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Man died from anti-diarrhea ingredient that can be ‘dangerous’ if misused, officials say

The FDA in January asked manufacturers of over-the-counter anti-diarrhea treatments to change their packaging to try to curb abuse of the the drug.
The FDA in January asked manufacturers of over-the-counter anti-diarrhea treatments to change their packaging to try to curb abuse of the the drug. AP

Arjun Patel, 29, died last November in his suburban Pittsburgh home, according to the Tribune-Review. And officials say his death was caused by too much of an over-the-counter medication aimed at treating diarrhea.

The medical examiner’s office this week ruled Patel’s cause of death as loperamide poisoning, the newspaper said. Officials said it was the first death of its kind in the region, Action News 4 reported.

Loperamide, the active ingredient in anti-diarrhea medications such as Imodium A-D, is sometimes called the “poor man’s methadone,” The Washington Post reported.

That’s because high doses of the drug can induce a mild high and soothe withdrawal symptoms for drugs such as morphine or heroin, the newspaper said in January. As a result, people who suffer from addiction have resorted to the drug as it becomes more difficult to get prescription opioids.

Loperamide poisoning cases have been on the rise locally over the past two years, CBS Pittsburgh reported. Dr. Michael Lynch of the University of Pittsburgh Medical Center told the news station that since 2015 through the end of 2017, the hospital saw a 167 percent increase in calls related to “loperamide toxicity,” and more than half of those people had to be hospitalized.

But it’s hardly just a local concern. Food and Drug Administration Commissioner Scott Gottlieb announced in January that the agency is asking manufacturers of over-the-counter anti-diarrhea treatments to change their packaging to try to curb abuse of the the drug, The Washington Post reported.

Manufacturers have been asked to make packages that carry only enough medication for short-term use, the newspaper said.

“When used at extremely high and dangerous doses, it’s seen by those suffering from opioid addiction as a potential alternative to manage opioid withdrawal symptoms or to achieve the euphoric effects of opioid use,” Gottlieb said, the Tribune-Review reported.

The FDA approved loperamide in 1976, The New York Times reported. It became an over-the-counter drug in 1988.

In the case of a 24-year-old man experiencing opiate withdrawal who died from too much loperamide, a toxicology test found more than 25 times the regular dose in his blood, the newspaper reported.

The drug is safe at recommended doses — up to four 2-milligram tablets daily, The Washington Post said.

Patel’s family has declined to speak about the man’s death, Actions News 4 reported.

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