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I don't think I've ever had those side effects with Imodium. I think it's probably your other medications - or the D itself - that's making you tired and dizzy.
I think you should try taking two capsules (4 mg) as your first dose and then another capsule (2 mg) if you continue to have D. When I was at my worst, I would take the recommended starting dose of 2 capsules and then 1/2 -1 capsule following each BM, if I continued to have D. This helped. To me half a dose or 1 mg, is good as a maintenance dose or preventive, but when I'm actually having an attack, I take however much I need to stop the attack. I've also found that taking lorazepam helps with the spasms, but I only use that for really bad, painful attacks.
HTH. I hope you're feeling better today. Having D on top of everything else sucks.
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Thanks, I just got a script for lomotil, hopefully that will slow things down! 
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Taking it one day at a time.....
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Thanks Alicia. I am taking probiotics but my system is just wacky right now. I just found out I have strep as well and I'm sure my body isn't going to like the antibiotics one little bit! However, the doc did give me a script for lomotil so hopefully that will slow things down for the time being!
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Taking it one day at a time.....
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Wow, I was totally flabbergasted to see that you've never taken more than 4. Back when I was having really, really, really awful D, I took lots of Imodium and Levsin every day. The key is to take them BEFORE you get sick. So, the second I got up every morning, I would take 2 Levsin and 2-4 Imodium (depending on how bad I felt). After that I took a minimum of 1 Imodium and 1 Levsin every four hours. Most of the time it was more -- I took anywhere from 6-10 Levsin and 8-15 Imodium every day. I tapered off late in the day. It hardly ever made me C -- I usually had one BM during the day and then 2-3 BMs later at night. I started out taking the Imodium/Levsin on an as-needed basis when I felt bad, but at that point it was usually too late.
I do think your body gets used to it to a certain extent and you have to increase it -- but on the other hand, if you need it, then you need it. I never had any side effects from Imodium -- I agree with everyone else that it's got to be the dehydration or your other meds making you weak/dizzy. Every doctor I've asked has said that Imodium is completely safe long-term, even in higher doses.
I'm having pretty bad D again now that my gallbladder's out, so once again I'm taking Levsin on a clockwork schedule as a preventative. I rarely take Imodium anymore, though, because it just makes me C and then the next time I go it's extremely painful and crampy. I recently started back at work after being at home for several months, and I've panicked a couple times and taken Imodium, and boy have I paid for it later.
You might want to try taking an anti-spasmodic regularly as a preventative. I don't know if you can do so safely with your other meds or not. I've heard you mention using Donnatal, but if you're taking an anti-spasmodic regularly, you might want to use something that isn't as strong and doesn't have phenobarbital. I'm pretty sure that the main anti-spas in Donnatal is hyoscyamine, which is the same thing in Levsin, only the dose in Donnatal is about three times the strength. I haven't tried any of the other anti-spasmodics except Bentyl, which didn't work and which I am pretty sure I am mildly allergic to.
Anyway, something to think about -- that's the only thing I've ever managed to find that's really truly helped. I did just get a script from my doctor for Questran, and I'm really hoping that's going to help. I haven't tried it yet.
I saw your other posts about the hair loss and strep. No words of advice, just wanted to say how sorry I am about all the rotten things that seem to be happening to you. I know you said you didn't want to deal with it, but if you start to feel worse I hope you do go to the hospital.
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jen
"It's one of the most serious things that can possibly happen to one in a battle -- to get one's head cut off." -- LC
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Thanks Jen. I had to stop the donnatol because it dried out my already dry eyes too much! The RA effects my eyes, I've pretty much got the uvietis under control with the injections but the dryness is still really bad and when I take the donnatal, no amount of lubricating eye drops helps.  I really need to talk about getting the punctual plugs for my dry eyes but I just haven't had the energy to deal with it lately!
I took my first lomotil this morning and so far so good. I had two bouts of D before I left home and this stopped it almost immediately! We will see what happens after lunch!
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Taking it one day at a time.....
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Actually Immodium can cause low bp. You have to make sure you eat and rink when taking it or you're at risk. I had a scary episode a while back when it caused my bp to drop so low I could not move. I sat down in a chair and then couldn't move my legs for hours! Luckily (as the out of hours doc thought I was lying) I have cousins who are MDs and they sussed out what it was and once I was lying down flat and had eaten I recovered. But it was scary!
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Hmm, that would explain why my bp was low at my last visit. The steroids I am on cause it to be high so when it registered at something like 99/50 they were kinda freakin! I guess that would explain the dizziness!
I haven't taken any in a couple of weeks, been using the lomotil which seems to be working pretty well for me at the moment!
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