Editing Antidiarrheal (section)

== Adverse effects ==

=== Opiates ===
Loperamide is effective and safe for treating chronic diarrhea. [[Diphenoxylate]] and [[difenoxin]] work similarly but can affect the brain at high doses, so they're combined with [[atropine]] to reduce misuse risks. Stronger opiates like [[morphine]] or [[codeine]] can treat severe diarrhea, but they're rarely prescribed due to the risk of misuse, and careful monitoring is needed.<ref name=":12">{{Cite journal |last=Schiller |first=Lawrence R. |last2=Pardi |first2=Darrell S. |last3=Sellin |first3=Joseph H. |date=2017-02-01 |title=Chronic Diarrhea: Diagnosis and Management |url=https://www.cghjournal.org/article/S1542-3565(16)30501-8/fulltext |journal=Clinical Gastroenterology and Hepatology |language=English |volume=15 |issue=2 |pages=182–193.e3 |doi=10.1016/j.cgh.2016.07.028 |issn=1542-3565 |pmid=27496381}}</ref> While generally safe, even when combined with antibiotics, the use of opiates may slightly increase the risk of acquiring antibiotic-resistant bacteria.<ref name=":2" />

=== Bismuth subsalicylate ===
[[Bismuth subsalicylate]] is commonly used for diarrhea, but long-term use raises safety concerns and should be monitored.<ref name=":12" /> Bismuth can cause common side effects such as nausea, a bitter taste, diarrhea, and darkened stools.<ref>{{Cite journal |last=Gorbach |first=Sherwood L. |date=September 1990 |title=Bismuth therapy in gastrointestinal diseases |url=https://linkinghub.elsevier.com/retrieve/pii/0016508590909838 |journal=Gastroenterology |language=en |volume=99 |issue=3 |pages=863–875 |doi=10.1016/0016-5085(90)90983-8}}</ref> Since it is a heavy metal, in may cause [[encephalopathy]] in rare cases.<ref name=":02" />

=== Bile acid resins ===
Bile acid binding resins like [[Colestyramine|cholestyramine]], [[colestipol]], and [[colesevelam]] are effective but can cause constipation and may interfere with the absorption of other medications, so they should be taken at least two hours apart from other drugs.<ref name=":12" />

=== Alpha-2 (α<sub>2</sub>) adrenergic agonists ===
[[Clonidine]], used for diabetic diarrhea, is often limited by its ability to lower blood pressure.<ref name=":12" />

=== 5-HT<sub>3</sub> antagonists ===
[[Alosetron]], often used for IBS-related diarrhea, poses a risk of colonic ischemia and severe constipation, which makes it infrequently used.<ref name=":12" />