Two new and important articles have been added to my ARTICLE CLEARINGHOUSE page regarding the deadly cardiac effects of high-dose loperamide. Both papers introduce new cases and call for further studies and more clinician awareness. They further underline the causal relationship between high dose loperamide and cardiac arrhythmias. It’s no joke folks. Legit.
Hannah L. Spinner, 1,* Nick W. Lonardo, 1 Roja Mulamalla, 2 and Josef Stehlik 2 — 1 Department of Pharmacy, University of Utah Health Care, Salt Lake City, Utah; 2 Division of Cardiovascular Medicine, University of Utah Health Care, Salt Lake City, Utah
PHARMACOTHERAPY: Article first published online: 3 FEB 2015 DOI: 10.1002/phar.1540
“Conclusion: Our report concurs with two previous observations that patients exposed to high doses of loperamide may be at an increased risk of ventricular dysrhythmias. Further studies are needed to confirm a causal relationship, but clinicians should be aware of possible cardiac adverse effects related to the overuse of loperamide.”
1 LUCAS N. MARZEC, MD, 1,2 DAVID F. KATZ, MD, 1,2 PAMELA N. PETERSON, MD, MSPH, 1 LAUREN E. THOMPSON, MD, 3 MARK C. HAIGNEY, MD and 1,2 MORI J. KRANTZ, MD — 1 Cardiology Division, University of Colorado Hospital, Aurora, CO; 2 Cardiology Division, Denver Health Medical Center, Denver, CO; 3 Cardiology Division, Uniformed Services University, Bethesda, MD
THE JOURNAL OF INNOVATIONS IN CARDIAC RHYTHM MANAGEMENT: January 2015, vol 6 (2015), pp 1897–1899
“Conclusion: We report a case of markedly prolonged QTc and recurrent TdP in a patient who ingested large doses of loperamide coincident with cimetidine in an attempt to simulate the euphoric effects associated with opioid abuse. This is a sentinel case, as ingestion of large doses of loperamide for self-treatment of opioid withdrawal and as a drug of abuse appears to be increasing through internet dissemination. This may represent a growing public health danger and warrants further investigation.”