Loperamide toxicity

Background

  • Loperamide is widely used nonprescription anti-diarrheal medication
  • Increasing reports of intentional overdose at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal[1]
  • Has a wide margin of safety, largely due to extremely low bioavailability (0.3%)[1]

Clinical Features

Loperamide-induced cardiac toxicity[1]

  • Often young
  • May present in cardiac arrest or with recurrent syncope in conjunction with ECG agnormalities

Differential Diagnosis

Sedative, hypnotic, and alcohol toxicities

Evaluation

ECG Findings

Management

Disposition

See Also

External Links

References

  1. ↑ 1.0 1.1 1.2 Wu PE, et al. "Clinical Review: Loperamide Toxicity." Annals of EM. August 2017. 70(2):245-252
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