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Loperamide misuse may be increasing in Iceland, with some individuals exceeding recommended dosages. This excessive use, potentially linked to opioid availability, carries risks of serious cardiac events and necessitates greater awareness among healthcare professionals.

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Area of Science:

  • Pharmacology
  • Toxicology
  • Public Health

Background:

  • Loperamide, a μ-opioid receptor agonist, is used for antidiarrhoeal effects.
  • It is generally considered to have low abuse potential due to metabolism and blood-brain barrier efflux.
  • However, high doses can cause central nervous system effects and life-threatening cardiac dysrhythmias.

Purpose of the Study:

  • To investigate potential loperamide misuse in Iceland between 2006 and 2017.
  • To analyze prescription data for excessive loperamide usage patterns.

Main Methods:

  • Retrospective analysis of prescription drug database records from The Directorate of Health in Iceland.
  • Examination of loperamide prescription data from 2006-2017.

Main Results:

  • Analysis revealed 94 individuals used more than one Defined Daily Dose (DDD) of loperamide (10 mg/day).
  • Seventeen individuals used more than two DDDs (20 mg/day) daily over a year.
  • These findings suggest excessive loperamide use, though reasons and over-the-counter sales remain unquantified.

Conclusions:

  • Loperamide is being used excessively in Iceland, indicating potential misuse.
  • Increased surveillance and reduced availability of prescription opioids may contribute to this trend.
  • Healthcare professionals must be informed about the severe adverse effects of loperamide overdose, including cardiac dysrhythmias.