This article describes possible interactions with loperamide oral capsule. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Loperamide comes as capsules that you’ll swallow. It’s also available as an oral liquid solution and an oral tablet.
Boxed warning: Risk of torsades de pointes and sudden death
Loperamide has a boxed warning for the risk of torsades de pointes (a type of irregular heart rhythm) and sudden death. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
See the end of this article for more information about this warning.
Other drugs and loperamide
The drugs in the list below may interact with loperamide oral capsule. This article doesn’t include all drugs that may interact with loperamide.
Drug classes or drugs that may interact with loperamide oral capsule include:
- antipsychotic drugs:
- drug examples: ziprasidone (Geodon), haloperidol (Haldol)
- what might happen: can increase the risk of side effects of loperamide and the antipsychotic drug
- certain antibiotic drugs:
- drug examples: clarithromycin, erythromycin (Eryc)
- what might happen: can raise the risk of side effects of loperamide
- certain antifungal drugs:
- drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
- what might happen: can increase the risk of side effects of loperamide
- certain HIV drugs:
- drug examples: ritonavir (Norvir), cobicistat (Tybost)
- what might happen: can raise the risk of side effects of loperamide
- certain irregular heart rhythm drugs:
- drug examples: amiodarone (Pacerone), sotalol (Betapace)
- what might happen: can increase the risk of side effects of loperamide
- ceritinib (Zykadia):
- what might happen: can raise the risk of side effects of loperamide
- cyclosporine (Gengraf, Sandimmune, Neoral):
- what might happen: can increase the risk of side effects of loperamide
- gemfibrozil (Lopid):
- what might happen: can raise the risk of side effects of loperamide
- methadone (Methadose):
- what might happen: can increase the risk of side effects of loperamide and methadone
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Certain health conditions or other factors could increase some risks with loperamide oral capsule. Because of this, doctors may not prescribe loperamide in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for loperamide oral capsule:
- Children under 2 years old. Children under 2 years old should not take loperamide due to the risk of serious side effects. This includes respiratory depression (dangerously slow breathing).
- Abdominal pain without diarrhea. Loperamide should not be used to treat abdominal pain if you don’t have diarrhea. Loperamide is used to treat diarrhea in certain cases. The medication does not treat abdominal pain.
- Diarrhea related to certain intestinal infections. Loperamide should not be used to treat diarrhea caused by certain intestinal infections, such as Clostridioides difficile-associated diarrhea. Instead, your doctor will treat the infection that’s causing your symptoms.
- Dysentery. Loperamide should not be used to treat diarrhea related to dysentery (bloody diarrhea with fever). Instead, your doctor will treat the infection that’s causing your symptoms.
- Worsening ulcerative colitis symptoms. Loperamide should not be used to treat diarrhea related to the worsening of ulcerative colitis (UC) symptoms. (UC is a type of inflammatory bowel disease.) Your doctor will prescribe treatments for this condition instead.
- Past allergic reaction to loperamide. If you’ve ever had an allergic reaction to loperamide oral capsule, taking it again may cause another allergic reaction.
Before you start taking loperamide, tell your doctor if anything listed above relates to you. They can recommend whether you should take loperamide.
Questions about loperamide and interactions
Here you’ll find answers to some common questions about loperamide and possible interactions.
Can I take loperamide and an antacid together?
Yes, if your doctor agrees that it’s safe for you to do so. Antacids are used to help relieve indigestion (upset stomach) and heartburn.
Loperamide and antacids aren’t known to interact with each other. However, other drugs and health factors can interact with antacid medications. Before taking an antacid, your doctor or pharmacist can check whether these other interactions apply to you. They can help determine whether an antacid is safe for you to take.
Talk with your doctor or pharmacist if you have questions about taking loperamide and an antacid together.
Is it safe to take loperamide with acetaminophen?
Yes, if your doctor determines that these medications are safe for you. Acetaminophen is used to ease mild to moderate pain and reduce fever.
There’s no known interaction between loperamide and acetaminophen. But acetaminophen does have other interactions with medications and certain health conditions. Before taking acetaminophen, talk with your doctor or pharmacist to see if other interactions apply to you. They’ll help determine whether acetaminophen is safe for you to take.
If you have questions about taking loperamide and acetaminophen together, talk with your doctor or pharmacist.
Alcohol and loperamide
Loperamide oral capsule is not known to interact with alcohol.
That said, drinking alcohol can cause or worsen diarrhea for some people. And loperamide is prescribed to treat diarrhea in certain cases. Loperamide should not be used to treat diarrhea caused by consuming alcohol.
If you drink alcohol, talk with your doctor about whether it’s safe to consume it while taking loperamide oral capsule.
Other interactions and loperamide
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether loperamide oral capsule has these interactions.
The information below doesn’t include all other possible interactions with loperamide.
Loperamide and supplements
Before taking loperamide oral capsule, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Loperamide interactions with herbs
Loperamide oral capsule isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before using any of these products while taking loperamide oral capsule.
Loperamide interactions with vitamins
Loperamide oral capsule isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking loperamide oral capsule.
Loperamide and food
Loperamide oral capsule may interact with grapefruit and grapefruit juice. Consuming grapefruit while taking loperamide oral capsule may increase the risk of side effects of loperamide.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking loperamide oral capsule.
Loperamide and vaccines
Loperamide oral capsule isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking loperamide oral capsule.
Loperamide and lab tests
Loperamide oral capsule isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking loperamide oral capsule.
Loperamide and cannabis or CBD
Loperamide oral capsule isn’t known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this doesn’t mean interactions can’t happen or won’t be identified later.
As with any drug or supplement, tell your doctor before taking cannabis with loperamide.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Health factors and loperamide
Certain medical conditions or other health factors may increase the risk of interactions with loperamide oral capsule. Before taking loperamide, tell your doctor about your health history. They’ll determine whether loperamide is right for you.
These health conditions or other factors might interact with loperamide oral capsule:
- dysentery
- ulcerative colitis
- bacterial infection of the intestine, including Clostridioides difficile-associated diarrhea
- irregular heart rhythms, especially long QT syndrome
- heart conditions, such as heart failure
- unusual electrolyte levels, such as high or low blood potassium
- liver conditions, such as liver cirrhosis
- pregnancy or breastfeeding
- past allergic reaction to loperamide
Preventing loperamide interactions
You may be able to help avoid certain interactions with loperamide oral capsule. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking loperamide oral capsule.
Taking loperamide exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about loperamide and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- If I take medications that interact with loperamide, what other diarrhea treatments are available?
- Does loperamide have similar interactions as other diarrhea medications?
- Could I still take loperamide even if it interacts with a health condition I have?
- Does my risk of interactions depend on my dosage of loperamide?
Boxed warning for loperamide
Loperamide has a boxed warning for the risk of torsades de pointes and sudden death. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Rarely, loperamide can cause serious heart-related side effects, including torsades de pointes and sudden death. Taking a higher loperamide dosage than recommended increases this risk.
Torsades de pointes is a life threatening irregular heart rhythm. With this condition, the two lower heart chambers beat faster than the upper heart chambers. The beats are also out of sync with each other. Symptoms can include a racing heartbeat, lightheadedness, and fainting. You should seek immediate medical attention, such as dialing 911 (or a local emergency number), if you think you’re experiencing symptoms of torsades de pointes.
Because of this risk, doctors typically won’t prescribe loperamide if you already have long QT syndrome or another irregular heart rhythm. They may also avoid prescribing loperamide in other situations, such as if you have unusual electrolyte levels. This includes low blood potassium level.
To learn more, talk with your doctor.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.