[Scoundreller]

FDA pressured loperamide manufacturers to stop selling large quantity bottles because people thought eating a whole bottle was a good idea.

Problem: taking massive amounts of loperamide to get an opiate effect is a myth

Of course, the manufacturers were all happy to fall in line anyway and dramatically raise per-tablet prices (and packaging!)

Except one manufacturer.

Several years ago, I bought a 200-ct bottle for US$9 shipped to Canada. Now it's US$36.

[girvo]

It’s not a myth so much as it’s not particularly effective: large doses of it (dangerously so, I might add, people should not do this) are quite effective in getting rid of opioid withdrawals — and not just the peripheral effects.

In extremely large doses it has a distinctly weird feeling. I wouldn’t call it getting high, so I’d suppose that is indeed a myth, but gosh it feels hard on your heart at those doses.

Typically it’s addicts trying to avoid withdrawals (and who felt they did not have access to other opioid replacement therapies for various reasons) that tried that. Some died.

[philipkglass]

Problem: taking massive amounts of loperamide to get an opiate effect is a myth.

A decade or so ago I was reading a drug forum where an addict-chemist reported that acylating loperamide extracted from OTC pills allowed it to pass the blood brain barrier and deliver a true opiate high. His only reported test subject was himself, so I don't know if it was a genuine effect or not. And I haven't kept up with drug forums in recent years to see if this idea/technique spread. If so, it could explain the pill quantity restrictions; pseudoephedrine went through many years of changes in packaging/formulation as manufacturers tried to keep their products OTC while placating governments that didn't want those pills used as illicit drug precursors.

[HarryHirsch]

Tell me who needs 200-ct bottles of imodium. People who observe proper hygiene have food poisoning maybe once in 10 years (and whether a motility agent is a good idea in such cases is another question).

[suresk]

I have chronic gastrointestinal issues and the best "treatment" for them has been taking one every morning (on the recommendation of my GI doctor). This change has made it a lot more expensive and inconvenient to deal with.

[Broken_Hippo]

In a just world, you'd get a 3 month supply covered like your normal prescription. It is an injustice that it isn't.

[Scoundreller]

People that ignore expiry dates. And at least in our household's case, a clinically ignored case of endometriosis.

[HarryHirsch]

a clinically ignored case of endometriosis

That's exactly what I mean (and the sibling posting is more of the same). If you need more than six doses in a row then you should see a physician for a thorough workup because loperamide is just for the symptoms. The package will say as much. It's really hard to find fault with the FDA coming down on the extended-family size packaging.

[Scoundreller]

I meant the clinician's ignorance about endometriosis.

The package will say to take 2 tabs stat and 1 after each loose bowel movement. Not hard to go through a dozen+ each menstrual cycle.

[HarryHirsch]

I'm sorry you had to put up with a hippocratic oaf. This should never have happened.