Does Imodium Interact With Metoprolol?

In our latest question and answer, the pharmacist discusses whether or not it is safe to take Imodium with metoprolol.

Question

I take metoprolol tartrate 25 mg twice a day. Can I take Imodium for a stomach bug while being on the metoprolol? I take the metoprolol for a rapid heartbeat.

Asked by TKI On Jan 04, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

On Jan 05, 2022

Key points

  • There is no known drug interaction between Imodium (loperamide) and metoprolol.
  • Only take Imodium as directed. High doses have been associated with negative cardiac (i.e. heart) effects.

Hello and thank you for your question!

Even though Imodium (loperamide) is available over the counter, that doesn't mean it can't interact with certain drugs, so we appreciate you reaching out.

It's always a good idea to check to see whether or not an over-the-counter drug you plan on taking has any potential to interact with your prescription medication.

Imodium With metoprolol

Moving on to the specific drug from your question, there are no known drug interactions between Imodium and metoprolol.

Although Imodium works, partly, by slowing down how quickly things move through our digestive tract, there doesn't appear to be any clinically significant interaction between it and metoprolol.

Now, Imodium does actually interact with plenty of medications, including some antifungals (e.g. fluconazole and posaconazole), antibiotics (e.g. clarithromycin), and a variety of heart medications (e.g. amiodarone), so be sure to check into all of the medications you take, not just metoprolol.

Use Imodium Only As Directed

I really want to emphasize that you should only be taking Imodium as directed by the dosing instructions on the package for the medication.

Imodium, at high doses, has been associated with negative heart effects, and I feel this is important to mention due to the fact you take metoprolol.

The FDA even issued a warning about this in 2016, and again, in 2018. One such warning read:

Health care professionals should be aware that use of higher than recommended doses of loperamide can result in serious cardiac adverse events. Consider loperamide as a possible cause of unexplained cardiac events including QT interval prolongation, Torsades de Pointes or other ventricular arrhythmias, syncope, and cardiac arrest
FDA

Final Words

I wanted to thank you again for reaching out to us and be sure to contact us again with any further questions!

References

  • Loperamide Monograph, PubChem
  • Metoprolol Monograph, PubChem
  • Lopressor Prescribing Information, AccessFDA
  • FDA Drug Safety Communication: FDA warns about serious heart problems with high doses of the antidiarrheal medicine loperamide (Imodium), including from abuse and misuse, FDA
  • FDA limits packaging for anti-diarrhea medicine loperamide (Imodium) to encourage safe use, FDA

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication related questions!

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