Opioid antidiarrheals
- Peripheral gut mu-opioid agonism slows transit
- Loperamide/diphenoxylate are prototypes
- Reduce stool frequency, not underlying cause
- Avoid when invasive infection/toxic megacolon suspected
- High-dose loperamide can cause lethal arrhythmias
- Diphenoxylate has more CNS/abuse liability
Class at a glance
- Peripheral gut mu-opioid agonism slows transit
Practical pearls
- Loperamide/diphenoxylate are prototypes
Members / distinctions
- Reduce stool frequency, not underlying cause
- High-dose loperamide can cause lethal arrhythmias
- Diphenoxylate has more CNS/abuse liability
Safety / monitoring
- Avoid when invasive infection/toxic megacolon suspected
Self-check
- What do Opioid antidiarrheals primarily reduce?
stool frequency, not underlying cause.
- What clinically distinguishes Diphenoxylate within Opioid antidiarrheals?
more CNS/abuse liability.
Drugs in this class (4)
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