The Drug-Induced Respiratory Disease Website

Loperamide

Torsades de pointe

See under PMID 35012678

Isang E, Shali L, Morris CB, Mahlow J

Loperamide-Induced Torsades de Pointes.

Cureus 2021 Dec;13;e20299 — 2021 Dec — e20299

Jackson GG, Lopez CR, Bermudez ES, Hill NE, Roden DM, Ely EW, Stollings JL

Loperamide Induced Recurrent Torsades de Pointes: A Case Report.

Journal of pharmacy practice 2022 Oct;35;791-795 — 2022 Oct — 791-795

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 Mar - Apr;57;S63-S67 — 2017 Mar - Apr — S63-S67

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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