The Food and Drug Administration sent a letter to online retail giants Thursday asking them to limit the sale of an over-the-counter, anti-diarrheal medicine that drug users are taking to mimic a euphoric high from opioids.
In a letter to Amazon, Ebay, Walmart, and Jet, FDA Commissioner Scott Gottlieb noted that a growing number of people are taking the drug loperamide in high doses, which can result in serious heart problems or death.
The FDA has become aware that people are taking these high amounts of the drug, a caplet often known by its brand-name Imodium A-D, as an alternative to an opioid, both to manage symptoms of withdrawal and to get high. Imodium is often known in drug circles as the “poor man’s methadone.” Methadone is often prescribed by doctors to treat people with addictions to heroin or prescription painkillers.
Drug users are able to obtain large quantities of loperamide online. Gottlieb noted in his letter that retailers were selling it in bundled amounts that could result in customers obtaining 1,200 tablets in a single purchase.
Gottlieb asked the retailers to voluntarily cease selling more than one package at a time and to include warning labels on their websites.
This is one of a series of actions the FDA has taken on loperamide. In spring 2017, it added a warning to the product alerting customers against ingesting high amounts. The labels read: “Heart Alert: Taking more than directed can cause serious heart problems or death.”
The FDA also requested in January that manufacturers sell the drug in smaller containers that are more consistent with the doses people can take safely. The FDA asked that these changes occur in a “timely fashion.”
Gottlieb cited these examples in his letter, saying that retailers also must “do their part” to “stem the tide of abuse.” He stated in a previous release detailing FDA actions on opioids that, “I believe anyone who is distributing healthcare products has an obligation to be a partner in helping address the most pressing public health challenges like opioid abuse. If you’re selling a drug with the potential for abuse and misuse through an online website, you’re no longer in the business of selling widgets, or books. You have a social contract to take voluntary steps to help address public health challenges.”
Ebay said it would comply with the FDA’s requests. Inquiries sent to the other retailers were not immediately returned.
