Over-the-counter agents used improperly to curb opioid withdrawal or induce high-dose euphoria were linked to a disproportionate number of lethal arrhythmias reported to national pharmacovigilance systems, the researchers found. The antidiarrheal drug loperamide, a weak synthetic opioid, was significantly associated with ventricular arrhythmia (proportional reporting ratio [PRR] 3.2, 95% CI 3.0-3.4), with 37% of 1,008 FDA Adverse Event Reporting System (FAERS) reports involving death. The arrhythmic signal was worse — a PRR of 8.9 (95% CI 6.7-11.7) — for mitragynine, the main active ingredient in the herbal supplement kratom. Fully…
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