• Ann Emerg Med · Jan 2017

    Case Reports

    Loperamide Abuse Associated With Cardiac Dysrhythmia and Death.

    • William Eggleston, Kenneth H Clark, and Jeanna M Marraffa.
    • Upstate New York Poison Center, Syracuse, NY. Electronic address: williamdeggleston@gmail.com.
    • Ann Emerg Med. 2017 Jan 1; 69 (1): 83-86.

    AbstractLoperamide is an over-the-counter antidiarrheal with μ-opioid agonist activity. Central nervous system opioid effects are not observed after therapeutic oral dosing because of poor bioavailability and minimal central nervous system penetration. However, central nervous system opioid effects do occur after supratherapeutic oral doses. Recently, oral loperamide abuse as an opioid substitute has been increasing among patients attempting to self-treat their opioid addiction. Ventricular dysrhythmias and prolongation of the QRS duration and QTc interval have been reported after oral loperamide abuse. We describe 2 fatalities in the setting of significantly elevated loperamide concentrations.Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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