Drug Interactions, Kratom Guides

Kratom & Loperamide (Imodium): What You Need to Know

Loperamide (Imodium) is an over-the-counter medication used to treat diarrhea, inflammatory bowel disease, and food poisoning.

Kratom is an unregulated psychoactive herbal compound, much like coffee or the coca leaf. It has a wide range of effects and works on the body in a similar way to opioids.

Given that one is a psychoactive compound and the other is an anti-diarrheal medication, you might think the interaction between these two compounds is entirely benign.

However, drug interactions are complex things and there are certain factors you should be aware of.

Last updated 5 months ago by Dr. Devin Carlson

Kratom & Loperamide (Imodium): What You Need to Know

Does Kratom Interact With Loperamide (Imodium)?

Technically, loperamide (Imodium) is a synthetic opioid.

It works by affecting opioid receptors in the gastrointestinal tract. However, it is designed to minimize the typical effects of opioid receptor interaction because of its low oral absorption and inability to cross the blood-brain barrier [1].

This means that in terms of its effects, it has little to no interaction with kratom. Loperamide does not have any psychoactive effects if used properly.

Nevertheless, in terms of metabolism, loperamide is processed by the cytochrome P450 (CYP) system, specifically by the CYP3A4 enzyme [2].

Kratom is an inhibitor of the CYP3A4 enzyme, which means that taking both kratom and loperamide may inhibit the proper metabolism of loperamide, leading to increased concentration.

The build-up of loperamide in the body could increase the risk of adverse effects.

Loperamide Specs:

Drug NameLoperamide
Trade NameImodium
Other NamesDiamode, Maalox, Imotil
ClassificationAnti-diarrheal agent
CYP MetabolismCYP 3A4
Interaction With KratomKratom inhibits loperamide’s metabolization
Risk of InteractionLow to moderate

Is It Safe to Take Kratom With Loperamide (Imodium)?

Kratom and loperamide (Imodium) are both relatively safe compounds when taken responsibly.

As we’ve seen, kratom can inhibit the proper metabolization of loperamide, leading to an increased risk of adverse effects.

Still, the risk is minimal if you aren’t regularly mixing the two compounds and using loperamide according to the directions.

The risks are relatively low if you’re a daily kratom user and decide to take loperamide for the day. However, if you have a chronic condition and must take loperamide every day, the risk may be higher.

Additionally, there have been rising instances of people taking excessive doses of loperamide to ward off opioid withdrawal symptoms and achieve euphoric effects [3]. You should never take loperamide in this fashion or mix it with kratom when ingested in high doses.

What is Loperamide (Imodium)?

Loperamide (Imodium) is an orally-ingested medication used to lessen bouts of diarrhea. It falls under the class of medicines known as anti-diarrheal agents.

It’s frequently used by those who suffer from frequent intestinal problems or chronic intestinal conditions such as inflammatory bowel syndrome, short bowel syndrome, and Crohn’s disease.

Loperamide works by slowing down gut activity, which decreases the incidence of diarrhea and makes the stool firmer.

Loperamide is on the WHO’s list of essential medicines.

What Is Loperamide (Imodium) Used for?

Loperamide (Imodium) is used to control acute diarrhea.

Prescription loperamide can also reduce the amount of fluid caused by ileostomy surgery.

It is important to note that loperamide does not treat the causes of these conditions, only the symptoms related to gut activity.

Loperamide can cause adverse reactions in children under two years of age. Consult your doctor before giving loperamide to your child.

Additionally, don’t take loperamide if there is blood in your stool; this often means there are other intestinal problems at work. 

Generic & Brand Name Versions

Loperamide is sold under the following brand names:

  • Diamode
  • Imodium
  • Imodium A-D
  • Imogen
  • Imotil
  • Imperim
  • Kaodene A-D
  • Kao-Paverin Caps

What Are the Side Effects of Loperamide (Imodium)?

Loperamide may bring on these side effects:

  • Constipation
  • Dizziness
  • Nausea
  • Headaches
  • Gas
  • Abdominal cramps

More serious side effects can include:

  • Toxic megacolon
  • Necrotizing enterocolitis
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Syncope
  • QT/QTc interval prolongation
  • Torsades de pointes
  • Ventricular tachycardia
  • Other ventricular arrhythmias
  • Cardiac arrest

Recently, abuse of loperamide has increased as more people are attempting to treat opioid withdrawals. Over-ingestion to achieve euphoric effects has also been noted. Large amounts cause loperamide to cross the blood-brain barrier, causing typical opioid effects and can lead to death.

What Is Kratom?

Kratom is the all-natural plant compound derived from the leaves of the Mitragyna speciosa, a tropical evergreen tree native to Southeast Asia.

Local indigenous peoples have used kratom for many centuries to aid them in their day-to-day tasks. Now, the western hemisphere is finally noticing the many benefits of the plant.

Kratom’s effects are due to the many plant-based alkaloids it contains. These compounds interact with the opioid receptors in the body’s central nervous system to produce a range of effects.

Nevertheless, despite its many favorable properties, kratom can be addictive and has contributed to overdose deaths in the United States, though this is rare and usually due to other drugs.

What Is Kratom Used for?

Kratom is mainly used in two ways: as a stimulant and nootropic supplement or as an analgesic, anxiolytic treatment for numerous ailments.

The stimulant and nootropic benefits of kratom are best when consumed at a low dose. Users report kratom can help them achieve more euphoric moods and aid them in attaining sustained focus and overall enhanced mental energy.

The anti-anxiety and pain-relief benefits of kratom are stimulated best at middle to high doses.

It is an excellent option for chronic pain conditions. Kratom is usually a far safer choice than pharmacological options, which have a higher chance of causing dependence and adverse effects.

What’s the Dose of Kratom?

It’s important to get your kratom dosage right if you want to have a targeted kratom experience.

However, you should always keep in mind that formulaic dosage recommendations are never precise. Everyone’s bodies are different, and there are always many complicating factors like body mass and level of consumption.

With that said, kratom’s dosage recommendations are usually the following:

  • Low dose: 1-5 g
  • Medium dose: 5-10 g
  • High dose: 10-15 g

Remember: low doses are best taken for the stimulant and nootropic effects of the kratom plant, while medium to high is best for analgesic and anxiolytic benefits.

Related: Can You Overdose on Kratom?

What Are the Side Effects of Kratom?

Kratom, like almost all drugs, has the potential to cause side effects:

  • Nausea
  • Constipation
  • Insomnia
  • Low libido
  • Poor appetite
  • Dizziness
  • Loss of muscle coordination
  • Tremors
  • Low blood pressure
  • Itchiness in the skin
  • Seizures

Additionally, the opiate-like properties of kratom can cause symptoms of physical and mental dependence.

Be sure to consume kratom responsibly to minimize this risk.

What Are the Different Types of Kratom?

Kratom comes in an assortment of different strains.

Strains are sorted by the leaf’s vein color. Even though all strains have roughly the same effects, each strain emphasizes different elements of the kratom plant more prominently.

1. White Vein Kratom

White vein kratom strains are energetic and mind-based.

This means white-veined strains are best for the stimulant and nootropic benefits of the kratom plant. These strains are very popular with those who don’t like the taste of coffee. It also seems to be a favorite among those with creative jobs.

2. Red Vein Kratom

Red-veined kratom is the optimal strain for dealing with chronic pain conditions and anxiety. It promotes analgesic effects, as well as an all-around calm and sedative-like state.

These are the effects usually associated with a higher dose of kratom, which makes the red-veined strains perfect for those looking for these specific benefits without the high doses.

3. Green Vein Kratom

Green vein kratom is the middle point between white and red kratom strains.

It carries a good balance of the benefits found in both, making it the best strain for those who want to experience the full suite of the kratom plant’s effects.

4. Yellow Vein Kratom

Yellow vein kratom is a mixture of white and red, making it very similar to the green kratom strains.

However, yellow-veined kratom is milder than green-veined strains. This makes yellow vein kratom an excellent choice for beginners.

Key Takeaways: Is It Safe to Mix Kratom & Loperamide (Imodium)?

In most circumstances, yes, loperamide (Imodium) and kratom are safe to mix.

When it comes to their effects on the body, interaction is minimal unless an abnormal amount of loperamide is ingested. This is almost for its euphoric effects. Do not consume loperamide in this fashion.

The biggest problem with mixing these compounds is the inhibitory effect of kratom on loperamide’s metabolism. However, this is most likely a minor concern for most people, as very few individuals take loperamide daily.

Nevertheless, if you suffer from a chronic condition and have to ingest loperamide daily, you might want to think about the consequences of a loperamide build-up due to kratom use. Call your doctor and ask about the possible repercussions and the safest way to consume kratom if this is your situation.

References

  1. Alyautdin, R. N., Petrov, V. E., Langer, K., Berthold, A., Kharkevich, D. A., & Kreuter, J. (1997). Delivery of loperamide across the blood-brain barrier with polysorbate 80-coated polybutylcyanoacrylate nanoparticles. Pharmaceutical research, 14(3), 325-328.
  2. Baker, D. E. (2007). Loperamide: a pharmacological review. Reviews in gastroenterological disorders, 7, S11-8.
  3. Miller, H., Panahi, L., Tapia, D., Tran, A., & Bowman, J. D. (2017). Loperamide misuse and abuse. Journal of the American Pharmacists Association, 57(2), S45-S50.