Talk:Loperamide/Archive 1

Libelous Claims relative to Third World Marketing?
The Seattle Times article has an uncited source relative to the claim that Immodium is being pulled from third world countries. In fact anti-diarrheals have led to significant health gains in the Third World.

Use when running?
Anyone know if imodium can work for "runners trots"?
 * According to http://www.time-to-run.com/doctor/runnerstrots.htm

"If all other precautions fail ... consider the use of an over-the-counter anti-diarrhea product such as Imodium. Studies have shown this has reduced problems related to those prone to exercise-induced diarrhea. It is not recommended to use this on a daily basis."
 * Unfortunatly, they don't specify the studies.  Please keep in mind that Wikipedia does not give medical advice --Mdwyer 03:15, 28 September 2006 (UTC)

Side Effects
I always get gas when I use loperamide.


 * Well, the alternative is diarrhoea and gas. JFW | T@lk  23:33, 22 December 2005 (UTC)

Are you stalking me? :) Seriously, is that not a common side effect? Happens to other people I know too. PS. Sorry for not signing.  I forget sometimes.  PrometheusX303 01:34, 24 December 2005 (UTC)


 * No, it's just that I patrol a lot of medical pages, especially the ones that are commonly vandalized. I'm simply not aware of loperamide causing flatulence, but it does slow down bowel motility while the production of intestinal gases proceeds uninterrupted. It may simply be that the cessation of the diarrhoea brings the flatulence to prominence. JFW | T@lk  00:32, 26 December 2005 (UTC)

Drug Screens
Since Loperamide is an opioid, does it show up on drug tests when looking for heroin? --Mdwyer 18:36, 13 November 2006 (UTC)

This is doubtful, as loperamide is not an opiate, rather a synthetic substance with narcotic purposes such as Demerol(although meperidine may show up) and Tramadol and does not share chemical properties such as morphine's skeleton, which means that it likely will not metabolize into morphine-3-glucuronide and morphine-6-glucuronide, which are the active metabolites tested for. Can we have an expert verify this? Wcbradley 17:04, 4 March 2007 (UTC)

In regards to the statement that Loperamide is not an opiate, rather a synthetic substance with narcotic purposes, is only partially correct. Loperamide is not an opiate, as opiates must be derived directly from Papaver Somniferum(Morphine and Codeine), Papaver Bracteatum(Thebaine), or Papaver Orientale(Oripavine). Loperamide is a synthetic opioid of the phenylpiperidine class structurally related to the opioids Pethidine, Difenoxin, and Diphenoxylate. The term opioid refers to chemicals that bind to Mu, Delta, and/or Kappa Opioid receptors in the central or peripheral nervous system. Loperamide binds to Mu Opioid receptors, which classifies it as an opioid. Loperamide however does not penetrate the CNS in significant amounts unless taken in massive quantities or with a P-glycoprotein inhibitor. However, even in massive doses without a P-glycoprotein inhibitor, Loperamide would unlikely reach CNS concentrations great enough to produce effects even remotely as potent as its relatives Pethidine, Difenoxen, and Diphenoxylate which do cross the blood-brain barrier in significant quantities. You are correct in the fact that Loperamide does not produce any Morphinan type metabolites, such as the glucuronides, that you mentioned and therefore will not produce a positive test result for Morphine or its derivatives like Heroin, Oxycodone, etc. --rehayesiii — Preceding undated comment added 20:27, 4 May 2014 (UTC)

BBB
I'm not sure if the claim about insnufflation should be there as I've seen no evidence to support it in the case of loperamide. I removed the cold water extraction claim too as loperamide is hardly soluble in water. My phantom limb 15:12, 25 March 2007 (UTC)

Cold water extraction from what?
 * Yes, from what? There's no APAP in lope. 66.96.79.223 (talk) 00:49, 4 December 2014 (UTC)

Mild Euphoria?
Can someone post a source for that? I've never heard of it before. Psychoman364 03:47, 23 October 2007 (UTC)
 * 300 miligrams and up (700 and up is OD. I was Narcan'd five times taking over 1,250mg in 48 hrs, with heart failure) 66.96.79.223 (talk) 00:44, 4 December 2014 (UTC)

Allergy Issues
How about a discussion on allergy issues? Whenever I take loperamide, it always triggers asthma, wheezing, and shortness of breath. From the paper that comes with imodium, it says there that there are possibilities of experiencing asthma, swelling of face, lips, and tongue, skin rashes, severe blisters, and flaking or peeling of skin. Anyone who can expound more on this? Fmang (talk) 10:17, 14 June 2008 (UTC)

That's Poppycock reference is circular
Current reference 5, the That's Poppycock article, quotes Wikipedia as one of its sources. Wikipedia cannot be used as a source for Wikipedia, so the reference needs to be tracked back to primary sources.

Although it may be that the fact that is being used didn't come from Wikipedia, there is no way of confirming that without finding the true primary source. 193.122.208.213 (talk) 09:10, 9 October 2008 (UTC)

Some OR
I just got back from Thailand - Loperamide HCL is sold there under the brand name: Tedium ! Fitting, I think someone in marketing in Thailand has a sense of humor. But, since this is Original Research (how original, you don't want to know), I'm not putting it in the article. Sorry, too worn out to find & cite a good reference right now! --Tzf (talk) 07:17, 19 July 2009 (UTC)

Last edit changed diarrhea to "hard on"
This seems completely wrong - but I'm no expert — Preceding unsigned comment added by 86.8.148.165 (talk) 16:40, 3 June 2011 (UTC)

Recreational use
I have never contributed to Wiki before, but this has to be dealt with.This page literally says that high doses will produce true opiate effects, and that simply isn't so.Simply taking  — Preceding unsigned comment added by 24.98.250.155 (talk) 04:39, 30 July 2011 (UTC)


 * Since this specifically asks for evidence of abuse potential; from McNeil Consumer Healthcare. http://www.imodium.com/images/imodium/pdf/ImodiumLoperimideFacts.pdf  Section 11 "Overdose Management" page 31. "Overdosage of loperamide may result in constipation, CNS depression, and nausea." cited to Physicians Desk Reference.  All three are opiod effects.67.167.106.3 (talk) 16:46, 9 April 2012 (UTC)

legal stuff for the pdf © McNEIL-PPC, Inc. 1997-2012. All rights reserved. This site is published by McNeil Consumer Healthcare Division of McNEIL-PPC, Inc., which is solely responsible for its contents. It is intended for visitors from the United States. Questions or comments? Call 1-800-962-5357 or click here for Customer Service. If you reside outside of the United States, you can call us. Click here for a list of telephone numbers by country. Ask Us | Site Map — Preceding unsigned comment added by Qwh (talk • contribs) 19:49, 2 May 2013 (UTC)

New study discovers lope messes with blood vessels
Just saw a study on pub med saying that lop messes with blood vessels.

"The angiopoietin-Tie2 binding and related signal transduction pathways are crucial for vascular angiogenesis, blood vessel integrity and maturation. In this study, we preformed a virtual screening of small molecules targeting to Tie2. The binding site was selected at the extracellular ligand binding region of Tie2, rather than its conventional endocellular ATP binding region. It was found that loperamide, a widely-used antidiarrhea drug, was among the top hits."

https://www.ncbi.nlm.nih.gov/pubmed/22406116

this is potentially bad news for people taking this all the time.

I will add this data to the wiki when I get around to it, but someone else may if they feel so inclined.

SpenserTimothyAndrewRogerMolnar 13:36, 26 April 2012 (UTC)  — Preceding unsigned comment added by Spensermolnar (talk • contribs)

russain article talks of lope affecting emotional stress in mice
https://www.ncbi.nlm.nih.gov/pubmed/21544932

"The aim of the work was to study effect of peripheral administration of mu-opioid receptor ligands unable to penetrate through the hematoencephalic barrier on the measures of emotionality in rats and on the release of beta-endorphins from nerve endings of the anterior cingulate cortex during emotional stress. The mu-opioid receptor agonist loperimide mostly acted as an anxiolytic whereas the receptor antagonist methylnaloxon showed depressive activity. Lifetime microdialysis and subsequent immunoenzyme assay demonstrated that intraventricular infusion of loperamide and methylnaloxon decreased and increased respectively the surge of beta-endorphin into the intercellular space. Immobilization-induced emotional stress insignificantly increased the beta-endorphin level in the cingulate cortex. Peripheral administration of loperamide but not methylnaloxon markedly increased the release of the neuropeptide during stress. These findings confirm the hypothesis of the authors about reciprocal interaction of central and peripheral components of the endogenous opioid system and explain the mechanism of antistress action of loperamide."

SpenserTimothyAndrewRogerMolnar 14:16, 26 April 2012 (UTC)

russain article talks of lope affecting emotional stress in mice
https://www.ncbi.nlm.nih.gov/pubmed/21544932

"The aim of the work was to study effect of peripheral administration of mu-opioid receptor ligands unable to penetrate through the hematoencephalic barrier on the measures of emotionality in rats and on the release of beta-endorphins from nerve endings of the anterior cingulate cortex during emotional stress. The mu-opioid receptor agonist loperimide mostly acted as an anxiolytic whereas the receptor antagonist methylnaloxon showed depressive activity. Lifetime microdialysis and subsequent immunoenzyme assay demonstrated that intraventricular infusion of loperamide and methylnaloxon decreased and increased respectively the surge of beta-endorphin into the intercellular space. Immobilization-induced emotional stress insignificantly increased the beta-endorphin level in the cingulate cortex. Peripheral administration of loperamide but not methylnaloxon markedly increased the release of the neuropeptide during stress. These findings confirm the hypothesis of the authors about reciprocal interaction of central and peripheral components of the endogenous opioid system and explain the mechanism of antistress action of loperamide."

SpenserTimothyAndrewRogerMolnar 14:16, 26 April 2012 (UTC)  — Preceding unsigned comment added by Spensermolnar (talk • contribs)

loperamide HCl atc code
whats the ATC code for Loperamide HCL 65.175.134.44 (talk) 18:17, 30 July 2013 (UTC)

Recreational use of Loperamide
From the recreational section: "In recent times, loperamide has been used recreationally when combined with a p-glycoprotein inhibitor such as omeprazole."[24] However there have been several deaths when used in this manner."

This needs much clarification and citations. For these reasons: I know people who died without using omeprazole, he took a mega dose and drank alcohol and didn't use it recreationally (used it to mediate opioid withdrawal). Another kid took a fairly low number of pills(40-50) and died.

^citations please? This is fear mongering if there's no evidence for your claims...

It should be clarified that it can kill you without using a p-gp inhibitor as what causes death is not respiratory depression (or CNS mediated effects). I think it also needs more information on the deaths associated with loperamide use recreationally. ANY high dose of loperamide can be deadly - particularly if you lack any sort of tolerance.

^citations please? Fear mongering once again, unless there's evidence to support these claims... The packaging has no such warnings of death by loperamide OD...


 * I was narcan'd five times taking over a gram of loperamide, and yes my breathing slowed to less than five times a minute and I had technical heart failure. It's just an enzyme that actively transports the drug out of the brain, it seems to be CNS mediated. That enzyme can be overwhelmed. 66.96.79.223 (talk) 00:45, 4 December 2014 (UTC)

"Abuse" as an opioid
This does not state it crossed the blood brain barrier or had an opioid affect.

Just because it states "abuse" does not mean that and therefore it does not support the content in question. Doc James (talk · contribs · email) 12:24, 3 February 2016 (UTC)

Analogous Wording, Cost Section
Ran into a news story about this, LOL'd a bit, then realized it was serious.

Quoth the final sentence:


 * The authors of one of the reports has called for the FDA to limit the availability of loperamide for public safety reasons, in an analogous manner to restrictions put on the sales of pseudoephedrine (which can be transformed into methamphetamine via clandestine chemistry).[64]

How is this analogous to the restrictions on Pseudoephedrine? It's an (apparently) abused drug, by very few people, not a direct precursor, but more importantly the article doesn't seem to mention it being a precursor. The only supporting information in the article for this link is regarding sales being signature-restricted, the meth thing seems to not be necessary.

Also, the Cost section mentions a price from 2015, but the summary has been updated to a higher price that is much more recent. Should this be updated or should the summary price just be folded into this section? They Terk Err Jerbs (talk) 13:30, 11 May 2016 (UTC)

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