diphenoxylate and atropine, Lomotil

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

woman with abdominal pain

Other important side effects include:

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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets (2.5 mg diphenoxylate and 0.025mg atropine); liquid (2.5mg diphenoxylate and 0.025mg atropine per teaspoonsful).

STORAGE: Lomotil should be stored at room temperature, 15-30 C (59- 86 F).

DOSING: In adults, the usual dose is 5 mg (2 tablets) of diphenoxylate three to four times per day initially. Thereafter, the dose may be decreased to 2.5 mg (1 tablet) two to three times a day. The dose for children (2 to 12 years old) is 0.3 to 0.4 mg/kg/day in four divided doses. If diarrhea is not better within 48 hours, diphenoxylate is not likely to be effective with more prolonged treatment.

DRUG INTERACTIONS: 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).

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.

Medically Reviewed by a Doctor on 9/10/2015

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