Diarrhea can be uncomfortable, and if it lasts too long, it can lead to complications. Fortunately, most of the time, diarrhea will go away on its own. If it continues for more than a few days, a doctor may recommend or prescribe medication.
Note that some diarrhea medications can be harmful to infants and young children. Always talk with a doctor before giving children OTC medication.
Various medications are available to treat diarrhea, both OTC and on prescription. Treatment options will vary for different people, so you should talk with a doctor to find the right medication for you.
Sex and gender exist on spectrums. This article uses the term “women” when discussing people who are assigned female at birth to reflect language that appears in source materials.
OTC diarrhea medication
In most situations, you can use OTC medication to treat diarrhea. You should contact a healthcare professional first if you have blood in your stools or a fever, as this could indicate a bacterial infection or parasites.
It’s important to seek advice from a healthcare professional if you’ve been taking OTC diarrhea medication for over 2 weeks and still have diarrhea.
Loperamide
Loperamide (Imodium) is a common OTC medication to treat diarrhea.
Read the instructions on the packaging and follow them carefully. Do not take more than the recommended dose. Loperamide can cause severe or life threatening heart problems if not taken as instructed. Other side effects include:
- bloating
- nausea
- stomach pain
Talk with a doctor before taking loperamide if:
- you’ve ever had a prolonged QT interval, which is a heart rhythm problem that can cause an irregular heartbeat, fainting, or sudden death
- you have an irregular or slow heartbeat
- you have low levels of potassium in your blood
- you’re taking certain medications, such as amiodarone (Nexterone), chlorpromazine (Largactil), or methadone (Methadose)
Call a doctor or 911 immediately if you or someone near you develops any of the following symptoms while taking loperamide:
- they become unconscious or unresponsive
- have a fast heart rate or palpitations
- feel dizzy or lightheaded
- feel like fainting
Always talk with a doctor before giving this medication to a child. Loperamide can cause severe heart or breathing problems in children under 2 years. People should not take loperamide while nursing, and evidence is conflicting on whether it is safe during pregnancy. Speak with a doctor if you’re pregnant or nursing before taking this medication.
Bismuth subsalicylate
Bismuth subsalicylate (Pepto-Bismol, Kaopectate) is also available OTC. People often use it to treat traveler’s diarrhea and infection caused by Helicobacter pylori (H. pylori).
Talk with a doctor or pharmacist before taking bismuth subsalicylate if you’re also taking:
- anticoagulants, or blood thinners, such as warfarin (Coumadin)
- tetracycline antibiotics, such as demeclocycline (Declomycin)
- medication with “salicylate” in the name, such as aspirin
- medication for arthritis, gout, or diabetes
Do not take bismuth subsalicylate before talking with a doctor if you’ve ever had:
- bloody or very dark stools
- bleeding problems
- kidney disease
- an ulcer
If you have a fever or mucus in your stool, talk with a doctor before taking this medication. You should also seek professional advice before taking bismuth subsalicylate if you’re pregnant or nursing because of the salicylate content, which might affect a fetus or a breastfed child.
Prescription medications for diarrhea
If OTC medication isn’t working, a doctor may prescribe medication for your diarrhea. The medication they recommend will depend on the cause of the diarrhea.
Alosetron
Doctors may recommend alosetron (Lotronex) only for women in the United States with severe diarrhea and irritable bowel syndrome (IBS) if they:
- have chronic IBS
- are not responding to other treatments or medications
- do not have certain gastrointestinal tract problems
Alosetron trials have not confirmed that it can benefit men.
Because of the side effects that are possible with alosetron, namely ischemic colitis, a doctor will likely only recommend and prescribe this medication if the benefits outweigh the risks.
You should stop alosetron immediately and call a doctor if you develop constipation or symptoms of ischemic colitis, such as:
- an urgent need to have a bowel movement
- abdominal pain and cramping
- abdominal tenderness
- bloody diarrhea
- nausea
Xifaxan
A doctor may recommend and prescribe Xifaxan (the brand name for rifaximin) for diarrhea caused by certain conditions, such as
- traveler’s diarrhea caused by the bacteria Escherichia coli (E. coli)
- IBS with diarrhea
- hepatic encephalopathy, a liver disease that affects the brain
Do not take Xifaxan if you have a fever or blood in your diarrhea caused by something other than E. coli.
Viberzi
If you’re an adult with IBS, a doctor may recommend Viberzi, the brand name for eluxadoline.
Before starting Viberzi, tell the doctor if you:
- have had severe or chronic constipation
- may have sphincter of Oddi dysfunction
- drink more than three alcoholic beverages daily
- may have a biliary duct obstruction
- have had your gallbladder removed
- have severe liver problems
- have had pancreatitis
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