From the Guidelines
For diarrhea, besides Imodium (loperamide), you can take Bismuth subsalicylate, such as Pepto-Bismol, as it has antimicrobial, anti-inflammatory, antisecretory, and adsorbent properties, although it is less effective than loperamide, as stated in the guidelines for adults on self-medication for the treatment of acute diarrhoea 1. When considering alternatives to Imodium, it's essential to evaluate the cause and severity of the diarrhea.
- For travellers' diarrhoea caused by E. coli, Bismuth subsalicylate can be an option, although it is less effective than loperamide 1.
- Antimicrobials like quinolones can be used for dysentery or identified infectious diarrhoea, but their use should be limited due to increasing bacterial resistance 1.
- It's crucial to stay hydrated by drinking clear fluids or oral rehydration solutions, and for mild cases, dietary changes like following the BRAT diet can help.
- If your diarrhea is severe, lasts more than 2 days, contains blood, or is accompanied by fever over 102°F, you should see a doctor as these could indicate a more serious condition requiring different treatment. The dosage and choice of medication should be based on the individual's specific needs and medical history, and it's always best to consult a healthcare professional for personalized advice.
- Quinolones, in general, are well-tolerated with minor adverse events, but their use should be judicious due to the risk of increasing bacterial resistance 1.
From the FDA Drug Label
XIFAXAN is indicated for the treatment of travelers’ diarrhea (TD) caused by noninvasive strains of Escherichia coli in adults and pediatric patients 12 years of age and older XIFAXAN is indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.
Alternatives to Imodium for loose stools:
- Rifaximin (XIFAXAN): for travelers’ diarrhea caused by noninvasive strains of Escherichia coli and for irritable bowel syndrome with diarrhea (IBS-D) 2
Note: The FDA drug label does not provide a comprehensive list of alternatives to Imodium. The information provided is based on the specific drug labels available.
From the Research
Alternatives to Imodium for Diarrhea
- Bismuth subsalicylate is an alternative to Imodium (loperamide) for treating diarrhea, as shown in studies 3, 4, 5, 6.
- Bismuth subsalicylate has been found to reduce the number of stools passed and alleviate subjective symptoms in patients with traveler's diarrhea 3.
- A study comparing loperamide and bismuth subsalicylate found that loperamide was more effective in reducing the average number of unformed bowel movements and providing overall subjective relief 4.
- Bismuth subsalicylate has also been shown to be effective in preventing traveler's diarrhea, with a protection rate of 65% for the high-dose regimen 6.
Comparison of Loperamide and Bismuth Subsalicylate
- Loperamide has been found to be more effective than bismuth subsalicylate in treating acute diarrhea, with faster and more effective relief 4, 5.
- However, bismuth subsalicylate has been shown to have beneficial effects on chronic infantile diarrhea and selected symptoms associated with Norwalk virus-induced gastroenteritis 3.
- Both loperamide and bismuth subsalicylate are generally well-tolerated, with few adverse reactions reported 4, 7, 5, 6.