The Drug-Induced Cardiotoxicity Website and App

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

II.a

Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)

Publications

Modi V, Krinock M, Desai R, Stevens S, Nanda S

Loperamide-Induced Cardiac Events: Case Reports and Review.

Cureus. 2021;13(12):e20744

Khan N, Chitturi KR, Hatcher C, Clewing M, Nagueh SF

Loperamide Toxicity Revealing Apical Hypertrophic Cardiomyopathy.

Methodist DeBakey cardiovascular journal. 2021;17(1):65-67

White CM

Loperamide: A Readily Available but Dangerous Opioid Substitute.

Journal of clinical pharmacology. 2019;59(9):1165-1169

Idris A, Mihora DC, Kaye K

Loperamide abuse cardiotoxicity. Should loperamide still be an over the counter medication?

The American journal of emergency medicine. 2018;36(9):1716.e1-1716.e3

Smith NA, Sehring M, Chambers J

Loperamide abuse and cardiotoxicity.

Journal of community hospital internal medicine perspectives. 2017;7(4):275

Swank KA, Wu E, Kortepeter C, McAninch J, Levin RL

Adverse event detection using the FDA post-marketing drug safety surveillance system: Cardiotoxicity associated with loperamide abuse and misuse.

Journal of the American Pharmacists Association : JAPhA. 2017;57(2S):S63-S67

Lasoff DR, Koh CH, Corbett B, Minns AB, Cantrell FL

Loperamide Trends in Abuse and Misuse Over 13 Years: 2002-2015.

Pharmacotherapy. 2017;37(2):249-253

Upadhyay A, Bodar V, Malekzadegan M, Singh S, Frumkin W, Mangla A, Doshi K

Loperamide Induced Life Threatening Ventricular Arrhythmia.

Case reports in cardiology. 2016;2016:5040176