Learn more about loperamide abuse cases from experts in the field.
A 43-year-old female presented to the emergency department (ED) with syncope. While in the ED, she experienced multiple episodes of torsades de pointe and ventricular arrhythmias. Intravenous lidocaine, amiodarone, sodium bicarbonate, magnesium, and fatty acid emulsion therapy were all given. She required repeated cardioversion, with at least 15 shocks. Control was ultimately achieved by transvenous pacemaker insertion with overdrive pacing. She required overdrive pacing for three days.
She reported taking 144 tablets of loperamide (each 2 mg) daily, totaling 288 mg, to manage symptoms of opioid withdrawal.