Is There a Prescription Drug That Stops Diarrhea? A Guide to Medical Treatment

October 8, 2025 •

4 min read

While most acute diarrhea resolves on its own within a couple of days, persistent or severe cases—often affecting an estimated 1% to 5% of the adult population with chronic diarrhea—frequently require medical intervention. When lifestyle changes and over-the-counter remedies fail, patients may need a specialized prescription drug that stops diarrhea by addressing its underlying cause.

Quick Summary

This article explores the types of prescription medications available for controlling diarrhea, focusing on conditions like irritable bowel syndrome with diarrhea (IBS-D) and inflammatory bowel disease (IBD). It details medications such as Diphenoxylate/Atropine and Rifaximin, and outlines when medical intervention is necessary for chronic or severe symptoms.

Key Points

Prescription vs. OTC: Prescription antidiarrheals are typically used for chronic, severe, or complex diarrhea, while OTC options like lower-dose loperamide treat mild, acute cases.
Underlying Causes: Effective treatment for chronic diarrhea depends on an accurate diagnosis of the underlying cause, such as IBS-D, IBD, or specific infections.
Targeted Action: Different prescription drugs work through various mechanisms; for example, Diphenoxylate/Atropine slows gut motility, Rifaximin is an antibiotic, and Eluxadoline targets specific gut receptors.
Safety First: High doses or misuse of certain antidiarrheals, particularly opioid-based ones like loperamide, can lead to serious adverse effects, including cardiac issues.
Medical Consultation: Always consult a healthcare provider before taking prescription or high-dose antidiarrheal medication, especially if symptoms include fever or bloody stools.
Dietary Role: Alongside medication, dietary changes are an important part of managing chronic diarrhea, often involving avoiding trigger foods and ensuring proper hydration.

The Difference Between Acute and Chronic Diarrhea

Diarrhea is a common ailment, usually defined by passing three or more loose or watery stools per day. The vast majority of episodes are acute, meaning they come on suddenly and last less than two weeks, often resolving with basic care like increased fluid intake and dietary adjustments. However, when symptoms persist beyond four weeks, the condition is classified as chronic diarrhea, and it often points to a more complex underlying issue. In these scenarios, a doctor's diagnosis is essential to determine the best course of treatment, which may involve prescription-strength medication.

When is a Prescription Drug Necessary?

Medical professionals typically reserve prescription antidiarrheal medications for chronic conditions or situations where over-the-counter (OTC) treatments are ineffective or unsafe. A prescription is often warranted in the following cases:

Chronic diarrhea: For symptoms lasting more than four weeks that do not respond to OTC drugs or dietary changes.
Underlying medical conditions: Diarrhea caused by conditions such as Inflammatory Bowel Disease (IBD), including Crohn's disease, or Irritable Bowel Syndrome with Diarrhea (IBS-D).
Traveler's diarrhea: If the condition is severe or persistent, particularly if caused by specific bacterial pathogens.
Certain infections: Some bacterial or parasitic infections may require specific antibiotics or antiparasitics rather than general symptom relievers.
Severe symptoms: Diarrhea accompanied by fever, blood in the stool, or signs of dehydration should prompt a visit to a healthcare provider.

Key Prescription Antidiarrheal Medications

Diphenoxylate with Atropine (Lomotil)

This combination medication contains the opioid agonist diphenoxylate, which slows gut motility, and a small amount of atropine, a substance added to prevent drug abuse. Diphenoxylate with atropine is a Schedule V controlled substance and is typically prescribed for moderate to severe diarrhea when other treatments are insufficient.

How it works: By slowing the movement of intestinal muscles, it reduces the frequency of bowel movements and allows for more water absorption.
Prescribing information: Exclusively available by prescription and generally intended for short-term use in acute cases or specific chronic conditions.

Rifaximin (Xifaxan)

An oral antibiotic with poor systemic absorption, rifaximin primarily works within the gut to reduce bacterial overgrowth. It is specifically indicated for treating IBS-D in adults and for traveler's diarrhea caused by non-invasive E. coli.

How it works: It targets bacteria that can contribute to the symptoms of IBS-D and certain types of infectious diarrhea.
Prescribing information: Prescribed for specific conditions and not for viral diarrhea. It may be used intermittently for IBS-D.

Eluxadoline (Viberzi)

Eluxadoline is a Schedule IV controlled substance specifically indicated for adults with IBS-D. It works by targeting opioid receptors in the gut to reduce abdominal pain and looseness of stools.

How it works: It decreases bowel activity, helps regulate gastrointestinal function, and may reduce abdominal discomfort.
Important considerations: It can cause constipation and carries a risk of more severe side effects, such as pancreatitis, so it's only suitable for specific patients.

Specialized Agents

For certain complex causes of chronic diarrhea, other prescription agents may be used:

Alosetron (Lotronex): A highly restricted medication for women with severe IBS-D who have not responded to other treatments due to rare but serious side effects like ischemic colitis.
Bile Acid Sequestrants: For bile acid malabsorption, which can cause chronic diarrhea, medications like cholestyramine can bind to excess bile acids in the gut.
Opioid Tincture: In rare, severe cases of refractory diarrhea, a stronger opioid tincture may be prescribed, but it carries a higher risk of dependence and misuse.

Comparison of Common Antidiarrheal Medications


Feature	OTC Loperamide	Prescription Loperamide	Diphenoxylate/Atropine (Lomotil)	Rifaximin (Xifaxan)	Eluxadoline (Viberzi)
Mechanism	Slows gut motility and reduces fluid/electrolyte loss.	Slows gut motility and reduces fluid/electrolyte loss.	Slows gut motility, regulated by opioid receptors.	Non-absorbable antibiotic reduces bacterial overgrowth.	Targets gut opioid receptors to reduce pain and stool looseness.
Primary Use	Acute, short-term diarrhea, including traveler's diarrhea.	Chronic diarrhea associated with IBD; high-dose OTC abuse risk.	Acute and chronic diarrhea, restricted use due to abuse potential.	IBS-D and traveler's diarrhea.	Severe IBS-D in adults.
Availability	Over-the-counter (OTC) and prescription.	Prescription only (higher strength).	Prescription only, controlled substance.	Prescription only.	Prescription only, controlled substance.
Side Effects	Constipation, dizziness, nausea, drowsiness.	Constipation, dizziness, nausea, drowsiness; cardiac issues at high doses.	Constipation, dry mouth, blurred vision, drowsiness, headache.	Headache, abdominal pain, nausea.	Nausea, constipation, abdominal pain; risk of pancreatitis.

Patient Safety and Considerations

While effective, prescription antidiarrheals are not without risk and should be used under medical supervision. Key safety points include:

Dosage and interactions: Adhering strictly to a prescribed dosage is critical to avoid serious side effects. High-dose loperamide, for example, has been linked to severe cardiac issues, especially when combined with interacting medications.
Underlying cause: Treating diarrhea with an antidiarrheal without first identifying the cause can be dangerous. For instance, using motility-slowing drugs for an infectious diarrhea with fever or bloody stool can prolong the infection by preventing the body from clearing the pathogen.
Dependence: Opioid-related antidiarrheals like diphenoxylate and loperamide have a potential for dependence, though loperamide’s is lower at standard doses.
Diagnosis: A thorough medical history and proper diagnosis are necessary before prescribing medication, especially for chronic diarrhea, where the cause could be anything from infections to inflammatory conditions.

Conclusion

In conclusion, yes, a number of prescription drugs are available to stop diarrhea, especially when it is chronic, severe, or tied to a specific medical condition. Unlike general OTC symptom relievers, these prescription options target underlying issues, such as bacterial overgrowth in IBS-D or the gut inflammation in Crohn's disease. Patients should always consult a healthcare provider to determine the root cause of their diarrhea and receive an appropriate, safe treatment plan. Proper diagnosis is crucial to avoid potentially serious complications from improper medication use. For more information on managing diarrhea, consult reliable medical resources like the Mayo Clinic.

Frequently Asked Questions

Yes, Imodium (loperamide) is available in both over-the-counter (OTC) and higher-strength prescription forms. Prescription loperamide may be used for managing chronic diarrhea, particularly that associated with inflammatory bowel disease.

Lomotil (diphenoxylate with atropine) is a prescription-only antidiarrheal that works by slowing gut motility, similar to Imodium, but contains a small amount of atropine to discourage abuse. Imodium is available over-the-counter, though higher-strength loperamide requires a prescription.

Opioid-related antidiarrheals like diphenoxylate/atropine and high-dose loperamide have a potential for dependence and abuse, which is why their use is carefully monitored. The atropine in Lomotil is specifically included to deter misuse.

Rifaximin (Xifaxan) is a non-absorbed oral antibiotic prescribed for specific conditions like irritable bowel syndrome with diarrhea (IBS-D) and traveler's diarrhea caused by non-invasive E. coli.

Yes, chronic diarrhea from Crohn's disease may be managed with prescription antidiarrheal agents like higher-dose loperamide or diphenoxylate with atropine. A doctor will select the appropriate medication based on the specific symptoms and severity.

Risks include constipation, dizziness, and nausea. Serious side effects, such as dangerous cardiac arrhythmias, can occur with misuse of high doses of loperamide. There is also a risk of worsening infections if used in cases of bacterial or parasitic diarrhea with fever or bloody stool.

You should see a doctor if your diarrhea lasts for more than a few days, or if you experience severe abdominal pain, fever, bloody stools, or signs of dehydration. These symptoms may indicate an underlying condition or infection requiring prescription treatment.