What role does black pepper play in the abuse of loperamide?
Black pepper, which contains piperine, an inhibitor of both P-gp and CYP3A4, is used to enhance the systemic absorption and central nervous system penetration of loperamide.
Wu PE, Juurlink DN. Clinical Review: Loperamide Toxicity. Ann Emerg Med. 2017 Aug;70(2):245-252. doi: 10.1016/j.annemergmed.2017.04.008. Epub 2017 May 13. PMID: 28506439.
Submitted by: Dawn Sollee, PharmD, DABAT on behalf of Florida/USVI Poison Information Center – Jacksonville
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