A Rare Case of Loperamide-Induced Cardiac Arrest

Loperamide (Imodium) is an opioid receptor agonist available over-the-counter and can be used for the treatment of diarrhea. When ingested in excessive doses, loperamide can penetrate the blood-brain barrier and is reported to produce euphoria, depression of the central nervous system, and cardiotoxicity. It may also be used for its euphoric effects and potentially to alleviate opioid withdrawal. Loperamide has a US boxed warning for torsades de pointes and sudden death. Loperamide has been reported to cause torsades de pointes, cardiac arrest, and death when higher than the recommended dosage is consumed. We report a rare case of ventricular arrhythmia provoked by accidental ingestion of loperamide to treat simple diarrhea.

Keywords: arrhythmias; loperamide; opioid abuse; qtc prolongation; ventricular arrhythmia.