# Generic Imodium



## Drama (Aug 16, 2011)

Now that Imodium A-D is hard to find on store shelves, I have had to switch to the generics. I have tried the Members Mark brand, Walgreens, Walmart's Equate, and the CVS Gel Caps.The generics appear to work when I take them but I usually get severe cramps with bad diarrea the next day, or in the evening after I eat(I usually take 2-3 pills in the morning before work). I do not get these symptoms with Imodium A-D. Some users suggest that it could be because the generics use lactose, and maybe I am lactose intolerant(although I do not see lactoseas an ingredient in the CVS gelcaps).My question is, does anyone else have these type of symptoms with the generics, and what would be the cause if the active ingredient is the same. Also, if it is becauseof the lactose, would taking a pill like lactaid help with the generics? I travel a lot for work, and I it is hard not being able to get Imodium A-D and not trustingthe generics.


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## BayRat (Mar 28, 2011)

Most likely scenario is that the Imodium AD was a combined Anti-diarrhea & Anti-gas type. (Loperamide + an Anti-Gas med.) Loperamide, taken alone, commonly causes increased gas/bloating/cramping/abdominal pain.Try taking a dose of Simethicone (Like Gas-X) with the Loperamide. Both are best taken with meals.*Double check whatever generic anti-diarrhea med you're taking and see if it already has any anti-gas aid or simethicone. Double dosing is not advised.


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## Drama (Aug 16, 2011)

BayRat said:


> Most likely scenario is that the Imodium AD was a combined Anti-diarrhea & Anti-gas type. (Loperamide + an Anti-Gas med.) Loperamide, taken alone, commonly causes increased gas/bloating/cramping/abdominal pain.Try taking a dose of Simethicone (Like Gas-X) with the Loperamide. Both are best taken with meals.*Double check whatever generic anti-diarrhea med you're taking and see if it already has any anti-gas aid or simethicone. Double dosing is not advised.


I was taking just plain Imodium A-D. But I did find a couple of boxes of Imodium Multi-Symptom Relief at the store(It has the 125mg of Simethicone). I will try that tomorrow and hopeall goes well. I am just trying to find something to help me along until regular Imodium gets back on the store shelves(sometime this Fall from the what the messages on this forum says).Thanks for the suggestion!


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## jmc09 (Oct 5, 2009)

If the generic is not working as well as the branded stuff have you tried taking another 2-3 with your evening meal and seeing if that helps?I was taking 12 a day at one stage and it didnt cause me any problems other than its effects keep wearing off regularly.Try upping the dose if necessary.


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## BayRat (Mar 28, 2011)

Heh, I was dead wrong with my guess. Gee, I've _never_ been wrong before!







Maybe it _is_ lactose and/or some other inactive ingredient of the contents or even the coating that caused your issues. I'm LI, so that has happened to me before, minor amounts that you wouldn't dream could cause problems - did.jmc09 has a good point. Were they (The Imodium AD you had been taking and the new generic ones) all the same dose? Anti-Diarrhea meds that use Loperamide do come in two doses: 1mg per tablet, or 2mg per tablet.Believe me, if you can still find *any* Imodium branded products at all, even the liquid type, you're lucky. Buy the smallest one you can & see how they work for you. If all goes well, head back and get more. Most everyone is out. The shortage seemed to have started on the east coast and spread from there. Well, hopefully that'll be sorted soon-ish. Fall is what the McNeil manufacturer had said as of last month, but who knows for sure?You're in the US. Motofen (an Rx grade anti-diarrhea med) became re-available just after the Imodium shortages began. Quite a few folks turned to that for help and found great relief. From their feedback, it seems that Motofen works much better for D, no bloating/cramping, but perhaps doesn't work as long. Motofen would require a doctor consultation as it's a prescription drug. Just something else to look into.MOTOFEN is back on the market!


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## Drama (Aug 16, 2011)

Thanks for the excellent suggestions. I will try upping the dosage on the generics, as well as asking my doctor about the Motofen. I think upping the dosage could work. According tothe Walgreens generic, the ingrediants are:*Active Ingredients*Loperamide Hydrochloride - 2 mg Antidiarrheal*Inactive Ingredients*Corn Starch , D&C Yellow #10 Aluminum Lake , Dicalcium Phosphate Dihydrate , FD&C Blue #1 Brilliant Blue Lake , Magnesium Stearate , Microcrystalline Cellulose , Silica GelI don't see any lactose, so its beyond me why it isn't as effective as the regular name brand Imodium A-D. Right now I am on 20mg Bentyl(Dicyclomine) tablets 4 times a dayand I take the Imodium A-D(2-3 pills in the morning) M-F and give myself a break from the imodium on Sat-Sun when I am off(As long as I don't plan on leaving the house), otherwiseI will take 1-2 Imodium if I go out. Life has been manageable until this shortage of Imodium and I was forced to the generics and now I have bad IBS-D in the morning when I wake up or evening after I eat dinner.Yesterday I took 1 Imodium Multi-Symptom and 2 CVS brand Gelcaps(Morning) and I was ok all day at work, but I woke up with IBS-D this morning. Normally with regular Imodium I will havesolid stools in the morning, but since switching to the generics its just straight liquid.CVS Gelcap Ingrediants:*Active Ingredient (in Each Capsule)*: Loperamide HCI (2 mg). *Inactive Ingredients*: Butylated Hydroxyanisole, Edible Ink, FD&C Blue No. 1, Gelatin, Glycerin, Glyceryl Caprylate, Polyoxyl 40 Hydrogenated Castor Oil and Purified Water.It just sucks trying to experiment with dosages and brands and stuff while trying to make it through a full day of work and not wanting to get sick. There are times when I amnot near a bathroom and I really don't want to get a bout of IBS-D =(Again, thanks everyone for the suggestions!


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## BayRat (Mar 28, 2011)

Drama said:


> the Walgreens generic, the ingrediants are:*Active Ingredients*Loperamide Hydrochloride - 2 mg Antidiarrheal*Inactive Ingredients*Corn Starch , D&C Yellow #10 Aluminum Lake , Dicalcium Phosphate Dihydrate , FD&C Blue #1 Brilliant Blue Lake , *Magnesium Stearate* , Microcrystalline Cellulose , Silica Gel





> Imodium Multi-Symptom Relief CapletsActive Ingredients (in each Caplet): Loperamide HCl (2 mg), Simethicone (125 mg).Inactive Ingredients: Acesulfame K, Cellulose, Dibasic Calcium Phosphate, Flavor, Sodium Starch Glycolate, Stearic Acid.


Interesting, Imodium Multi-Symptom & CVS Soft Gels, neither has any form of Magnesium, which is used in many laxatives. Magnesium Stearate is used as a sort of binder with many meds. I'm no chemist, so I don't know if that form is anything at all like regular Magnesium, good question for your pharmacist... but, maybe that's your suspect? I was a faithful Imodium user till the shortage, then switched to the CVS Soft Gels. Neither has caused my symptoms to worsen.Hmm, maybe the Corn Starch in the Walgreen's brand. Imodium Multi Symptom uses Sodium Starch Glycolate. For me, that might explain why the CVS Soft Gels actually worked better than the Imodium brand. Starches can be hard on the tummy. Hah! You may just have found _my_ answer to a puzzler.







Be careful with the double dosing. Yes, I've done it out of sheer desperation plenty of times and lived to tell the tale, so it won't kill ya. Still, if you have the time to play it safe, try upping by half a tablet/dose at a time until you achieve an effective amount. The manufacturer's recommended maximum adult dosage of Loperamide is no more than 16mg per day. More, over an extended period, can harm your liver and mess up your eloctrolyte balance, among other nasty things.With your Doctor, you can ask about Motofen, Lotronex, or Lomotil, though Motofen seems to be quite a hit as it doesn't seem to cause the bloating/cramping.Just don't take a double dose of Simethicone. Yeppers, I tried it once, and once was quite enough. Gads, it caused me 6 hours of pain and nausea.


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## justincarry (Jun 29, 2011)

castor oil is a over-the-counter laxative, with its major site of action the small intestine. Although it may be used for constipation, it is not a preferred treatment, because it can *produce painful cramps*, *fecal incontinence* and *explosive diarrhea*. Its action can go on for hours, sometimes unpredictably and powerfully causing an involuntary bowel movement at inconvenient locations and during sleep.


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## BayRat (Mar 28, 2011)

justincarry said:


> castor oil is a over-the-counter laxative, with its major site of action the small intestine. Although it may be used for constipation, it is not a preferred treatment, because it can *produce painful cramps*, *fecal incontinence* and *explosive diarrhea*. Its action can go on for hours, sometimes unpredictably and powerfully causing an involuntary bowel movement at inconvenient locations and during sleep.


Good point! Could be a sensitivity to that. I'm fairly certain the ingredient listings go in descending order of amounts in both meds & foods. The most first, the least last. Still, even a small amount can trigger a sensitivity reaction.


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## Drama (Aug 16, 2011)

I'll keep those suggestions in mind as well. Imodium A-D ingrediants are:Imodium AD Caplets: *Active Ingredient (in each Caplet*): Loperamide HCl (2 mg). *Inactive Ingredient*s: Colloidal Silicon Dioxide, Dibasic Calcium Phosphate, D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake, Magnesium Stearate, Microcrystalline Cellulose. So the Magnesium Stearate is in the name brand as well. I have a Doctor's appointment in about 2 hrs, so I will inquire about the Motofen, Lotronex, or Lomotil. In the mean time, I switched to theWalgreens brand and will try that for a couple of days. I know the CVS soft gels are giving me fits, so maybe it is the Castor Oil. I took 2 Walgreens brand pills this morning and 1 Imodium Multi-Symptomjust so I can make it to the Doctors Office. I woke up in my sleep because of cramps and IBS-D.Again, thanks everyone for the help. This is tough because although everyone might have IBS-D, everyone's body is different and medication affects everyone's body in different ways. I do blood tests1-2 weeks before each doctors visit to keep a look out for signs of Liver/Kidney disease...ect that could be brought on by the prescription drugs I do take. And my doctor monitors me by only givingme prescriptions for 3-6 month intervals, then I have to do the blood tests before I see him again. This gives me a little piece of mind when taking the Bentyl/Imodium..ect that it isn't messingup my body.Thanks Again!


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## Drama (Aug 16, 2011)

Well...The Doctor wants me to try Paxil because the serotonin could be beneficial for treating my stomach. I have heard that Paxil could make the IBS-D worse(or better) depending on the person. Italso could have other bad side effects(Such as vivid dreams, low sex drive)...ect. But he said he has other IBS-D patients that have seen a huge improvement when taking it. He said to try it out for3 months to see if it helps, or if things get worse to come back to him immediately. He also said that I might have more anxiety when taking the Generic brands of Imodium which is why I am havingbad IBS-D. He said maybe because it is something different in my normal routine and I worry about it more because I don't trust the generics that its causing my stomach to be much worse thannormal.I have started researching the Paxil, and I will have to see if it is worth it to start taking it or not.


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## BayRat (Mar 28, 2011)

Drama said:


> Well...The Doctor wants me to try Paxil because the serotonin could be beneficial for treating my stomach. I have heard that Paxil could make the IBS-D worse(or better) depending on the person. Italso could have other bad side effects(Such as vivid dreams, low sex drive)...ect. But he said he has other IBS-D patients that have seen a huge improvement when taking it. He said to try it out for3 months to see if it helps, or if things get worse to come back to him immediately. He also said that I might have more anxiety when taking the Generic brands of Imodium which is why I am havingbad IBS-D. He said maybe because it is something different in my normal routine and I worry about it more because I don't trust the generics that its causing my stomach to be much worse thannormal.I have started researching the Paxil, and I will have to see if it is worth it to start taking it or not.


Well I'm glad that your visit was productive and you've got something to try out. I've no experience at all with Paxil so I can't be of much use there, not like I was super helpful before... Hah!I do know that antidepressants are often tried with IBS-D sufferers due to their effects on serotonin. Not just with the D, but it's also sometimes helpful for abdominal pain. Something about the serotonin effecting the neurological pain receptors/pathways. Keep in mind that you're now on an SSRI (Selective serotonin reuptake inhibitors), and while you're on it, double check any future meds both Rx and OTC to make certain that there's no conflict. I've heard/read that antidepressants used for IBS-D and/or abdo. pain can take several weeks to work, so be patient.[[My hubby takes Celexa, also an SSRI. His GP once gave hime a sample drug to help with some temporary issue he was having (some MAOI class drug, can't recall it specifically). Because it was a free sample the meds didn't go through the usual pharmacy adverse interaction checker. Well, he had an adverse reaction alright. Thank G-d it was mild and quickly discovered, actually be me. yay, I do get some things right! At higher doses, or more prolonged treatment length, the damage was potentially very serious. S'why I made that suggestion.Serotonin syndrome ]]I'm of two minds concerning any doctor's remarks about anxiety with IBS. One- yes, sure, it may indeed be a factor. Two- it's a cop-out to blame the patient. Only time and results can tell which mouth they were speaking from. Anxiety and IBS often come as a set. They set up a cycle of failure; stress worsens IBS, worsened IBS increases stress, and around we go. Kathleen often calls it the chicken-or-the-egg problem... which comes first?In any case, you're on a new road now and trying a different medical treatment. I hope it works wonders for you! If you've got questions about the Paxil, I'd suggest that you start a new thread altogether, as that's a whole new topic from this one. You'd get better, more precise, answers with a new dedicated thread here in the IBS-D subforum, or in the Prescription Medications Subforums.


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## Drama (Aug 16, 2011)

I'll keep that in mind. Again, thanks for the help and suggestions. I've had IBS-D since I was 15 years old(I am now 37). Back then, they did a upper/lower GI tract x-ray type thing, and saideverything was normal and that it was all in my head(because IBS wasn't really diagnosed back then) and my parents thought I was complaining of stomach discomfort/diarrhea to get out of school.It was really tough back then, and no one understood what someone with IBS had to go through. So I totally understand when you say its a cop-out for the doctor to blame the patient.There is nothing worse to be sick and the doctor says that your fine and its all in your head.I am going to wait until the upcoming labor day weekend to start the Paxil so that I can have an extra day or so to adjust to the side effects(if there are any). A friend of mine that was inmedical school said that sometimes the side effects are spot on, and other times they are way off. The reason being, when you start a trial drug, the doctors ask you everyday how you feel andhave to write down your symptoms. So, if I suffer from headaches and I am on the trial for Paxil(or whatever drug) and I have a headache tomorrow and report it to the doctor, he has to write thatdown. Now, the headache may have been due to the Paxil, or it might have been a headache I would have gotten due to me suffering from headaches and has nothing to do with the Paxil. Anyhow, they have to write down headaches as a side effect. I don't know if this is true or not, but it sounds crazy enough that they would really use this meathod.







I will post an update in the Prescription Medications Subforums as was suggested in a month or so.


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## backtonature (Jul 15, 2011)

DramaI know this is not what you want to hear when you've just started taking a new drug but I really think you should research Paxil before you continue taking it. I know medications work differently for everyone etc, but Paxil is well known to have some awful side effects including self harm and suicidal thoughts. This comes from www.paxil-side-effects.us : 'Over the course of its history, 5,000 lawsuits have been filed against GlaxoSmithKline for the damage caused by Paxil. In 2004 GSK settled a consumer fraud lawsuit accusing it of deliberately and systematically suppressing unfavorable research results. In 2005, GSK was accused of suppressing data regarding Paxil’s effect on suicidal tendencies.' 'Paxil has been associated with a long list of dangerous side effects, including: headaches, dizziness, blurred vision, fainting, and more. One of the most troubling side effects is the drug’s tendency to increase suicidal thoughts, and its addictive nature, which results in extreme withdrawal symptoms. GlaxoSmithKline has run into heavy criticism and lawsuits for its endorsement of Paxil as a “non-habit forming” drug, when evidence not only shows the contrary, but that GSK was well aware that the drug caused severe withdrawal symptoms.'I have had personal experience of this when I was prescribed Paxil for depression some years ago. Straight away it made me feel manic and suicidal. I felt completely out of control yet when I rang my doctor he said I was being ridiculous and that it was a very safe drug. About 2 months later it was the subject of a documentary investigating the suppression of it's more serious side effects. I opted for an older Tri-cyclic anti-depressant. Tri-cyclics are also prescribed for IBS as they are good for pain relief and have a constipating effect on the bowel. Please do some research and way up the pros and cons for yourself, but if you start to have strange thoughts it may well be those pills!


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## PD85 (Aug 19, 2010)

Order Imodium A-D on eBay. That's what I do now, and it's fairly cheap. The CVS gelcaps literally do nothing at all for me, and they are expensive. But the brand name Imodium A-D really works.


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## Romeo (Aug 31, 2011)

I've been a long time sufferer of IBS-D and have been taking off brand immodium for some time when symptoms got really bad. I had noticed that it didn't seem to work as well as the immodium previously did and simply thought my symptoms were getting worse. I stumbled across this board by accident and am so thankful. I quickly found out that the brand I use has both magnesium and lactose in it which has no doubt been worsening my symptoms. Thank you so much for making me aware of this, I'm so glad there's a community out there to help me out with this issue.


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## harriet (Jun 15, 2011)

BayRat said:


> Most likely scenario is that the Imodium AD was a combined Anti-diarrhea & Anti-gas type. (Loperamide + an Anti-Gas med.) Loperamide, taken alone, commonly causes increased gas/bloating/cramping/abdominal pain.Try taking a dose of Simethicone (Like Gas-X) with the Loperamide. Both are best taken with meals.*Double check whatever generic anti-diarrhea med you're taking and see if it already has any anti-gas aid or simethicone. Double dosing is not advised.


I thought that you had to take the Loperamide like 30 minutes before each meal??? I think I will get some Gas-X and try that before each meal...I have the worst back pain sometimes...If I am at home I just have to get in a tub of hot water and try to relax...It seems to help..


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