Cardiac Arrhythmia Secondary to Loperamide Abuse and Toxicity

Mohammed Ali; Aisha Mujahid; Chinthaka P Bulathsinghala; Salim Surani

doi:10.7759/cureus.6936

Cardiac Arrhythmia Secondary to Loperamide Abuse and Toxicity

Cureus. 2020 Feb 10;12(2):e6936. doi: 10.7759/cureus.6936.

Authors

Mohammed Ali¹, Aisha Mujahid², Chinthaka P Bulathsinghala³, Salim Surani⁴

Affiliations

¹ Pulmonary and Critical Care Medicine, Corpus Christi Medical Center, Corpus Christi, USA.
² Medicine, Shadan Institute of Medical Sciences, NTR University of Health Sciences, Hyderabad, IND.
³ Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.
⁴ Internal Medicine, Texas A&M Health Science Center, Bryan, USA.

Abstract

Loperamide is a synthetic, over-the-counter, antidiarrheal medication that is widely available and used for the treatment of diarrhea. It is a peripherally acting opioid agonist acting mostly on the μ-opioid receptors in the gut. It was thought to be a very safe medication up until very recently, as the bioavailability of the drug is very low. At significantly higher doses, it is able to cross the blood-brain barrier and mimic the effects of centrally acting opioids. However, at these significantly high doses it also leads to significant cardiotoxic consequences. Here we present a case of a 31-year-old male with significant cardiotoxicity secondary to misuse and abuse of loperamide.

Keywords: cardiotoxicity; loperamide abuse; opioid; opioid abuse; qt prolongation; ventricular dysrhythmia.

Publication types

Case Reports