Tapering off daily loperamide

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vcastaldo
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Joined: Sat May 20, 2023 4:16 am

Tapering off daily loperamide

Post by vcastaldo »

I was diagnosed with MC in 2009; prescribed the normal meds to try to control the diarrhea; however, none seemed to be effective for me. I switched gastroenterologists who told me to just take Imodium am / pm. It worked! I’ve been taking it now for about 12 years. I’d like to see that if I taper off the Imodium how that affects my situation. I currently have about 3 bowel movements daily (some urgently where I either make it to the toilet in time — or not, but this only happens 1-2 times per month).

Anybody else do this or have advice on what I should do?

Many TIA!!
vcastaldo
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Joined: Sat May 20, 2023 4:16 am

Re: Tapering off daily loperamide

Post by vcastaldo »

P.S. Currently taking 2 mg am / 2 mg pm. Bowel movements in AM.
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tex
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Re: Tapering off daily loperamide

Post by tex »

Hi,

Welcome to the group. Imodium doesn't address the inflammation that causes MC, and since loperamide only slows down motility, it's very likely (almost a certainty) that as you reduce your dosage, the diarrhea is going to return, especially if you're not avoiding gluten 100%.

Again, welcome aboard, and please feel free to ask anything.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
vcastaldo
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Joined: Sat May 20, 2023 4:16 am

Re: Tapering off daily loperamide

Post by vcastaldo »

Hi Tex,

Sure do appreciate your advice and all the information to be found on this most helpful site.

I tried to taper off the Imodium, and, of course, my D let me know that it’s not a good idea. So, as I consider how to navigate gluten-free diet changes, I am wondering when is the best time to take Imodium. As my bowel movements are first thing in the early AM (it’s what wakes me up), Is it best to take it both AM and PM with/before/after food…or only PM…? Any thoughts on this?

Thanks!!
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tex
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Re: Tapering off daily loperamide

Post by tex »

That's a classic pattern with microscopic colitis — our bathroom trips occur most frequently first thing in the morning, and less frequently as the day wears on. So if you have to go to work, or go anywhere other than the bathroom, taking Imodium before breakfast usually works best. Imodium starts working within about 1/2 hour of taking it, and it's usually effective for about 8 to 12 hours. Depending on your schedule needs, if you're going to be away from home all day, or much of the day, one caplet may not be enough, and it's safe to take the full labeled amount (up to a maximum of 8 mg per day), just don't take more than you need, because that will cause constipation.

The FDA has warned that high doses (well above labeled rates) can cause heart problems. But that warning refers to people who are trying to take Imodium in order to get high on an opioid effect, and that requires doses in the several hundred milligrams range, so you're not likely to accidentally overdose on Imodium. Prescription doses allow up to 16 mg per day.

Some people feel that if you don't have to leave early, it may be best to get more of that out of your system, before taking the Imodium, but that will depend on your schedule, and your personal situation, of course. We all seem to have different behavior patterns, and most medications affect each of us slightly differently, according to our personal situation. But as far as I'm aware, Imodium is one of the most forgiving medications available for use with MC.

I hope this helps,

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Eddy
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Re: Tapering off daily loperamide

Post by Eddy »

I,m new on this forum.

Mijn name is Eddy.

I go to toillet about 6 times a day with normal stool but with large quantities.
I have collagen collitis but no diarrhea

I could try immodium to stop the stool

I have also problems with teh weight
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tex
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Re: Tapering off daily loperamide

Post by tex »

Hello Eddy,

Welcome to the group. Most of us have problems with losing weight when our microscopic colitis (MC) is active, because the inflammation that causes the disease prevents us from being able to to absorb many of the nutrients in our food. We are all sensitive to gluten, and it causes our immune system to react against it, which keeps our intestines inflamed, if we continue to we eat gluten. We have to eliminate gluten 100% from our diet in order to stop the inflammation. After we do that, our intestines will slowly heal, and we will again be able to absorb the nutrients in our food. As our intestines heal, we will slowly gain back the weight we lost.

Many of us also react to the main protein in milk, casein, and products made from soybeans. Some of us also react to chicken eggs. We have to avoid all foods that cause us to react, in order to stop the inflammation, and control the disease.

I hope this helps. Again, welcome to the group, and please feel free to ask anything.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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