Medications and Drugs
GENERIC NAME: diphenoxylate and atropine
BRAND NAME: Lomotil
DRUG CLASS AND MECHANISM: Lomotil is a combination of
two drugs,
diphenoxylate and atropine. It is used to treat acute diarrhea
(diarrhea
of limited duration). Diphenoxylate is a man-made narcotic
chemically
related to meperidine (Demerol). Diphenoxylate reduces diarrhea
by
interfering with the propulsion of intestinal contents through
the
intestines. Although diphenoxylate is chemically related to
narcotics, it
does not have pain- relieving (analgesic) actions like most
other
narcotics. In higher doses, However, like other narcotics,
diphenoxylate
can cause euphoria (elevation of mood) and physical dependence.
In order
to prevent abuse of diphenoxylate for its mood-elevating
effects, atropine
is combined with diphenoxylate in small quantities. As a
result, if
Lomotil is taken in greater than recommended doses unpleasant
side effects
from too much atropine will occur. Lomotil was approved by the
FDA in
1960.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: tablets (2.5mg diphenoxylate and 0.025mg
atropine); liquid (2.5mg diphenoxylate and 0.025mg atropine per
teaspoonsful).
STORAGE: Store at room temperature, 15-30°C (59-
86°F).
PRESCRIBED FOR: Lomotil is used for the relief of acute
diarrhea.
DOSING: In adults, the usual dose is 5 mg (2 tablets)
three to
four times per day initially. Thereafter, the dose may be
decreased to
2.5mg (1 tablet) two to three times a day. The dose for
children is based
on weight. If diarrhea is not better within 48 hours,
diphenoxylate is not
likely to be effective with more prolonged treatment.
DRUG INTERACTIONS:
Reduced effectiveness: The combination of
diphenoxylate and
monoamine oxidase inhibitors (MAO's) - for example,
isocarboxazid
(Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and
procarbazine (Matulane)] - can cause severe high blood pressure
with the
possibility of a cerebrovascular accident (stroke).
Constipation: Drugs which increase the propulsion of
intestinal
contents theoretically can reduce the effectiveness of
diphenoxylate. Such
drugs include bethanechol (Urecholine), cisapride (Propulsid),
metoclopramide (Reglan), and erythromycin. Drugs which decrease
the
propulsion of intestinal contents may exaggerate the effects of
diphenoxylate and cause constipation. Such drugs include
hyoscyamine
(Levsin; Cystospaz), antihistamines such as hydroxyzine
(Vistaril, Atarax)
and diphenhydramine (Benadryl), opiate agonists such as
oxycodone
(Percocet), hydrocodone (Vicodin), some phenothiazine
antipsychotics such
as chlorpromazine (Thorazine), thioridazine (Mellaril),
triflupromazine
(Stelazine), and some tricyclic antidepressants such as
amitriptyline
(Elavil), amoxapine (Asendin), clomipramine (Anafranil),
doxepin
(Sinequan), imipramine (Tofranil), nortriptyline (Pamelor),
protriptyline
(Vivactil), and trimipramine (Surmontil).
Sedation: Taking diphenoxylate with ethanol or other
chemicals
or medications that can depress the central nervous system may
cause
excessive sedation. Such drugs include barbiturates,
benzodiazepines, for
example, lorazepam (Ativan), diazepam (Valium), temazepam
(Restoril),
oxazepam (Serax), or clonazepam (Klonopin)], zolpidem (Ambien),
narcotics,
and tricyclic antidepressants (listed above).
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Diarrhea - Read the causes of diarrhea including infections, parasites, food poisoning, medications, IBS, IBD, cancer, endocrine disease, fat malabsorption, laxative abuse and more.
- Drugs: What You Should Know About Your Drugs - Find out what you should know about your drugs such as side effects, warnings and precautions, storage information, and if a generic version is as good as the brand name.
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