Loperamide-Induced Torsades de Pointes: A Case Series

Background: Loperamide (Imodium™) is an antidiarrheal opioid acting at the μ receptor agonist in high concentrations. Due to the US opioid epidemic, loperamide abuse and ensuing life-threatening toxicity have surfaced. Hypothesis: The timing and duration of Torsades de Pointes (TdP) from loperamide toxicity is unpredictable and should be heeded with caution, even in asymptomatic patients and drug discontinuance. Methods: Two patients presenting with life-threatening TdP requiring lengthy hospital admissions for confirmed loperamide toxicity are discussed. Patient data were retrieved from the hospital’s EMR system