Loperamide is an over-the-counter anti-diarrheal that normally does not cross the blood-brain barrier due to P-glycoprotein efflux. At therapeutic doses (2-16 mg/day), it is safe and effective. High-dose misuse (50-400+ mg) to achieve opioid effects or manage withdrawal is extremely dangerous and has caused numerous deaths from cardiac arrhythmias (QT prolongation, Torsades de Pointes). The FDA issued warnings in 2016 about life-threatening cardiac complications. Combining with P-glycoprotein inhibitors dramatically increases CNS effects and toxicity risk.
Imodium molecular structure diagram from the DrugsPRO substance library.
Also known as: Fad, Lope, Select, Entrocalm, Immodium a-d
Classification
Chemical: Medicine
Chemical: Opioid
Psychoactive: Depressant
Tag: Habit-Forming
Tag: Over-the-counter
Tag: Phenylpiperidine
Effects
Pain Relief
Physical Euphoria
Sedation
Itchiness
Pupil Constriction
Respiratory Depression
Cognitive Euphoria
Anxiety Suppression
Reduced Anxiety
Euphoria
Compulsive Redosing
Dream Potentiation
Dulled Perception
Acuity Suppression
Decreased Libido
Appetite Suppression
Orgasm Suppression
Routes of Administration
Oral
Dosage
Threshold: 0.5 mg
Light: 1-2 mg
Common: 2-8 mg
Strong: 8-16 mg
Heavy: 16 mg
Duration
Onset: 0.5-1 h
Comeup: 1-2 h
Peak: 2-5 h
Offset: 12-24 h
After Effects: 24-48 h
Rectal
Dosage
Threshold: 0.5 mg
Light: 1-2 mg
Common: 2-8 mg
Strong: 8-16 mg
Heavy: 16 mg
Duration
Onset: 0.5-1 h
Comeup: 1-2 h
Peak: 2-5 h
Offset: 12-24 h
After Effects: 24-48 h
Harm Reduction
Check interactions before mixing substances, pay attention to dose spacing and hydration, and treat all dosage guidance as approximate rather than guaranteed safe.
Sources
Substance data is aggregated from the following public harm-reduction and reference sources.
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Imodium - DrugsPRO stofgids
Imodium: Loperamide is an over-the-counter anti-diarrheal that normally does not cross the blood-brain barrier due to P-glycoprotein efflux. At therapeutic doses (2-16 mg/day), it is safe and effective. High-dose misuse (50-400+ mg) to achieve opioid effects or manage withdrawal is extremely dangero
