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Immodium AD tolerance?

Question:

In article <37FDDC0A.1E9D3…@aeonix.com>, Pete Masterson <p…@aeonix.com> writes: >Lomotil’s active ingredients are Diphenoxylate hydrochloride and >Atropine sulfate. These are clearly not the same chemicals active in >Immodium. However, Lomotil has the same effect–it directly controls >(slows down) the muscle activity in the intestines.

They both belong to the same chemical class, as well as having similar effects. Immodium, if I’m remembering correctly, is absorbed by the body at a much much much lower rate than is Lomotil.  That’s why it’s less likely to be toxic even with overdosing. K. ********************************************************* Access to power must be confined to those who are not in love with it. -Plato kmot…@aol.com

Response:

Immodium is the only thing that helps with my IBS -D, I take it about every other day – but would like to know – has anyone here developed a tolerance to it then it works less effectively? Or need to take larger doses to achieve results? Can it be bad for the gut? My g.i. doc said it was okay, but he is very flippant about my ‘problem’ so would like to hear from someone else.

Response:

In article <19991001235940.00574.00000…@ng-bh1.aol.com>, paraf…@aol.com (Parafinn) writes: >Immodium is the only thing that helps with my IBS -D, I take it about every >other day – but would like to know – has anyone here developed a tolerance to >it then it works less effectively? Or need to take larger doses to achieve >results? Can it be bad for the gut? My g.i. doc said it was okay, but he is >very flippant about my ‘problem’ so would like to hear from someone else.

On occasion some people have reported some tolerance to it,  but generally most people seem to be able to take it a constant doses for extended periods of time (some people, esp with one of the IBD’s make need pretty large doses to control it, but once they find the effective dose they tend to be able to stay there).  There have been some moderately long term studies (of a few months in length) that didn’t find there any indication of increased tolerance, or any indications of side effects (other than getting too stopped up).   K. ********************************************************* Access to power must be confined to those who are not in love with it. -Plato kmot…@aol.com

Response:

I have found that over the last 4-5 years, the dose that I took in the beginning is less effective now. Given that I take the Immodium prior to an event, I have been needing to take more. I take 3-4 pills now. And if I need some the next day, I go to 2. I do have a question to add. Is there anywhere online or by phone where you can order generic loperamide by bulk? I get tired of going to the drugstore, and buying nine other things so that I don’t just waltz up to the register with the immodium. Thanks. Matt (remove nospam from my email to send me an email message)

Response:

Matt have you talked to your doctor about the drug Lomotil ?  It’s by script only but is very effective for diarrhea for a lot of people.  Is worth checking into I think to see if he would let you get some.  It is a narcotic so not all docs will give it out. — MrsRat Admin XWorld NetWork http://www.xworld.org http://sefl.satelnet.org/~brats/

Response:

Regarding Lomotil, my doc said it is the same active ingredient as immodium ad, but there are other side effects, although he didn’t elaborate – so he told me it is better to stick witht the immodium.

Response:

Paraffin wrote: > Regarding Lomotil, my doc said it is the same active ingredient as immodium ad, > but there are other side effects, although he didn’t elaborate – so he told me > it is better to stick witht the immodium.

The active ingredient in immodium is loperamide hydrochloride. In its over the counter form, the recommended (adult) dose is 2 caplets followed by two more doses of 1 caplet each. Each caplet is 2 mg of loperamide hydrochloride. The package maximum dose is 8 mg of the active ingredient. In severe cases of diarrhea, the daily dosage may be increased (with your doctor’s advice) up to 8 caplets (16 mg) per day for at least 10 days. A "maintenance dose" is 2 to 4 caplets per day (4 to 8 mg per day). I have been able to control my IBS-D fairly well by taking 1 caplet in the morning and 1 caplet in the evening each day. If my ‘gut’ is rumbling and overly active (but no feeling of an immediate "attack"), I may take an additional caplet to calm things down. I have gone from near daily "attacks" to only once or twice per month. Immodium acts directly on the digestive system to "slow down" the muscle contractions that move things along. Immodium is fairly safe, as drugs go. Some literature suggests that the "toxic" level is not reached until 3 or 4 times the ‘normal’ dose is taken. Side effects of Immodium may include: Abdominal distention, abdominal pain or discomfort, allergic reactions, including skin rash, constipation, dizziness, drowsiness, dry mouth, nausea and vomiting, tiredness. Even when high levels of the drug are (accidentally) taken, the consequences are rarely life threatening. Symptoms of an Immodium overdose may include: Constipation, drowsiness, lethargy, and depression, nausea. ——- Lomotil’s active ingredients are Diphenoxylate hydrochloride and Atropine sulfate. These are clearly not the same chemicals active in Immodium. However, Lomotil has the same effect–it directly controls (slows down) the muscle activity in the intestines. Lomotil dosage is usually 2 tablets (5 mg) 4 times a day (20 mg/day). A maintenance dose might be as little as 2 tablets (5 mg) per day. If you take 20 mg per day for 10 days… and your diarrhea persists, then Lomotil is likely not going to work for you. Side effects may include: Abdominal discomfort, confusion, depression, difficulty urinating, dizziness, dry mouth and skin, exaggerated feeling of elation, fever, flushing, general feeling of not being well, headache, hives, intestinal blockage, itching, lack or loss of appetite, nausea, numbness of arms and legs, rapid heartbeat, restlessness, sedation/drowsiness, severe allergic reaction, sluggishness, swelling due to fluid retention, swollen gums, vomiting. An overdose of Lomotil can be lethal. (I have not done enough research to find the dose level at which toxicity is found.) An overdose of Lomotil may cause Coma, dry skin and mucous membranes, enlarged pupils of the eyes, extremely high body temperature, flushing, involuntary eyeball movement, lower than normal muscle tone, pinpoint pupils, rapid heartbeat, restlessness, sluggishness, and/or suppressed breathing. Suppressed breathing may be seen as late as 30 hours after an overdose. While your doctor’s remarks were not exactly "on the mark" his/her attitude is essentially reasonable. One should try to stick with Immodium as long as possible. The literature suggests that there is no evidence that "resistance" to Immodium occurs over time. Lomotil is a much more "risky" drug so far as toxicity and side effects are concerned. (Many years ago, I once took a ‘course’ of Lomotil after a visit to Mexico. It worked.) You can find information on Lomotil, Immodium and most other drugs by researching on the Internet at one of the many "health sites" … I suggest assuring yourself of the quality of information by reading the information at a recognized "expert" site, such as the Mayo Clinic web site. — Pete

Response:

I have IBS-D and the only thing that seems to help now is an Immodium AD tablet – but does anyone know if the body develops a tolerance? i don’t want to take one every day – if it is not going to work after a while (rather to use it only for ’special occasions – ie.parties, long drives, etc.) Any opinions?

Response:

There is a new herbal  Formula for IBS developed by Samra Health & Beauty. Please check out the web site: http://www.choicemall.com/ibs good luck! Michael Chi

Response:

In article <19990803224832.13318.00007…@ng-fr1.aol.com>, paraf…@aol.com (Parafinn) writes: >I have IBS-D and the only thing that seems to help now is an Immodium AD >tablet >- but does anyone know if the body develops a tolerance? i don’t want to take >one every day – if it is not going to work after a while (rather to use it >only >for ’special occasions – ie.parties, long drives, etc.) Any opinions?

The general opinion is that it’s unlikely that you’ll become tolerant to it (although there are some people who end up over time needing more, whether that is due to tolerance, or a worsening of their condition, it unknown).  Some people need fairly large doses of Immodium, anyway, and seem to be able to take is safely (especially people with Chrons or ulcerative colitis who will take large doses for a long period of time, usually the don’t have to keep increasing, but they require the same large dose, daily). A lot of people seem to be having good luck with Caltrate Plus (a calcuim supplement with minerals, it seems to be the most often mentioned brand).  Usually take one with each meal.  You might want to try that, and save the Immodium for special occasions. K. ********************************************************* Blessed is he who has learned to laugh at himself, for he shall never ceased to be entertained                                           —John Powell kmot…@aol.com

Response:

You can build a tolerance to any medication.  So if you feel you want to save immodium for trips and such try it.  I have also had some success with Caltrate Plus in the purple box.  I take one with each meal (I try to have 3 meals a day). Eileen

Response:

> In your opinion, why is Caltrate (or other treatments that > you don’t think one will build tolerance against) different > than medications (like Immodium) where you keep warning > against building tolerance

I guess what I am saying is that Immodium or Lomotil is used for what I would call emergency situations, while Caltrate is taken on a maintainence schedule.  So therefore I find that if I have to take a trip where I will not be able to guarantee a bathroom nearby I take the Lomotil prescribed by my doctor.  I don’t like to take it if I am just staying home (we work out of our house).  I am concerned that if I take the Lomotil every day it will eventually not work as effectively for me in times of emergencies (like if I have to go to town 35 miles away to take my dog to her vet, which has happened a few times when she had severe neurological problems and very high fever requiring IV treatment).  I never know when something like that will occur and I want to make sure that the Lomotil will work when I need it to.  While the Caltrate is taken, as I mentioned above, on a maintainence routine.  I might add I already take Cantil 4 times a day to control diarrhea and still there are times when 2 Lomotil before a trip are absolutely necessary. I think that is what I was trying to say. Eileen

Response:

In article <19990803224832.13318.00007…@ng-fr1.aol.com>, paraf…@aol.com (Parafinn) writes: >I have IBS-D and the only thing that seems to help now is an Immodium AD >tablet >- but does anyone know if the body develops a tolerance? i don’t want to take >one every day – if it is not going to work after a while (rather to use it >only >for ’special occasions – ie.parties, long drives, etc.) Any opinions?

Here’s some info on using Immodium (Loperamide) in some fairly long-term studies. Title       Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. Author       Palmer KR; Corbett CL; Holdsworth CD Source       Gastroenterology, 79(6):1272-5 1980 Dec Abstract       As no adequate comparison of these widely used drugs has been made, we have performed a double-blind cross-over trial in 30 individuals with chronic       diarrhea. Each underwent three randomized treatment periods of 4 wk duration. Patients were instructed to increase the daily dose gradually until control was       achieved or side effects became intolerable. Stool frequency, consistency, urgency, and incontinence were then compared when a stable dose was reached.       Though 2.3 capsules (4.6 mg) of loperamide, 2.3 capsules (103.5 mg) of codeine and 2.5 capsulses (12.5 mg) of diphenoxylate all reduced stool frequency       to the same extent, diphenoxylate was significantly less effective in producing a solid stool. Before treatment 95% of patients experienced urgency, sometimes       associated with fecal incontinence, often as their major diability. Loperamide and codeine were more effective in relieving this than was diphenoxylate. Side       effects, particularly central nervous effects, were greatest with diphenoxylate and least with loperamide. Approximately equal numbers discontinued each       preparation; poor control and central-nervous-system side effects were the usual reasons for stopping diphenoxylate and codeine, and abdominal pain and       constipation for stopping loperamide. We conclude that both loperamide and codeine phosphate are superior to diphenoxylate in the symptomatic       treatment of chronic diarrhea. Language       Eng Unique Identifier       81067755 Title       A double-blind crossover comparison of lidamidine, loperamide and placebo for the control of chronic diarrhoea. Author       Allison MC; Sercombe J; Pounder RE Address       Academic Department of Medicine, Royal Free Hospital School of Medicine, London, UK. Source       Aliment Pharmacol Ther, 2(4):347-51 1988 Aug Abstract       Fourteen patients with chronic diarrhoea, but no evidence of active organic disease, completed a double-blind crossover comparison of the anti-diarrhoeal       effects of loperamide, placebo and the clonidine analogue, lidamidine. Failure of diarrhoea control led to early withdrawals from seven placebo- and six       lidamidine-treatment periods, but there was only one early withdrawal during treatment with loperamide. Loperamide was found to be superior to       lidamidine or placebo for the control of stool consistency in patients with chronic diarrhoea. Language       Eng Unique Identifier       92032352 Title       A comparative study of loperamide and diphenoxylate in the treatment of chronic diarrhoea caused by intestinal resection. Author       Bergman L; Dj

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