Although the dose of atropine in Lomotil is too low to cause side effects when taken in the recommended doses, side effects of atropine (including dryness of the skin and mucous membranes, increased heart rate, urinary retention, and . Does the Lupus Drug Benlysta Work for Black Patients? Loperamide toxicity should be considered in any patient with fainting episodes not . Health care professionals should be aware that use of higher than recommended doses of loperamide can result in serious cardiac adverse events. The adverse effects from loperamide depend on how much someone takes, and what other drugs they are on, Marienfeld noted. Yes you can- None of these drugs should interact with the others, however, the immodium will slow down the intestine transit time and you should be aw what are you treating? Common side effects include dry mouth, dizziness, drowsiness, stomach discomfort, nausea or vomiting, and constipation. Here are 5 common types of prescription and over-the-counter medications may need to be adjusted or replaced if you have kidney damage. The most common OTC medicine that could do this is probably diphenhydramine, the active ingredient in medicines like Benadryl, which is used for colds, allergies, and promoting sleep. Dr. Hayden Gharibyar is a Doctor of Pharmacy graduate from the University of Colorado. NOBODY asked for Crohns, IBS, Ulcerative Colitis or any of the many other diseases that give you chronic diarrhea. Enter other medications to view a detailed report. About to leave on a long flight, he picked up a packet of Imodium from a pharmacy in the airport so he wouldnt have to keep going to the restroom on the plane. YouTubes privacy policy is available here and YouTubes terms of service is available here. * To learn . But lobe abusers as they sometimes call themselves have reported ingesting 100 two-milligram tablets daily for weeks. Lets grow up and act like one and you will find your life will be more peaceful. Higher than recommended doses of loperamide can cause serious cardiac events, including QT interval prolongation, Torsades de Pointes, other ventricular arrhythmias, cardiac arrest, syncope, and death. Travelers diarrhea can be caused by eating or drinking contaminated food or water. The recommended dose of loperamide is safe. Among the 17 patients who used loperamide for diarrhea, 11 reported taking therapeutic doses of loperamide, 5 reported using higher than recommended doses, and one did not report a loperamide dose. If your diarrhea lasts more than 2 days, stop taking loperamide and contact your health care professional. Of the cases that reported the duration of loperamide use, the duration ranged from less than 1 day to 18 months. Stop Suboxone to take hydrocodone? Imodium can also be used off-label for diarrhea caused by cancer medications. Spinner HL, Lonardo NW, Mulamalla R, Stehlik J. Ventricular tachycardia associated with high-dose chronic loperamide use. In our latest question and answer, the pharmacist discusses taking Benadryl (diphenhydramine) and Imodium (loperamide) together. Fish Oil (omega-3 polyunsaturated fatty acids), Email this report to a friend, doctor, or patient. Chlorpheniramine Dose Table Find the recommended dosage of Chlorpheniramine to safely give your child using the St. Louis Children's Hospital child and infant medication dosage tables. Imodium (loperamide) is an over-the-counter drug used to treat diarrhea in adults and kids. Clin Toxicol (Phila) 2016;54:454-8. Ive used a handful in my whole life.. Its usually prescribed to treat diarrhea caused by a chronic condition, such as inflammatory bowel disease. Whats Causing My Liquid Bowel Movements? He found it was easy to get access to drugs and began buying OxyContin (oxycodone) from a dealer. The combination of Imodium (also known as loperamide) & bentyl (also known as dicyclomine) MAY increase risk of severe constipation. By 2014, there were reports in medical literature about near-fatal incidents from overdoses. Highly clinically significant. If you have questions about Imodium, talk with your doctor or pharmacist. Bob Swan you are a very ignorant and judgmental with things you probably have no clue about since you seem pretty clueless from your statement. Seek medical attention immediately by calling 911 if you or someone taking loperamide experiences any of the following: Ask a pharmacist or your health care professional if you are not sure how much loperamide to take, how often to take it, or whether a medicine you are taking may interact with loperamide. For some cases of Torsades de Pointes in which drug treatment is ineffective, electrical pacing or cardioversion may be required. Ask the FDA to Restore DES Research Funding by Signing the Petition, 5 Lifestyle Changes to Maintain Heart Health, How Addicts Substitute Anti-Diarrhea Drug as an Opioid, Task Force Again Recommends Cervical Cancer Screening, Q&A: Antibodies to Prevent, Not Treat, COVID-19, Give Your Immune System a Boost With These 8 Superfoods. You can take Loperamide (Imodium) tablets for diarrhea in the usual dose. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. Ten cases resulted in death. You can definitely get high from it, and even kill yourself with it, a commenter wrote in 2013 on Bluelight, a website where people discuss drug use. Advise patients taking loperamide to follow the dosing recommendations on the label because taking higher than recommended doses, either intentionally or unintentionally, may lead to abnormal heart rhythms and serious cardiac events leading to death. Quinine and its isomer quinidine are also present in Tonic Water. Some cases reported more than one cardiac event. dizziness *. Nine of the deaths were due to ingestion of large amounts of loperamide, and there was one sudden cardiac death after the patient ingested an unknown amount of loperamide. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. If loperamide-induced cardiotoxicity is suspected, promptly discontinue loperamide and start therapy to manage and prevent cardiac arrhythmias and severe outcomes. This medication list is not intended to be complete and additional brand names may be found for each medication. What should he do? Some mixtures of medications can lead to serious and even fatal consequences. 3.3k views Reviewed >2 years ago. Loperamide can be abused if taken in very high doses, it's a mu agonist but really high doses press it through the BBB. Imodium is an OTC drug for people with acute diarrhea. Do not take more than 8 tablets per day. If you are pregnant, talk with your doctor before taking Imodium. High-dose loperamide abuse associated ventricular arrhythmias. How Imodium Became Appealing to Opioid Addicts. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Advance Local. Advertising Guidelines | Terms & Conditions | Privacy Policy, Copyright 2022, MedShadow Foundation. Do not offer this . Type above and press Enter to search. We avoid using tertiary references. The FDA has issued new information about this safety issue, see the, An official website of the United States government, : and confessed her habit, Dr. OConnell asked her to stop. This is followed by 2 mg for each loose stool that occurs after that. The more people sounding the alarm, the more likely the F.D.A. abdominal pain. The agency is warning consumers that taking too much of the anti-diarrhea drug Imodium, whose generic name is loperamide, can cause fatal heart problems. It works by making the muscles in your intestines contract more slowly, resulting in firmer stools. lightheadedness. Diphenhydramine is widely used in pregnancy as a sedative, an antihistamine, and an anti-nausea drug, although few data confirm its safety during pregnancy. HeartRhythm Case Reports. dry mouth or nose. The dosing of certain cholesterol medications, known as "statins", may need to be adjusted if you have chronic kidney disease. In more practical terms, the average 10-pound cat would need one-half of the regular 25 mg tablet or 4 ml of over-the-counter liquid Benadryl (the liquid form contains 12.5mg per 5ml). I did experience heart palpitations, but I continued using large doses while I was withdrawing, not so much to get high on it, he said. Can i take phenegran and imodium (loperamide) plus together? Find the recommended amount of Benadryl to give your child based on age and weight using the St. Louis Children's Hospital Benadryl dosage chart. February 2014. While there, unknown to doctors, she was still taking 100 tablets of loperamide a day from a private stockpile. Marketing Director for UK and Ireland responsible for J&J's OTC Brand portfolio - Nicorette, Calpol, Benylin, Sudafed, Benadryl and Imodium brands. It was cheaper, so I started using it twice a week, then it very quickly became every day.. What is loperamide? Loperamide abuse may go undetected in emergency departments, experts warn, because routine drug screens cannot detect it. Imodium Won't Get You High (At Least Not Safely) Seek medical attention if your symptoms worsen or your diarrhea lasts longer than 2 days. Bismuth subsalicylate, the active ingredient in OTC medications like Kaopectate and Pepto-Bismol, protects your stomach lining. Poor CNS penetration (low addictive potential in therapeutic dose). *The cases were reported to the FDA Adverse Event Reporting System (FAERS). Doctors typically provide answers within 24 hours. Most of the problems have occurred in people who are intentionally abusing loperamide, "often attempting to achieve euphoria or self-treat opioid withdrawal," the FDA noted. It is sold over-the-counter (OTC) under the brand name Imodium A-D, as store brands, and as generics. As most vets recommend a fraction of an adult pill, you'll be giving your cat a pill with an uncoated edge that will dissolve in her mouth if not thoroughly covered with food. Yet loperamide used to be a prescription drug and a controlled substance, in the same class as cocaine or methadone. Bonus points: Iodine is also used to for radiation emergencies, to protect the thyroid gland against radiation. headache. Our website services, content, and products are for informational purposes only. Multiple drugs that act on different metabolic or transporter pathways may act synergistically to increase loperamide concentrations. But since absorption from the gut is poor, very little of the drug permeates the blood-brain barrier at normal doses, which is why it takes large amounts to induce a high. Thirty-one of these cases resulted in hospitalizations, and 10 patients died. The FDA reported that more Americans are combining the drug with Prilosec (generic name omeprazole), a drug used to prevent heartburn, to get high or cope with withdrawals from opioid painkillers. 6. It should also be used with caution in pregnant or nursing dogs. # ! Its side effects include drowsiness and dizziness. Press Esc to cancel. Myasthenia gravis is a rare autoimmune disease with a prevalence of approximately 14 to 20 cases per 100,000 people. 4 disease interactions, and 1 alcohol/food interaction. Also, some OTC cold medicines may lower the threshold for seizures, for example cold medicines with pseudoephedrine. Last medically reviewed on January 19, 2022. More than half of those 48 cases came . If you have epilepsy, ask your pharmacist or . Loperamide is approved for use in single doses of 4 mg for the first dose followed by 2 mg after each loose stool for adults. In May, FDA Commissioner Scott Gottlieb wrote a blog post about the increasing abuse of loperamide, and how he is working with manufacturers to transition to blister packaging, to post warnings about risks on their website and packaging, and to reduce the number of pills available in one package. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Other drugs that have the same active ingredients (e.g. This product is available in the following dosage forms: Capsule; Powder for Suspension Patients and consumers should only take loperamide in the dose directed by their health care professionals or according to the OTC Drug Facts label. See Examples of Drugs that Can Potentially Interact with Loperamide. Toxicology analysis found more than 25 times the regular dose in his blood. To get a high or to cope with withdrawal symptoms, it needs to be taken in very large amounts, in the range of 50 to 100 2 mg capsules. This article explores berberine's effect. When side effects do occur, they tend to be mild. These medications are not usually taken together. Loperamide hydrochloride is the drug in the over-the-counter anti-diarrhea medication called Imodium AD. such as diphenhydramine , which treat allergies; These symptoms may be a sign of some other problem in your digestive tract. In 2016, the FDA realized there was an emerging problem with loperamide abuse leading to fatal events, and issued a warning. There is 1 alcohol/food interaction with Imodium (loperamide). TICAGRELOR/STRONG CYP3A4 INHIBITORS . Loperamide is an opioid that has relatively low gastrointestinal absorption and poor blood-brain barrier penetration. should be ok. f you feel you need multiplle doses call you doctor. Yes. Many people (like me) suffer from certain emotional issues that are chronic and lifelong, sometimes beginning in childhood. And also a big thank you to the government for trying to save a minuscule percentage of the population at the expense of the rest of us. In a few days, an electrocardiogram showed her heart normalizing, and the fainting subsided. Pharmacotherapy 2015;35:234-8. (2021). Antihistamines (for hay fever or runny nose) Chlorpheniramine (CHLOR-TRIPOLON) or diphenhydramine (BENADRYL) are safe to use but may make you feel drowsy. The epidemic of opioid addiction sweeping the country has led to another form of drug abuse that few experts saw coming: Addicts who cannot lay hands on painkillers are instead turning to Imodium and other anti-diarrhea medications. This medicine is available only with your doctor's prescription. Imodium is the brand name for a medication called loperamide. Loperamide is not recommended for use in children under 2 years. Refer patients with opioid use disorders for treatment (see Additional Information for Health Care Professionals). Can you take Sudafed with Dymista nasal spray? Refer patients with opioid use disorders for treatment. Xanax and ativan together. I care for people who make choices that lead to diseases such as some type 2 diabetics, and COPD. * 5. He stopped taking the drugs once he began recovering. Imodium Usage, Dosage, and Side Effects. With diarrhea, the gut muscles contract too quickly. Imodium Dosage for Dogs. Learning Objectives At the conclusion of this presentation, the audience member should be able to: Explain the pathophysiology of medication allergies and sensitivities Describe the risk for allergic cross- reactivity for beta lactam antibiotics, Also advise patients that drug interactions with commonly used medicines also increase the risk of serious cardiac adverse events. Polyethylene Glycol 3350 (Miralax) - Take this in combination with loperamide to help 'level' you out, as the loperamide will plug you up when taking high doses to combat withdrawal. The most frequently reported cardiac events were syncope (n=24), cardiac arrest (n=13), QT interval prolongation (n=13), ventricular tachycardia (n=10), and Torsades de Pointes (n=7). Moderately clinically significant. Keep reading to learn what to expect when taking Imodium and how to take it safely. By using our website, you consent to our use of cookies. Heres how you can help. One child experienced syncope and hypoventilation, and the other experienced ventricular tachycardia. 1. melatonin, Benadryl, Imodium, laxative, personal medications. When a drug screen comes back negative, emergency room staff may assume the test was faulty, or by that time, if the patient is responsive, they may write it off as nothing, said Dr. Jennifer Dierksen, a pathologist at the University of Texas Health Science Center at Houston. A first step would be legislation or regulation that places the items behind the counter.. The standard daily dose of Imodium A-D is no more than four caplets, or eight milligrams. and the other is an anti-spasmodic drug. In one case at the Harris County Institute of Forensic Sciences, opioid abuse was suspected after a 19-year-old Texan was found dead at home with a distended bladder full of urine. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. narcotic pain medications such as morphine, oxycodone, and fentanyl. Before sharing sensitive information, make sure you're on a federal government site. 0 " # ' #! HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Some users complain the high does not compare to that produced by opioids. The nature of Imodium is to stop diarrhea or, in other words, cause constipation, so the effects of using both drugs might increase the chance of constipation. euphoria, depression, lethargy, restlessness, numbness of extremities, loss of. Analysis of loperamide-related European Medicines Agency (EMA) pharmacovigilance data reports. Make an appointment with a doctor if you have bloody or black stools. 1. Several of the 48 cases indicated the patients were intentionally misusing concomitant drugs that are cytochrome P450 (CYP3A4 or CYP2C8) or P-glycoprotein inhibitors, such as quinidine, which have the potential for drug-drug interactions with loperamide that can increase the blood levels and the effects of loperamide. It is sold over-the-counter (OTC) under the brand name Imodium A-D, as store brands, and as generics. Antihistamines found in Benadryl, Claritin, Zyrtec, Allegra and others, that are used to treat cold and allergy symptoms, nasal pressure, or pain and fever; Antidiarrheals such as Imodium and Pepto Diarrhea Control; Antiemetics, such as Bonine and Dramamine, for nausea, vomiting and motion sickness . Imodium. More recent studies found antihistamines can relieve pain. We continue to evaluate this safety issue and will determine if additional FDA actions are needed. Imodium is a safe medication for most people. Additional cases of serious heart problems associated with the use of loperamide were reported in the medical literature.1-9 Cases reported to FDA and in the medical literature indicate that individuals are taking significantly high doses of loperamide in situations of both misuse and abuse, often attempting to achieve euphoria or self-treat opioid withdrawal. More than half of those 48 cases came after 2010, and there are likely others that have gone unreported. Dosing for children depends on the age of the child. Learn about the causes of liquid bowel movements, also known as diarrhea. Bismuth subsalicylate (PEPTO-BISMOL). There are 335 drugs known to interact with . Imodium may cause serious side effects including: diarrhea that is watery or bloody, stomach pain or bloating, ongoing or worsening diarrhea, fast or pounding heartbeats, fluttering in your chest, shortness of breath, and. View interaction reports for Imodium (loperamide) and the medicines listed below. Currently, 1417 drugs are known to cause Benadryl interactions - the . Some patients also misused loperamide by taking higher than recommended doses to treat diarrhea. Food matter moves through your system too fast, resulting in watery bowel movements that are more frequent than usual. Drug Safety and Availability, Recalls, Market Withdrawals and Safety Alerts, Information about Nitrosamine Impurities in Medications, Food and Drug Administration Overdose Prevention Framework, Medication Errors Related to CDER-Regulated Drug Products, Postmarket Drug Safety Information for Patients and Providers, Risk Evaluation and Mitigation Strategies | REMS, Multistate outbreak of fungal meningitis and other infections, FDA Drug Safety Communication: FDA warns about serious heart problems with high doses of the antidiarrheal medicine loperamide (Imodium), including from abuse and misuse, FDA Adverse Event Reporting System (FAERS), Examples of Drugs that Can Potentially Interact with Loperamide*, Additional Information for Patients and Consumers, Additional Information for Health Care Professionals, Loperamide (marketed as Imodium A-D) Information, The FDA's Drug Review Process: Ensuring Drugs Are Safe and Effective, Think It Through: Managing the Benefits and Risks of Medicines, Rapid heartbeat or irregular heart rhythm, Unresponsiveness, meaning that you cant wake the person up or the person doesnt answer or react normally. All cases of cardiac problems associated with the misuse or abuse of loperamide should be reported to the F.D.A.s Medwatch online registry. How long will I have to wait before I can take NyQuil to treat my cold? This medication has been in wide use since the 1940s. blurry vision *. Diarrhea: Causes, Symptoms, and Treatments, Caring for Your or Your Babys Bottom after Diarrhea. In the 39 years since loperamide was approved, the FDA said it got reports of 48 cases of serious heart problems --10 of them fatal -- connected to the drug. ciprofloxacin, Bactrim, sulfamethoxazole / trimethoprim, sulfasalazine, Imodium, Pepto-Bismol, Lomotil, neomycin, atropine / diphenoxylate, bismuth subsalicylate. Designed by Dante Steward. 2023 Advance Local Media LLC. The researchers found that people who took the drugs performed worse than non-users on tests of short-term memory and executive function skills, such as verbal reasoning, planning, and problem solving. All rights reserved. Loperamide has a possibility to interact with more drugs. Take 4-8 250mg pills for moderate effects. How Addicts Substitute Anti-Diarrhea Drug as an Opioid. Change in diet; loperamide (Imodium, etc)15 Metoclopramide (Reglan) in patient with Parkinson's disease (B) Antidopaminergic effect5 They also help cut down on the ope-itch. Here are three of the key myths about Imodium and the truth that paints a different story from what some people have been led to believe. In addition, these guys also slightly inhibit subset CYP2D6. Benadryl(diphenhydramine HCl) and CPM(chlorpheniramine maleate) are both over-the-counter anti-histamines that increase the analgesic and euphoric properties of opiates to some extent. Learn more: Pregnancy and diarrhea: Causes and remedies . Diphenhydramine inhibits histamine, and also increases the analgesic, as well as the mood properties associated with opiates to a tiny degree. Benadryl is a well-tolerated medication and is unlikely to cause digestive side effects which the Gas-X is used to relieve. Weve seen patients who have been on loperamide for months at a time, said William Eggleston, the lead author of the recent report and a clinical toxicologist at SUNY Upstate Medical Center. Using loperamide together with promethazine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. An electrocardiogram showed dangerously irregular heartbeats and abnormal electrical conduction through her heart. Previously based in Singapore for J&J Asia Pacific (5 years)<br> Regulatory Affairs . Imodium contains loperamide, a drug that slows down muscle contractions in the gut. c. Understand the role and risk of loperamide and bismuth subsalicylate a. Loperamide is for chronic diarrhea so they really should be going to the doctor, so don't really want to recommend, avoid in patients with fecal leukocytes, high fever, blood/mucus in stool, don't use if have infection, need to get the infection out! The simplest way to get your cat to take an over-the-counter Benadryl pill is to wrap it in cheese, a bit of hamburger or tuna. Diphenhydramine therapy was associated with minimal side effects, and it was most effective in treating patients with dystonia who experienced lightning jerks. Loperamide: Imodium: At doses used to treat diarrhea, this drug will cause neurological toxicity in dogs with the MDR1 mutation. What do you suggest for bad ibs fit a few hours ago and i panicked and took 2 imodiums plus 1 benytl pill.. is this safe to take togeather? Imodium: Loperamide belongs to the family of medications called antidiarrheals. At doses of 16 mg and higher, the half-life has been found to be as high as 41 hours. The risk of these serious heart problems, including abnormal heart rhythms, may also be increased when high doses of loperamide are taken with several kinds of medicines that interact with loperamide (see Examples of Drugs that Can Potentially Interact with Loperamide). We urge patients, consumers, and health care professionals to report side effects involving loperamide or other medicines to the FDA MedWatch program, using the information in the Contact FDA box at the bottom of the page. certain antihistamines such as diphenhydramine, tricyclic antidepressants such as amitriptyline), cholestyramine, . American Association of Poison Control Centers National Poison Data System Annual Reports, 2006-2014. (The most common ingredients on the label are diphenhydramine, chlorpheniramine, dimenhydrinate, meclizine/buclizine, loperamide, and ranitidine.) (Staten Island Advance), STATEN ISLAND, N.Y. -- The Federal Food and Drug Administration says more Americans are combining two popular over-the-counter drugs used to treat diarrhea and heartburn, to get high or cope with withdrawals from opioid painkillers -- and the combination could be fatal. Of the total drug interactions, Bisacodyl is a laxative. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Loperamide is approved to help control symptoms of diarrhea, including Travelers' Diarrhea. Dosage should be based on weight. Minimally clinically significant. He got kicked off the squash team, and continued to use heroin on and off for a year, before switching to fentanyl. Also, do not take it for longer than 2 days unless directed by a doctor to do so. Bob thank you for your statement!! Learn more about some of the drugs that can be involved in adverse interactions and what can be done to protect our pets. Ann Emerg Med 2016 Apr 26. http://dx.doi.org/10.1016/j.annemergmed.2016.03.047 [Epub ahead of print]. The recommended Loperamide dosage for dogs is 0.5 mg per 10 pounds of body weight every 8 to 12 hours (2-3 times per day). Name-calling is reserved for the less educated. In contrast, syncope and ventricular tachycardia events occurred when patients took therapeutic doses of loperamide. Loperamide may cause a condition that affects the heart rhythm . Anti-diarrhea medications are cheap, legal and can be bought easily in large quantities without raising suspicion. Loperamide can also work to make stool less watery, and it can be . However, it can sometimes cause side effects. Take both. For these, please consult a doctor (virtually or in person). Keep in mind, these products should only be used by people that are 12 years of age and older. Use of and/or registration on any portion of this site constitutes acceptance of our User Agreement, Privacy Policy and Cookie Statement, and Your Privacy Choices and Rights (each updated 1/26/2023). Products containing diphenhydramine (Benadryl) are more sedating than other antihistamines. The active . Another commenter cataloged loperamides downsides the need to continually take stool softeners, for one but wrote that the medication took away the misery of opioid withdrawal: Dont wish to be dead so thats a plus.. The OxyContin was really expensive, and one time the dealer gave me a small bag of heroin, and thats how I got started. We also searched the medical literature and identified additional cases of serious cardiac events with loperamide.1-5 One case resulted in death, one was loperamide-induced Brugada syndrome, and three were Torsades de Pointes after ingesting large doses of loperamide. generic drugs) are not considered. Get medical help right away, if you have any of the symptoms listed above. There is no drug interaction between Gas-X and Benadryl. With loperamide abuse, concomitant use of drugs that inhibit CYP3A4, CYP2C8, and/or P-glycoprotein may increase the risk of serious cardiac events. Both drugs are currently available over-the-counter, as well as in prescription-strength-doses. Loperamide is approved to help control symptoms of diarrhea, including Travelers Diarrhea. The F.D.A. If you need to measure blood levels of loperamide, specifically request the test. And from personal experience, no one asked for a mental illness that contributed to addiction. Loperamide Interactions. The high was not worth the health risks, whatever they are, the commenter wrote. Avoid combinations; the risk of the interaction outweighs the benefit. Cough & Cold Medicine . Id they want to get high and kill them selves let them .. but let those with real diagnosis ! At-home biomarker tests can screen for fertility, heart health, STIs, and certain cancers. Usually, a toddler holding poop is caused by constipation or by normal toddler fears, anxieties, and power struggles. Loperamide can interact with antifungal drugs such as itraconazole and ketoconazole; the cholesterol drug gemfibrozil; the heart drug quinidine; the antimalarial drug quinine; the HIV drug ritonavir; drugs to treat acid reflux including histamine type 2 receptor antagonists (H2RAs); and the antibiotics erythromycin and clarithromycin (see Examples of Drugs that Can Potentially Interact with Loperamide).