Loperamide(immodium) is an opioid receptor agonist and acts on the μ-opioid receptors in the myenteric plexus large intestines; it does not affect the central nervous system like other opioids.
It works by decreasing the activity of the myenteric plexus which decreases the motility of the circular and longitudinal smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the fecal matter. Loperamide also decreases colonic mass movements and suppresses the gastrocolic reflex.
Loperamide molecules do not cross the blood-brain barrier in significant amounts, and thus it has no analgesic properties. Any that do cross the blood-brain barrier are quickly exported from the brain by P-glycoprotein (Pgp), also known as multidrug resistance protein (MDR1). Tolerance in response to long-term use has not been reported.
However, loperamide can cause physical dependence. Symptoms of opiate withdrawal have been observed in patients abruptly discontinuing long-term therapy with loperamide. For this reason, the drug was briefly classified as a Schedule V controlled substance upon its introduction.
I disagree. I am no doctor but I got caught in the lie of Loperamide. I used it when i,did not have opiates. I abused 20 to 40 a day for over a year, and 2 months later, i am still in withdrawal. Its very real and worse than anything I have ever taken, I am very depressed and my anxiety is horrible. Its my fault i took so much, but don't use this like I did, it's a nightmare...
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