Opioids Loperamide (Imodium) Megathread v. 2

[svacheme3]

I'm sure that everyone has done a good job at disseminating this information, but it can't be said enough the high-dose Loperamide (Immodium) is dangerous and is to be avoided. There is no practical reason to use Loperamide to get off of another Opioid. Using another Opiod simply prolongs the withdrawal process. This is why Loperamide should only be used at the dosage that leaves the individual without constant diarrhea.

Believe me, if Loperamide wasn't dangerous, I would be sanctioning its use, because, why not? However, this is not the case. Using Loperamide in high doses has produced numerous instances of severe Cardiotoxicity (Toxic effects related to the Heart and circulatory system). These events have lead to death in many instances. So, those who use Loperamide in high doses do so at their own risk. It can't be treated as just another Opioid or withdrawal tool. It's seriously dangerous when used in an excessive manner.

I apologize for hijacking the thread. I just really want people to be safe with this stuff. I'm not saying never use it, but use it for its intended purpose and nothing more.

Define "high dose" that should be avoided. I don't know why recommendations based on the most recent medical data on adverse cardiac events are suppressed here. Isn't 'if you're going to do this, here's the safest way besides abstinence to go about it' a basic HR principle?
The bottom line is cases severe enough to warrant medical attention average close to 400mg a day, going up to 1200mg a day. That's way beyond what's needed to even virtually eliminate withdrawal in all but the most extreme tolerance levels. We should differentiate between high-dose in the withdrawal aid context and high dose in the recreational context. 100mg or less q24-36h is 'high dose' but there is nothing in the literature to support proarrythymic properties on a short timescale (less than a month). Danger comes from doses far exceeding that or persisting for months. Take Immodiumsux above. Maybe if my recommendations hadn't been censored here previously, he might have been warned that when using high-dose for with withdrawal, the reported elimination half-life is 11 hours (and literature suggests longer in high dosages due to decreased absorption) so you need to account for that and not contintually dose in a way that excessively increases plasma levels, so his loperamide level just kept rising and he wound up in the hospital, instead of maybe seeing my post about this.

I want people to be safe too. People WILL use loperamide at levels sufficient to kill withdrawal, they need to know what that actually is, and how to avoid cardiotoxicity, without saying "well just don't do it". That's supposed to be how HR works.

 

[Backfromthebrink]

Define "high dose" that should be avoided. I don't know why recommendations based on the most recent medical data on adverse cardiac events are suppressed here. Isn't 'if you're going to do this, here's the safest way besides abstinence to go about it' a basic HR principle?
The bottom line is cases severe enough to warrant medical attention average close to 400mg a day, going up to 1200mg a day. That's way beyond what's needed to even virtually eliminate withdrawal in all but the most extreme tolerance levels. We should differentiate between high-dose in the withdrawal aid context and high dose in the recreational context. 100mg or less q24-36h is 'high dose' but there is nothing in the literature to support proarrythymic properties on a short timescale (less than a month). Danger comes from doses far exceeding that or persisting for months. Take Immodiumsux above. Maybe if my recommendations hadn't been censored here previously, he might have been warned that when using high-dose for with withdrawal, the reported elimination half-life is 11 hours (and literature suggests longer in high dosages due to decreased absorption) so you need to account for that and not contintually dose in a way that excessively increases plasma levels, so his loperamide level just kept rising and he wound up in the hospital, instead of maybe seeing my post about this.

I want people to be safe too. People WILL use loperamide at levels sufficient to kill withdrawal, they need to know what that actually is, and how to avoid cardiotoxicity, without saying "well just don't do it". That's supposed to be how HR works.

Good post...

 

[Tzcatlipoca]

In my dog days I have crushed and smoked loperamide pills on top of weed for an opiate high,
Eaten up to 20mgs with black pepper in hopes of making the lope cross the BBB,
And I have come here to say,
Don't be me :'D (I know this isn't helping)
Love,
Tez

 

[Backfromthebrink]

In my dog days I have crushed and smoked loperamide pills on top of weed for an opiate high,
Eaten up to 20mgs with black pepper in hopes of making the lope cross the BBB,
And I have come here to say,
Don't be me :'D (I know this isn't helping)
Love,
Tez

20mg isn't all that much orally though (still way above the recommended dose but in the context of how many people take, bit huge).

I've never heard of anyone smoking them before l, although there was one crazy fucker who used to post here years ago who would crush up 100 pills, mix with water, filter the resulting green sludge and IV it. Don't know what happened to him actually.

If I'm not mistaken though we hsve actuslly lost a few bluelighters through loperamide overdoses over the years. I think from an overdose of its opioid properties when taking hundreds of tabs along with pgp and cyp-450 inhibitors rather than through cardiac arythmers.

During my days of prescription opiate addiction, I would quite regularly bridge the gap between my scripts with high dose lope along with fresh white grapefruit juice. It did work well but since I had such a high opiate tollerence, I was using silly amounts. It just never felt right somehow though...while it might have been my imagination, but every slight pain in my chest area I was having made me feel like a massive MI and my ultimate demise was immanent.

 

[Tzcatlipoca]

20mg isn't all that much orally though (still way above the recommended dose but in the context of how many people take, bit huge).

I've never heard of anyone smoking them before l, although there was one crazy fucker who used to post here years ago who would crush up 100 pills, mix with water, filter the resulting green sludge and IV it. Don't know what happened to him actually.

If I'm not mistaken though we hsve actuslly lost a few bluelighters through loperamide overdoses over the years. I think from an overdose of its opioid properties when taking hundreds of tabs along with pgp and cyp-450 inhibitors rather than through cardiac arythmers.

During my days of prescription opiate addiction, I would quite regularly bridge the gap between my scripts with high dose lope along with fresh white grapefruit juice. It did work well but since I had such a high opiate tollerence, I was using silly amounts. It just never felt right somehow though...while it might have been my imagination, but every slight pain in my chest area I was having made me feel like a massive MI and my ultimate demise was immanent.

The constipation and sepsis would be my premier and main concern, than of cardiac arhytmia or arrest.
Love,
Tez

 

[Backfromthebrink]

The constipation and sepsis would be my premier and main concern, than of cardiac arhytmia or arrest.
Love,
Tez

The guy was somewhat "out there" to say the least

Interesting that you mention constipation though. The constipation from lope isn't usually any worse than the constipation from other opioids that the person addicted is likely consuming anyway. Lope binds to the opiate receptors in the intestines and gut but so do other drugs in the same class. The reason lope is used to treat diahorria is because it binds to gut receptotrs without staying the right side of the BBB long enough to bind to opiate receptors in the brain at low doses.. at high doses and with pgp and cyp450 inhibition that changes as far as the brain is concerned....

You sometimes read people suggest that taking large amounts of lope will leave you unable to shit for a week but constipation shouldn't be any worse than if they tool a dose of heroin or oxy.

 

[Tzcatlipoca]

The guy was somewhat "out there" to say the least

Interesting that you mention constipation though. The constipation from lope isn't usually any worse than the constipation from other opioids that the person addicted is likely consuming anyway. Lope binds to the opiate receptors in the intestines and gut but so do other drugs in the same class. The reason lope is used to treat diahorria is because it binds to gut receptotrs without staying the right side of the BBB long enough to bind to opiate receptors in the brain at low doses.. at high doses and with pgp and cyp450 inhibition that changes as far as the brain is concerned....

You sometimes read people suggest that taking large amounts of lope will leave you unable to shit for a week but constipation shouldn't be any worse than if they tool a dose of heroin or oxy.

The thing is, the amount of lope required to become constipated is far too close for comfort to the dose required to get high.
Consistently I can smoke a bowl of heroin, feel buzzed for 3 hours, nod, wake up and take a deuce in the morning,
Whereas with lope my usage was "take a dozen, wait impatiently for a buzz, fall asleep in exhaustion and frustration after the said 3 hours, wake up with stomach cramps and rifle through my drawers for poop softeners in the morning"
Not the most recreational nor entertaining scenario...
Love,
Tez

 

[Jabberwocky]

Constipation from loperamide all depends on tolerance. When I was taking buprenorphine (2-8mg/day) I could dose ridiculously high doses of loperamide, catch that nasty lope buzz and then take a shit the next day.

For someone who didn't have a high long standing tolerance I wouldn't want to think what 150mg would do to them

I'm thinking about doing ibogaine treatment at home. Does anyone know of people who have used loperamide in the past and went through with ibogaine flood treatment?

I am taking 6mg of loperamide a day now, and plan to have about a month off before I do the ibogaine. I have abused it in the past though. Any similar experiences?

Didn't notice this until just now. I really would suggest you spend a week or three not taking loperamide before flooding. It probably wouldn't cause major issues, but considering both iboga and loperamide (albeit at high doses) is associated with heart problems I'd really suggest you don't combine them.

If you need something to help you stay off the loperamide, try just using a few grams of kratom per day for a week or two before you flood. Flooding seems to work better once the opioid withdrawal has already begun to set in, and I really would avoid flooding with any opioids in your system.

 

[meth444]

Interesting aside...i advised half a dozen opiate aficionados regarding the affects of lope, but nobody took my advice (i am a meth guy). I had no clue why not, until i had the conversation with a young lady listened, asked questions, and said no. I asked why, and she said "I'd rather be sick than not high".
Opiate addiction is no little organ grinder's capuchian monkey...it's a big fucking silverback mountian gorilla.

 

[Backfromthebrink]

Constipation from loperamide all depends on tolerance.

Exactly...

When you are already tollerent to opioids, high dose lope isn't going to make you any more constipated than you were on the high dose bupe/oxy/heroin/morphine or whatever..

Sometimes you hear people suggest that stopping your opioid of choice and doing high dose lope (for whatever time period) will suddenly leave you so constipated that it will hospitalised you...It won't though anymore that high dose (relative to the normal medicinal dose) of your current opioid does...

 

[Jekyl Anhydride]

I'm curious and need to do some more looking into how Lope and Lamotrigine interact together seeing as they both can cause Torsades de Pointes and concomitantly might synergize to an even greater risk.

Edit: I have no intentions of using lamictal much less the two together but I came across a "magic W/D recipe" someone posted awhile back and it's been nagging at me that I can't find the post. I think Lamotrigene was misspelled so the search engine's no help.

 

[Jabberwocky]

^that sounds like a very problematic combo (dangerous). I mean, the human body is amazing beyond what most people might imagine, but would there really be a good reason to tempt fate like that?

At low doses the loperamide probably won't be to bad unless you have a major sensitivity, but even then, perhaps you can find another solution.

Honestly I now feel like loperamide is something with a very narrow window of utility. Not something I'd want to use regularly for any purpose at any dose. I mean, not many people use it for anything other than opioid withdrawal (in terms of any opioid-like effects), but even for that purpose I'd want to find another, healthier solution.

 

[svacheme3]

I'm curious and need to do some more looking into how Lope and Lamotrigine interact together seeing as they both can cause Torsades de Pointes and concomitantly might synergize to an even greater risk.

Not only do they both cause it, they apparently have the same mechanism (Na+ channel blockage), so absolutely yes avoid this combination if you're taking more than 10mg or so of lope a day.

@toothpastedog, in a lot of the world you have OTC codeine, but in the US there simply is no OTC option besides lope. If you can plan ahead and afford to arrange for pods, that would also be a superior option. And sadly a lot of people are trying to use it recreationally, which accounts for the majority of adverse cardiac events... nobody is taking the ultra-dangerous 800-1200mg/day for withdrawal. Lope should never be used recreationally, only for withdrawal in absence of superior options.

 

[Jekyl Anhydride]

Every once in a while these posts put the "Whoa" in Lopes not that bad..

This past Sunday my gf just fainted, fell to the ground, was unresponsive and was slightly shaking. about 7 seconds later she snapped out of it and had no idea what it was. She didn't eat all day, was only drinking Dew and not sleeping well lately. Chalked it up to maybe low sugar. Couple hours later watching TV with her she slumped over near me and once again, unresponsive and shaking for about 20 seconds. Scared the holy crap out of me. Never seen something like that before. Googled it and symptoms looked to point at it possibly being seizures. I wanted to take her to the ER but she said she's not going. She was an addict years ago so that made me wonder and ask her "why, are you afraid something will show up?"...she just said no and that was it. Couldn't force her to go.

Next day I drive her to work cuz there was no way i was letting her drive and possibly pass out while driving. Drop her off, get home, 10 mins later I get a call to come back because she had 2 more episodes. She had a 3rd on my way there (40 min drive) so they called 911. Got there while the ambulance got there.

Got to ER and she was all hooked up to monitors. From our explanations the doctors said it sounds like a seizure but the fact that she's pretty much back to normal after snapping out of it, something didn't seem right. My GF's sister was also there, she's an ER Nurse. She asked them to hook her sister up to the heart monitor so she could see what's happening. The GF had another episode and the heart monitor told a different tale. Tox ER doc came back and asked her if she's been taking Imodium recently. To my surprise my gf said yes she has. I thought to myself "so what". The doctor asked her how many she's been taking..he asked "30 to 40?"...she said "yes, 30-40". I thought I heard them wrong and he meant 3-4. She then had another episode...passing out on the bed for about 10 seconds and then sitting up and tightly clenching. It's some of the scariest shit I've ever seen. Asked when the last time she took them she told them "this morning"...so after 2 seizures the day before and me dropping her off in the morning she took a "handful" of Imodium at work.

Her heart rate dropped down to 28-32 BPM at certain points. It was then determined she a lethal heart arrhythmia due to abuse of Imodium pills. I was shocked. I had no fucking clue she was doing this. I could never even tell she was high.

So after that she was giving drugs to speed up her heart so it doesn't dip down to levels to cause another attack. She was pumped with Magnesium and something else because her mag and potassium levels were very low. As of Monday she's in the ICU, her potassium and magnesium levels are up but her heart is still too toxic and needs to be on the Isopropysomething. She may have to have a temporary pace maker put on. They're keeping her there for a week. If she was stubborn and refused to go to the ER she would have died from fucking an overdose of anti-shitting pills. RIDICULOUS!

After further discussion we found out she was getting a 200 pill bottle every 2 days from Walmart. I'm was so disappointed in her. Told her when we started dating if she ever abuses again that I'm out of here. Seems like she chose addiction/drugs over our relationship. We will talk when she's out of the hospital and take it one day at a time. I love her but I told her i would not tolerate drug use again.

While she was zonked out in her ICU room I went through her phone and opened up her web browser and this forum was actually open on the screen. Lookign at her history she was researching the effects of imodium, seeing if imodium is causing her swelled feet...so she read shit yet still took it. I'm not addicted to anything so I have no idea what an addict is thinking when they choose possible death and getting high over family/relationship/job/money.

So you folks abusing this shit should be very careful. She's not in the clear yet. Heart still not clean enough to pump at a normal BPM without the drug they're giving her. Her seizures just keep replaying in my mind every so often. It's horrible to see.

 

[Backfromthebrink]

Every once in a while these posts put the "Whoa" in Lopes not that bad..

I don't know if you will know who I mean but there was this guy on YouTube (odd little guy...orthodox Jew wearing the traditional clothes and almost looked like a caricature of himself) who made videos on how he "beat" his oxy habbit by taking 300-400 lope per day...continuously. Weirdly enough, he said his reasoning was that he didn't want to be "stuck having to take pills" (I mean why take 2 safe pills per day when you can take 300 deadly ones, right?)

It probably goes without saying, but he's dead now..


https://youtu.be/bFavmKiGiNs

 

[Jekyl Anhydride]

^ I actually saw that. It was like he thought he invented something and he was proud of his discovery. The worst part is that it was linked from a post on BL.

 

[Backfromthebrink]

^ I actually saw that. It was like he thought he invented something and he was proud of his discovery. The worst part is that it was linked from a post on BL.

Yeah...as a caveat. He did have a lot of health issues anyway and it's not clear if there are some other meds in with all those hundreds of pills (I think the majority are lope though).

It's not clear (to me anyway) whether he died directly due to the loperamide but I think it's safe to assume that it wouldn't exactky have helped things...

The main thing though is that you simply don't need that many. I had a collosal tollerance when I was prescribed opiates (was scripted 560mg of oxy a day at one point...300mcg/hour fentanyl at another point) and I could almost completely reverse withdrawls with about 50 to 60 pills (that's still dangerous). I experimented going much higher but it wasn't necessary. I say this because I doubt his tollerence could have been higher than mine was.....so 300-400 pills is insane..Some people are just absolutely terrified of withdrawl and completely overdo it.

Also worth noting that lope is said to have a very protracted and unpleasant withdrawl itself...similar in duration to methadone.

 

[Lorne???]

Really wish if this is going to stay, that the front be reworked or something. Lope is just too dangerous, and recklessness can lead to problems. You don?t even need large doses(ultra large insane doses that is) with the right inhibitors; it has a really low ba%, and at recommended doses is actually barely absorbed from the stomach in some/many cases.

Point is, it?s more dangerous when toyed with than, arguably opioid we itself(that is obviously complicated, however the actual physical we syndrome is rarely lethal like say, Benzodiazepines, or ethanol)

And it has it?s own horrible wd syndrome, at least when taken at high enough doses(again taking inhibitors into play and personal physiology dosing varies)

Your body barely absorbs it, it barely crosses the BBB and normally is pushed right back out. There is probably a reason for these mechanisms, and this stuff has proven itself just plain toxic

Not to go on too much, just, be aware everyone

(Edit: to clarify that ?wish the front would be reworked? means that additional warnings be added or something, highlighting the potential danger of using it, especially to completely reverse severe wd or, to try and catch a buzz...

And that inhibitors magnify the danger, as in this case, you would be safer doubling your dose then taking something w/it that allows more of it to get into you?re bloodstream... The stuff is literally toxic

 

[Jekyl Anhydride]

I think Post 634 does more to educate than just saying " Lopes Bad, MMkay". But I completely agree about the pGp inhibitors.

 

[svacheme3]

30-40 pills, according to the post, so 60-80mg (HOWEVER--- she was getting a 200ct every 2 days? That's 100 pills = 200mg). Need to follow up and ask for how long had she been doing that and if it was the 30-40 pills or 100 pills daily. Ok say you're doing 80mg q22h (for simplicity), and the half-life is 11h (at least). You take 80mg, after 22 hours there's still 20mg in your system when you take 80 more mg, bumping it to 100mg. Another 22h, there's 25mg still in your system, +80, 105mg. So if you're doing daily dosing, the concentration of loperamide is continually rising. So even if you're only taking 30-40 pills a day, it starts to become dangerous after a month or two, which is why I say to increase to q36h and never longer than a month.

But let's follow up to determine just how long it had been going on. I'd absolutely change recommendations in the face of new evidence, but if she had been doing it for longer than a month every day it would already be past my red line of safety even at the 30-40 pill range.

Edit: Also to the 300-400 pills... there's simply no way that's just for withdrawal no matter how high tolerance is. I guess for some people, just being sober is unacceptable, and that was absolutely to get high. Even large habits 100, maybe 150mg for first dose, will eliminate 99% of withdrawal, but you'll just be stone cold sober. Never try to dose high enough to force a high.