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Lomotil vs Imodium: Loperamide Alternatives in Diarrhea Treatment

Imodium (loperamide) is an over-the-counter medication that is designed to stop diarrhea by reducing bowel movements. While it is a drug that is proven effective, users should also consider its alternatives. Other medicines that are popular for treating diarrhea include Lomotil, Pepto-Bismol, and Kaopectate. Lomotil comes with other ingredients and, unlike Loperamide, is not sold over-the-counter. It can only be taken under a medical doctor’s advice. Pepto-Bismol (Pepto), on the other hand, is an antacid that can treat nausea, stomach upset, and diarrhea. It shares the same chemical composition with Kaopectate and doesn’t require a doctor’s advice before administration.

This article will compare Lomotil vs Imodium to find similarities and dissimilarities. Imodium vs Pepto would be contrasted to determine the efficacy and side effects of both medications. Finally, Kaopectate vs Imodium would be assessed to determine the withdrawal and overdose symptoms.

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Why Loperamide?

Loperamide medicines are sold over the counter in the United States and many countries around the world. It is a safe drug that was initially thought to be addictive and thus was controlled. However, the FDA approved it as an OTC after discovering it did not affect the central nervous system. It is widely known as one of the most effective medicines efficient at treating diarrhea. Its Multi-Symptom Relief capsule not only treats diarrhea but does a good job at combating the symptoms. It is the most commonly used anti-diarrhea medication recommended by both patients and health workers for its rapid results.

Why Look For Alternatives?

There are several reasons for which people may prefer other alternatives to Loperamide. Chief among the reasons is its cost. Generally, some of the other alternatives like Pepto-Bismol may be relatively cheaper than Loperamide. Another reason may be the relief of symptoms associated with diarrhea. Aside from its Multi-Symptom Relief medication, the ‘usual’ Loperamide doesn’t treat symptoms. However, Kaopectate and Pepto treat symptoms associated with diarrhea. So in the absence of its Multi-Symptom Relief medicine, patients may seek other antidiarrheals to help treat the diarrhea symptoms. Health reasons may also cause people to look for alternatives. For example, patients who have a history of Loperamide abuse may receive medical advice to refrain from it any time they have diarrhea.

Common Loperamide Alternatives

There are numerous alternatives to Loperamide tablets, gel caps, liquids, and chewable tablets on the market. It is important that when considering these options, users do not assume that they are completely safe just because they are available OTC. Just as with loperamide interactions and side effects, other medications can also have health consequences. Thus medical advice should be sought before using any alternative.

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Lomotil vs Imodium

Lomotil is a Loperamide alternative, this time containing the active ingredients diphenoxylate hydrochloride and atropine sulfate. It is also an anticholinergic useful in treating gastrointestinal disorders. Lomotil has been classified as a Schedule V controlled substance by the DEA meaning it has a lower chance of abuse. Lomotil works by reducing bowel movement, solidifying stools, and reducing stool frequency. Unlike Imodium, Lomotil is a prescribed medication. This table contrasts Lomotil vs Imodium; their drug class, generic names, treatment time, approved age of use, etc.

Common Loperamide Alternatives.

GENERIC NAMELoperamideDiphenoxylate-Atropine
DRUG CLASSAntidiarrhealsAntidiarrheals
APPROVED AGE OF USE2 years and older13 years and older

So, just as with Imodium, Lomotil is strictly meant to treat diarrhea. However, there are a few key differences between the drugs. The first, and perhaps most important, is that Lomotil is not available OTC. It is a controlled substance in the United States because its chemical formula is very similar to that of the narcotic analgesic meperidine. It is considered to have a much higher potential for abuse than Loperamide. As a result, when weighing Lomotil vs Imodium, unless the diarrhea is serious enough to warrant a doctor’s visit, Lomotil will not be an option.

Another consideration is that Lomotil has significantly more side effects and known interactions than Imodium. As for deciding between Lomotil and Imodium during pregnancy, both are considered to carry the same risks.

Imodium vs Pepto-Bismol

Perhaps, the most well-known Loperamide alternative is Pepto. It has been around since 1900 and has a highly recognizable pink color. These days Pepto and Pepto Bismol refer to the same product. However, Pepto used to be another name for Pepsin – an enzyme found in the stomach of humans and animals. Bismol is termed Bismuth subcitrate, a gastrointestinal drug used to treat ulcers. The original name of the drug was Bismosal which was used as an antidiarrheal in infants. Over time, it was changed to Pepto-Bismol by a marketer in 1919. When comparing Imodium vs Pepto-Bismol, there are a few things to consider.

GENERIC NAMELoperamideBismuth Subsalicylate
DRUG CLASSAnti-diarrhealAnti-diarrheal
AVAILABILITY OF GENERIC VERSIONSOver the counterOver the counter
APPROVED AGE OF USE2 years and older12 years and older

While loperamide is an opiate, bismuth subsalicylate is simply an antacid. This can feel much safer to users who are comparing Imodium and Pepto. The next is what these two drugs treat. Both Pepto and Imodium treat diarrhea by slowing down bowel movements. However, when comparing the original formulas of each medication, Pepto treats a lot more. With Pepto, users can address upset stomach, heartburn, nausea, and indigestion as well. However, Pepto is known to cause some strange side effects, including temporarily turning the tongue black. It also does not work very long when compared to how long Imodium stays in the system. Contrasting Imodium vs Pepto it appears Pepto-Bismol is a stronger medication than Loperamide. This explains why it is not allowed to be administered to children below 12 years. Ultimately, when deciding between Imodium vs Pepto, there is no universal answer.

Kaopectate vs Imodium

Kaopectate is an alternative that is available OTC. It has the same active ingredient as Pepto-Bismol, and thus treats the same conditions and comes with the same concerns. When comparing it with loperamide OTC, it interacts with fewer medications but is contraindicated for more medical conditions. Anyone with Reye’s Syndrome or coagulation problems will be better off with Imodium OTC. Both drugs can be used in the treatment of diarrhea and its symptoms e.g nausea and gas. Weighing Kaopectate vs Imodium reveals that both medications have the same mechanism of action. The drugs work by slowing down bowel movement thus solidifying the stools. The drugs have similar side effects such as severe constipation, nausea, abdominal pain, and fast irregular heartbeat. Both medications have dire health consequences for abusers and they share similar withdrawal symptoms such as body aches and nausea. Anyone hooked to these drugs should seek immediate help from a rehabilitation center or contact a medical doctor.

When Considering Loperamide Alternatives

Many alternatives are only available by prescription. This means that even gaining access to them will require a doctor’s prescription. Users should, therefore, consult with a medical doctor before using any medication, even loperamide OTC to avoid unnecessary health risks. All medications have side effects and interactions, and it can be difficult for users to understand these on their own. The risks are greater in certain populations, that is why Imodium AD for children and its alternatives can be particularly risky to health. If a doctor is not available and the medication is needed urgently, contact a pharmacist before taking Imodium OTC or its alternatives.

When Considering Loperamide Alternatives.

Be Cautious With Loperamide Alternatives

Loperamide and its alternatives are effective for treating diarrhea and its symptoms by restricting bowel movements. However, there is a tendency for abuse if the prescription is not strictly adhered to. Abuse of these drugs can result in severe health problems including death if help is not sought early. Because there is potential for abuse, users should exercise caution. Anyone who feels an urge to abuse these drugs should seek help. Rehabilitation centers know how to get users clean and back on their feet so be sure to contact them. Their addiction treatment programs can be adjusted to help the particular patient to ensure their long-standing recovery.

Lomotil vs. Imodium

Lomotil (diphenoxylate and atropine) and Imodium (loperamide hydrochloride) are antidiarrheal medications used to treat diarrhea.

Lomotil also contains an anticholinergic.

Imodium is also used to reduce the amount of stool in people who have an ileostomy (re-routing of the bowel through a surgical opening in the stomach).

Imodium is available in generic form and over-the-counter (OTC).

What Are Possible Side Effects of Lomotil?

Common side effects of Lomotil include:

  • drowsiness, , , ,
  • restlessness, , , ,
  • vomiting,
  • upset stomach,
  • loss of appetite, rash, or .

Tell your doctor if you experience unlikely but serious side effects of Lomotil including:

  • stomach or abdominal pain or swelling,
  • severe nausea or vomiting,
  • mental/mood changes (e.g., confusion, depression), or
  • numbness and tingling of arms or legs.

What Are Possible Side Effects of Imodium?

Common side effects of Imodium include:

  • dizziness,
  • drowsiness,
  • tiredness, ,
  • stomach pain,
  • skin rash, or
  • itching.

Tell your doctor if you experience serious side effects of Imodium including

  • severe constipation/nausea/vomiting,
  • stomach or abdominal pain, or
  • uncomfortable fullness of the stomach or abdomen.

What Is Lomotil?

Lomotil (diphenoxylate and atropine) is a combination antidiarrheal medication, and an anticholinergic used to treat diarrhea.

What Is Imodium?

Imodium (loperamide hydrochloride) is an antidiarrheal used to treat diarrhea. Imodium is also used to reduce the amount of stool in people who have an ileostomy (re-routing of the bowel through a surgical opening in the stomach). Imodium is available in generic form and over-the-counter (OTC).


What Drugs Interact With Lomotil?

Lomotil may interact with barbiturates or MAO inhibitors. Lomotil may interact with other drugs. Tell your doctor all prescription and over-the-counter medications and supplements you use.

What Drugs Interact With Imodium?

Imodium may interact with saquinavir (Invirase). Other drugs may interact with Imodium. Tell your doctor all prescription and over-the-counter medications and supplements you use.

How Should Lomotil Be Taken?

The recommended initial adult dosage is two Lomotil tablets four times daily or 10 ml (two regular tsp) of Lomotil liquid four times daily (20 mg per day). The pediatric dose is determined by the child’s weight.

How Should Imodium Be Taken?

The recommended initial adult dose of Imodium is 4mg (two capsules) followed by 2 mg (one capsule) after each unformed stool. Daily dose should not exceed 16mg (eight capsules). In children 2 to 5 years of age (20 kg or less), the non-prescription liquid formulation Imodium A-D Liquid 1 mg/5 mL should be used; for ages 6 to 12, either capsules or A-D Liquid may be used.


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All drug information provided on is sourced directly from drug monographs published by the U.S. Food and Drug Administration (FDA).

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Drug information found in the drug comparisons published on is primarily sourced from the FDA drug information. The drug comparison information found in this article does not contain any data from clinical trials with human participants or animals performed by any of the drug manufacturers comparing the drugs.

The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. assumes no responsibility for any healthcare administered to a person based on the information found on this site.

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Kaopectate vs Imodium

Kaopectate vs Imodium – Comparison of Side Effects & Uses a

It is the brand name of a drug called bismuth subsalicylate, which belongs to a group of medications called antidiarrheals.

Bismuth subsalicylate is found in other brand names, including – Bismarex, Maalox Total Stomach Relief, Bismatrol, or Pepto-Bismol.

Mechanism of Action

It works by decreasing the flow of electrolytes and fluids into the bowel and may kill the organisms which can cause diarrhea.


This OTC medication is used to treat diarrhea, upset stomach, heartburn (a burning sensation in the chest and throat), indigestion, and nausea in adults and children 12 years and older.


The usual recommended dose is 524 mg orally every 30 to 60 minutes as required.

Note – do not take more than 8 doses in a 24-hour period.

Side Effects and Precautions

Common side effects may include:

  • darkened tongue;
  • dark-colored stools;
  • constipation.

Rare side effects may include:

  • worsened stomach symptoms
  • diarrhea lasting longer than 2 days;
  • ringing in the ears;
  • hearing loss.


Before taking this antidiarrheal, tell your healthcare provider if you have:

  • an allergy to salicylates, like – Salflex, Tricosal, aspirin, or Doan’s Extra Strength;
  • a recent history of stomach or intestinal bleeding;
  • stomach ulcer.


Avoid drinking alcoholic beverages while taking this antidiarrheal since alcohol use can substantially increase the risk of side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • other salicylates, like – aspirin, KneeRelief, Pepto-Bismol, Tricosal, Nuprin Backache Caplet, or Trilisate;
  • probenecid (Benemid);
  • a blood thinner like warfarin (Jantoven);
  • medication used to prevent blood clots, including – tenecteplase (TNKase), alteplase (Activase), urokinase (Abbokinase);
  • insulin or oral diabetes medications;
  • an antibiotic, like – minocycline (Dynacin, Solodyn), doxycycline (Doryx, Vibramycin), or tetracycline (Ala-Tet, Sumycin, Tetracap).

Pregnancy & Breastfeeding

There are no studies regarding the safe use of this antidiarrheal by pregnant women. Ask a healthcare provider before using this medication if you are pregnant.

Bismuth subsalicylate can pass into breast milk and may harm a nursing infant. Do not breastfeed an infant while taking this antidiarrheal.


It is the brand name of a medication called loperamide, which belongs to a group of medications called antidiarrheals.

Loperamide was originally approved by the US FDA in 1976.

Mechanism of Action

It works by affecting the nerves in the intestines to reduce stool frequency. Moreover, this medication reduces cramping and makes the stools more solid.


This medication is used to relieve the symptoms of diarrhea that start suddenly and last for several days.

Diarrhea is a condition that can be described as an abnormal increase in the frequency, liquidity, or volume of your stools.

Causes of diarrhea may include:

  • parasitic infections, such as those that cause giardiasis and amoebiasis;
  • food allergies and intolerance;
  • bacterial infections, such as Shigella, C.diff (Clostridium), E. coli, salmonella, or cholera (Vibrio cholerae);
  • a side effect of some medications;
  • irritable bowel syndrome (IBS);
  • viral infections.

Moreover, this medication may be used to treat people with inflammatory bowel disease or to decrease the amount of discharge in sufferers who have undergone an ileostomy.


Before taking this antidiarrheal, tell your healthcare provider if you have:

  • AIDS (acquired immunodeficiency syndrome);
  • liver disease;
  • mucus in your stools;
  • fever.


Important note – the effect of loperamide can be observed within 1-3 hours after intake. To keep you from getting dehydrated, take the medication with a full glass of water. This medication must not be taken by children under 12 years of age unless it is prescribed by a doctor.

For acute diarrhea, the usual recommended dosage is 4 mg, taken straightaway, followed by 2 mg after each time the sufferer goes to the toilet with diarrhea.

Pregnancy & Breastfeeding

There are no conclusive studies to determine the safety of antidiarrheal during pregnancy. Therefore, before using this medication, consult your doctor.

Since this medication can pass into breast milk and may negatively affect the breastfed infant, do not breastfeed while taking this antidiarrheal.

Side Effects and Precautions

Common side effects may include:

  • dizziness;
  • drowsiness;
  • nausea;
  • stomach cramps;
  • constipation.

Less common side effects may include:

  • ongoing or worsening diarrhea;
  • stomach pain or bloating;
  • fast or pounding heartbeats;
  • shortness of breath;
  • diarrhea which is watery or bloody;
  • a feeling like you might pass out;
  • fluttering in your chest;
  • sudden dizziness.


This medication contains a small quantity of opiates, and a growing number of scientific reports have concluded that ingesting large amounts of this antidiarrheal can result in getting mild narcotic effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • azithromycin;
  • Zantac (ranitidine);
  • Benadryl (diphenhydramine);
  • Zyrtec (cetirizine);
  • Cipro (ciprofloxacin);
  • Viberzi (eluxadoline);
  • Dicyclomine;
  • Lomotil (atropine/diphenoxylate);
  • Lexapro (escitalopram);
  • Zoloft (sertraline).


Drinking alcoholic beverages while taking this antidiarrheal may substantially increase the drowsy effect of loperamide.

Bottom Line – Kaopectate vs Imodium

Kaopectate (active ingredient – bismuth subsalicylate) is an antacid and anti-diarrhea medication which is used to treat nausea, heartburn, indigestion, diarrhea, and upset stomach.

Imodium (active ingredient – loperamide) is a medication that slows the rhythm of digestion. This allows the small intestines to have more time to absorb nutrients and fluids from the foods you consume.

2 thoughts on “Kaopectate vs Imodium”

Took Imodium at onset of diorreah and after one week it still didn’t relieve problem, then one day after three doses of over the counter the problem cleared completely! No idea why, just that we are all made differently I guess!

I’ve been using Imodium on a regular bases to solidify my stool while I wasn’t having diarrhea, I would have “surprises “ throughout the day, I started taking the Imodium only after trying other remedy suggestions from my gastroenterologist including fiber con, fiber one, Benefiber , even told me to take “milk of magnesia “. The Imodium has work perfectly, I just wonder if it’s safe to take a daily regimen of it. I’ve considered trying Kaopectate thinking maybe the ingredients are possibly safer. I’ve yet to here back from my doctor about this same question. Why I started this routine was my fear of traveling for a two week vacation, it solved the issue!




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