diphenoxylate and atropine, Lomotil (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Taking diphenoxylate with alcohol 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).

PREGNANCY: Adequate studies of diphenoxylate in pregnant women have not been done, so diphenoxylate should be used during pregnancy only when clearly needed.

NURSING MOTHERS: Diphenoxylic acid, a metabolite of diphenoxylate (that is, diphenoxylate that has been changed chemically by the body) is excreted into breast milk, as is atropine. Although there have not been problems reported in the infants of women who breastfeed, the benefits to the mother should be weighed against the potential risks to the nursing infant.

SIDE EFFECTS: The most common side effects reported in persons taking diphenoxylate include drowsiness, headache, nausea or vomiting, and dry mouth. Euphoria, depression, lethargy, restlessness, numbness of extremities, loss of appetite, and abdominal pain or discomfort have been reported less frequently. Although the dose of atropine in Lomotil is too low to cause side effects when taken in the recommended doses, side effects of atropine (including dryness of the skin and mucous membranes, increased heart rate, urinary retention, and increased body temperature) have been reported, particularly in children under two years of age and children with Down syndrome. Pancreatitis and toxic megacolon also have been reported.

Reference: FDA Prescribing Information


Last Editorial Review: 3/19/2012



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