The dosage of Imodium (Loperamide hydrochloride)

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Date Joined Jul 2007
Total Posts : 36
   Posted 6/1/2008 1:47 AM (GMT -7)   
  I am on Infliximab which makes me feel great but I still have to go the the toilet, quickly, between 8 to 12 times a day. I asked my consultant about Imodium and she said take one tablet if I'm going out on special occasions.
  I tried Imodium and it works brilliantly however I was hoping to take one a day - does anyone else take Imodium on Infliximab and at what does.
Thanking you in advance for help and advice,
(imodium is the brand name in the UK for an over the counter anti-diarrhoea drug)
diag 2005 with UC, upgraded to CD earlier this year. Have been admitted to hospital 3 times. Currently on 20mg Pred, Pentasa, Ferrous Suphate, Ad-Cal, Fish Oils, and Slippery Elm. Oh I get bouts of Arthritis linked to Crohns. 
"My one regret in life is that I am not someone else."
Woody Allen

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Date Joined Oct 2007
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   Posted 6/1/2008 9:52 AM (GMT -7)   
Jason, I keep four immodium pills in my pocket at all times. At the first sign of cramping (if I'm out in public), I pop em with just a couple swallows of water. It normally takes about 25 minutes for them to help.

I used to take four of them every morning before going to work. Now that my CD is under control, I don't have to do that anymore, but my doc did tell me it was ok to do it if I needed to. He did mention that four was the max dose to take at one time, although check with your doc to find out what he/she considers to be the max dose.

I'm not taking infliximab, but I am taking it's close cousin, Humira. Both are anti-TNF drugs.
Just trying to be a "Regular Member".
Entocort 9 mg/day, Prednisone 20 mg/day, Pentasa 4 gm/day, started Humira 1/22/08, started 100 mg of Azasan (Imuran) 2/20/08. I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.

Julia Hill
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   Posted 6/1/2008 2:04 PM (GMT -7)   
I have been taking 2 imodium/day every morning for at least 10 years.  I was on remicade for 9 treatments (approx. 1 1/2 years) and I continued to take imodium then also.  If it weren't for imodium, I wouldn't be able to leave my house.  All the best to you.

Cookie's Wife
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Date Joined Aug 2005
Total Posts : 299
   Posted 6/1/2008 6:08 PM (GMT -7)   
I'm on Humira and Asacol.  My GI has me taking Imodium 8x daily....
I'm like you Julia... wouldn't be able to leave my house without it!


Regular Member

Date Joined Jul 2007
Total Posts : 36
   Posted 6/2/2008 2:55 AM (GMT -7)   
Hi thanks for the advice.

I posted a similar message on a UK site (CrohnsZone) and they were telling me not to take to many tablets, just on specail occasions.

I think the UK is lagging way behind the US when it comes to Crohns ( and several other things I suspect ).
diag 2005 with UC, upgraded to CD earlier this year. Have been admitted to hospital 3 times. Currently on 20mg Pred, Pentasa, Ferrous Suphate, Ad-Cal, Fish Oils, and Slippery Elm. Oh I get bouts of Arthritis linked to Crohns. 
"My one regret in life is that I am not someone else."
Woody Allen

Chris B.
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Date Joined May 2005
Total Posts : 84
   Posted 6/14/2008 8:11 PM (GMT -7)   
I was just about to ask this! cool

So, taking daily Imodium doesn't have any associated side effects or risks?

Veteran Member

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   Posted 6/14/2008 8:29 PM (GMT -7)   
Many GIs are reluctant to tell patients to use Immodium or any other med that stops diarrhea on a regular basis. Most often this is out of fear that one might contract an infection where you'd be better off if the diarrhea flushed the infection out of your body. With ever increasing rates of c diff. this does make some sense. However, living life with CD is always a challenge and if an immodium or four will help us get through the day - then I'd be happy to take them.

Just like with any other med used for CD, we all have our own tolerance level. The directions for Immodium are to take 2 tablets and then an additional one after every subsequent bout of diarrhea. If I take 2 tablets, it might be days of uncomfortableness before my gut recovers. Instead, I start with 1/2 pill and then another 1/2 as needed.

I'd recommend that anyone who has not used Immodium regularly start on a lower dose and work their way up. It's really awful to go from one extreme to the other! You should also start it on a day when you don't have anything important to do so that you can work out what dose you need without the pressure of having to be out and about.

Good luck!
Keah a.k.a. Wormy
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   Posted 6/14/2008 9:31 PM (GMT -7)   
I use immodium when I have more than 1 or 2 urgent bowel movements and I am away from home. I find I get a lot less cramping if I get that first or second bm out before taking the immodium. Sometimes (like when flying) I know I need an immodium but I try to have my first morning regular movement first. One of the potential dangers of immodium is toxic megacolon. It is rare but more of a risk for people with IBD. It is explained on the UC board here:

Chris B.
Regular Member

Date Joined May 2005
Total Posts : 84
   Posted 6/15/2008 5:32 AM (GMT -7)   
I read that thread. UC patients have different issues than Crohn's patients, though.

Veteran Member

Date Joined Mar 2007
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   Posted 6/15/2008 1:23 PM (GMT -7)   
Hi As mentioned above as long as you are not having blockages or inflamed to the point not much is going threw that would be of concern to me. Would really discuss that issue with your GI he should know what shape your bowels are in .If I were taking it I would make sure I was not getting constipated and that there is more coming out then just water. lol gail

Veteran Member

Date Joined Dec 2006
Total Posts : 559
   Posted 6/15/2008 1:42 PM (GMT -7)   
I try not to take more than 4 Imodium a day. I spread them out evenly, never taking more than one at a time.

Fortunately, my diarrhea usually isn't too severe, but it comes and goes at unpredictable times.
Crohn's since 1988
3 resections

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Date Joined Feb 2007
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   Posted 6/15/2008 1:46 PM (GMT -7)   
I think there are several concerns about taking these drugs regularly: the potential to mask brewing problems, the potential to exacerbate ileus and the rare possibility of contributing to toxic megacolon. If you are in remission and clinically stable, I suspect you won't run into problems. But if you find your reliance on them is increasing and/or other symptoms occur I would use them with caution. Also, if you have a stricture, I would be reluctant to rely on them regularly. I have stricturing crohn's and have found that, while immodium does help with the immediate problem, it usually results in slowing my bowel too much and I have severe pain leading up to the next bm (which can sometimes be several days later)

30+ years living with Crohn's.

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Date Joined Mar 2007
Total Posts : 900
   Posted 6/15/2008 10:15 PM (GMT -7)   
I'm with Bell on this one. I took immodium a few weeks ago when I was having bloody diarrhea 20 times a day and couldn't get to the doctor or ER. I took 3 the first nite and 3 the next morning. I had two days of bloody D but then everything stopped....and I mean everything.. I am a tooter! I toot on every step going up the stairs to the bathroom...I toot when I bend over, I toot when I pick up the baby...etc.... well.... I wasn't tooting....nothing. Everything stopped cold and I was in a great deal of pain...luckily I saw my doctor right away and she sent me to my GI pdq. He said never to take the immodium again as I tend to block really fact the last time I was in hospital was for a blockage. He said because of the strictures , things can back up really quickly.
Maybe next time, I'll just try 1/2 or 1 . I can tell you that when I started tooting again, I thought that was the sweetest sound I'd ever heard(nose pinched of course)./
51 yr.old retired RN,Crohn's D for last35 yrs..severe esophagitis, migraines,strictures,urethral stricture,depression,probable MS.,RLS, arthritis

New Member

Date Joined Apr 2009
Total Posts : 6
   Posted 4/25/2009 3:50 PM (GMT -7)   
Hi. My name is lepontneuf and I have IBS. ;-) I've had it for three years and have had MRIs, colonoscopies, inflatable balloons inserted to test muscle tone - all showing no problems whatsoever - but I still cannot postpone bowel movements. I know there's a psychological/anxiety component to the whole thing, exacerbated by its continual cycle. It's not often diarrhea - I just have literally two minutes MAX to get my ass on a toilet, or it's completely over and I'm involved in some horrendously embarrassing clean-up operation hopefully not in a public restroom. My peristalsis is completely screwed up. When the hints of an urge to defecate come, things fast-forward to the very end, very quickly.

Not ONCE in the past three years has any of the ten doctors said the word Imodium to me.

Why, I don't know. Not going to judge medical establishment here. But everything I've recently stumbled upon in the IBS websites seem to indicate that Imodium has been the solution to their problem, the answer they've been looking for, that which has given them their lives back. Wow!

So since my attacks (as I like to call them) are usually in the morning, I have decided to take one Imodium every morning at the start of the day and see what happens. It's been fantastic so far, but it's only been three days. I know that loperamide (Imodium) is indeed an opioid and a degree of dependency can occur, as well as resistance to its effects, so I'm only taking 2mg - an extremely low dose. If I become dependent on it, I really don't care. If it means no more attacks, then I'd gladly take a chemical dependency (in the short term, while the constitutional cause is determined).

crohn's pt mom
Regular Member

Date Joined Nov 2008
Total Posts : 86
   Posted 4/25/2009 6:29 PM (GMT -7)   
I have IBS and was taking 4 immodium a day.  but I NEVER was constipated, that's something they said to watch out for. 
Everyone is different - I never get cramps or pain when taking them and usually it doesn't even totally stop my bm's.
Everyone is different -maybe you could talk to another dr.  I have found the new chewable immodiums work faster for me.

Regular Member

Date Joined Apr 2009
Total Posts : 85
   Posted 4/25/2009 6:35 PM (GMT -7)   
I am so glad this thread was started! I was thinking about picking up some Imodium just today because I've been doing really well (only 1-2 BM's a day), and then had some issues starting yesterday where I was going more frequently and having more stomach cramps... I think I ate something that doesn't agree. :( Anyway, after my resection in '07, I was going approx. 10 times a day, and I was going to be flying home with my daughter to visit family in a different state..... I was so scared!! I basically told my doc that he had to give me something because I was going to be on a plane for 5+ hours with a 3 month old baby, and otherwise I would have to cancel, because there was no way! He reluctantly prescribed me some loperamide (Imodium), but told me to use it accordingly and only during the time frame that I needed it. He mentioned the fact that it could mask symptoms that could be important, which is understandable.

For me, though, I think using it when I have a few bad days cannot hurt me, and for those that are going to the bathroom so much they can't do anything else, well, I think you have every right to give yourselves some relief, however small!!
Currently taking: Humira 40mg/every other week, Zoloft 50 mg/day, vitamins and supplements
Have taken: Cyclosporine, Pentasa/Asacol, Aciphex, Imuran, Sulfasalizine, Cipro & Flagyl, Prednisone, various pain med's, Xanax
Surgeries: Appendectomy 2001, Ileocecotomy 2007

Regular Member

Date Joined Apr 2009
Total Posts : 174
   Posted 4/25/2009 7:23 PM (GMT -7)   
I've used Imodium a fair amount in the last couple years (before I went back to the doctor) and it seemed to work fairly well... I normally went by the directions on the bottle (2 at first, then 1 after each subsequent loose bm) and it normally slowed things up fairly well... However if I had cramping and pain along with the loose bm's the Imodium still stopped the d but, if anything, made the pain and cramping worse (it seemed to subside by the next day or so).

I did get that intestinal virus that was going around about 2 months ago and had both vomiting and diarrhea so a doctor prescribed me some fenogren (sorry, can't spell meds very well) for the vomiting and some diphenoxylate for the diarrhea; but I found the Imodium worked better than the diphenoxylate

Regular Member

Date Joined Feb 2005
Total Posts : 232
   Posted 4/26/2009 3:14 PM (GMT -7)   
Does anyone find the effectiveness of immodium lessens the more they use it? Like building up immunity and you need to take higher and higher doses.

Veteran Member

Date Joined Mar 2005
Total Posts : 1289
   Posted 4/26/2009 4:23 PM (GMT -7)   
i've never taken more than 1 at a time...max 2 a day...lately if i take one (i haven't been much at all lately) the next day there seems to be more blood in my bm...has anyone noticed anything like this? it's kind of turned me off from taking imodium even though it helps the day i take it...
35 year old male living in AZ.  Diagnosed with Crohns at age of 15.
Currently tapering prednisone (15 mgs) and I've been on 6_MP for 2 months.
In the middle of a bad flare now for 6 months...lost almost 30 lbs.

crohn's pt mom
Regular Member

Date Joined Nov 2008
Total Posts : 86
   Posted 4/26/2009 5:53 PM (GMT -7)   
I've been taking immodium on and off for ten years.  I can go months without it then have to take it every day.  But again, I have IBS and I have never given it to my daughter with crohns.

Regular Member

Date Joined Feb 2005
Total Posts : 455
   Posted 4/27/2009 2:29 AM (GMT -7)   
Alot of the stuff doctors prescribe is wayyyy worse long term on your body than imodium, I love it when they make a big deal about it to people.
SCD since 01, remission since 01, occasional random junk food breaks :)
No meds ever.

Regular Member

Date Joined Apr 2009
Total Posts : 51
   Posted 4/27/2009 9:34 AM (GMT -7)   
I've been taking immodium for as long as I can remember (20 years?). Doc gives me RX for 8 a day. I take four as it is enough (2 after bfast, 2 after supper). When I feel any type of restriction that is out of the norm for me I stop taking it. If I were not taking immodium I could not leave the house. If I am traveling or have to go somewhere were a bathroom is unavailable I take tylenol 3, I don't take it for pain I take it for the codiene as it will temporaily stop you up. I have on going RX for both. Lately things have been good so I have not needed the tylenol 3 for about a month now. Every day is different you got to listen to your body and adjust to it. I agree with aoccc, there are far worse things prescribed every day. Immodium has been very very good to me!
Over 30 years experience! Dx 1976, surgery every seven years, the only effective long term drug has been very low doses of prednisone. Refuse to take anymore immune suppressants.

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