Drug-induced diarrhea
Diarrhea associated with medicinesDrug-induced diarrhea is loose, watery stools that occurs when you take certain medicines.
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Causes
Nearly all medicines may cause diarrhea as a side effect. The drugs listed below, however, are more likely to cause diarrhea.
Laxatives are meant to cause diarrhea.
- They work either by drawing water into the gut or by causing the muscles of the intestines to contract.
- However, taking too much of a laxative can cause diarrhea that is a problem.
Antacids that have magnesium in them may also cause diarrhea or make it worse.
Antibiotics also can produce diarrhea.
- Normally, the intestines have many different bacteria. They keep each other in balance. Antibiotics destroy some of these bacteria, which allow other types to grow too much.
- In some cases, antibiotics can allow a type of bacteria called Clostridioides difficile to grow too much. This can lead to severe, watery, and often bloody diarrhea called pseudomembranous colitis.
Many other drugs may cause diarrhea:
- Chemotherapy medicines used to treat cancer.
- Drugs used to treat heartburn and stomach ulcers, such as omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid). This is uncommon.
- Medicines that suppress the immune system (such as mycophenolate).
- Nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat pain and arthritis, such as ibuprofen and naproxen.
- Metformin used to treat diabetes.
Some herbal teas contain senna or other "natural" laxatives that can cause diarrhea. Other vitamins, minerals, or supplements may also cause diarrhea.
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Prevention
To prevent diarrhea due to antibiotic use, talk to your health care provider about taking supplements containing healthy bacteria (probiotics) and/or eating yogurt. Some of these products may reduce the risk for diarrhea. Keep taking these supplements for a few days after you finish your antibiotics.
References
Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 16.
Seller RH, Symons AB. Diarrhea. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 10.
Siddiqi HA, Rabinowitz S, Axiotis CA. Laboratory diagnosis of gastrointestinal and pancreatic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 23.