without it so I would like to thank you for that. This drug should be taken off the public shelves, put behind the pharmacy counter and sold in no more than 16mg total packs.

    Again, thank you for bringing to light the ugly demon hiding behind this medication. Although I did not begin taking this medication maliciously, it can certain get out of hand very quickly.

    Thank you.

  14. Jason Williams says:

    I am now 3+ weeks completely clean from Imodium and I will tell you, it feels amazing to not wake up and crave that small little green pill. The withdrawals were pretty bad but your mind can overcome a lot. I just had to keep repeating to myself “This is just a chemical change within my body” And that saying alone got me through it. I have very mild symptoms still (sometimes some excessive yawning..maybe goosebumps a few times a day and a bit of trouble falling asleep) But I am a slave no more, and my heart is on its way to complete recovery!

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