Drug Interaction Between Acetazolamide And Imodium

In our latest question and answer, the pharmacist discusses whether or not there is a drug interaction between Diamox (acetazolamide) and Imodium (loperamide).

Jul 05, 2018

stacey asked

Is there any drug interaction between Diamox (for altitude sickness) and Imodium?

Answer

Diamox (Acetazolamide) is a medication that is used in treatment of altitude sickness, edema, epilepsy and glaucoma. Imodium (Loperamide) is used in the treatment of diarrhea. There are no known interactions between the two medications. However, both medications can potentially cause drowsiness or dizziness.  Caution should be taken when taking these two medications together especially when driving or operating machinery. Below is further information on both medications.

Diamox (Acetazolamide)

As stated above. Diamox (Acetazolamide) is used in the treatment of altitude sickness, edema, epilepsy and glaucoma.  It is a common drug to use in the treatment or prevention of altitude sickness especially. It works by acidifying the blood which increases respiration that will lead to an increased oxygenation of the blood. When used for the prevention of altitude sickness, it is recommended the drug be started the day before the ascent to high altitude, continuing for 2-3 days while at high altitude.  

The CDC has information for traveler’s health including altitude sickness.  The following are tips from the CDC on acclimating to high altitude:

  • Ascend gradually if possible and avoid going directly from low altitude to more than 9,000ft
  • Sleeping at high altitude causes the most hypoxemia or oxygen deficiency.  Once above 9,000ft, avoid more than 1,600ft movement in a day for sleeping
  • Exercise should be minimal for first 48 hours
  • No alcohol consumption for 48 hours
  • Symptoms of acute altitude sickness include: headache, fatigue, loss of appetite, nausea and vomiting

Common side effects of Diamox (Acetazolamide) include:

  • dizziness/lightheadedness
  • dry mouth
  • increased urination
  • blurry vision
  • drowsiness
  • upset stomach, diarrhea, nausea, vomiting or loss of appetite 
  • headache
  • tiredness or confusion

Imodium (Loperamide)

Imodium (Loperamide) is used in the treatment of diarrhea.  It works by slowing down the intestinal transit time which will help decrease fluid and electrolyte loss.  It is not recommended for more than 2 days use without consulting a doctor.  

There are a couple of warnings that patients should be aware of.  Patients with liver impairment or AIDS should use with caution and should contact their health care provider.  Imodium (Loperamide) at higher than recommended doses can cause serious heart problems that include cardiac arrest, life threatening arrhythmias and death.  Patients with known cardiac problems should avoid using and contact their health care provider.

The most common side effects of Imodium (Loperamide) include:

  • dizziness
  • constipation
  • drowsiness or fatigue
  • nausea

Since this medication has the potential for drowsiness or dizziness, patients should be cautious when driving or operating machinery.  Patients should also remember to continue to hydrate and replace electrolytes.  

Conclusion

Diamox (Acetazolamide) and Imodium (Loperamide) have no known interactions and are fine to be taken together.  Since both medications have the potential to cause dizziness or drowsiness, patients should be aware of this and take precaution when driving or using machinery until the effects of the medications are known. 

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