- Does Lomotil (diphenoxylate and atropine) cause side effects?
- What are the important side effects of Lomotil (diphenoxylate and atropine)?
- Lomotil (diphenoxylate and atropine) side effects list for healthcare professionals
- What drugs interact with Lomotil (diphenoxylate and atropine)?
- Does Lomotil (diphenoxylate and atropine) cause addiction or withdrawal symptoms?
Does Lomotil (diphenoxylate and atropine) cause side effects?
Lomotil (diphenoxylate and atropine) is a combination of a man-made narcotic and an anticholinergic used to treat acute diarrhea (diarrhea of limited duration).
Like other narcotics, 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.
Common side effects of Lomotil include
- dry mouth,
- numbness of extremities,
- loss of appetite, and
- abdominal pain.
Serious side effects of Lomotil include
- pancreatitis and
- toxic megacolon.
Drug interactions of Lomotil include monoamine oxidase inhibitors (MAO's) because the combination can cause severe high blood pressure with the possibility of a cerebrovascular accident (stroke).
- Drugs which increase the propulsion of intestinal contents such as bethanechol, cisapride, metoclopramide, and erythromycin theoretically can reduce the effectiveness of diphenoxylate.
- Drugs which decrease the propulsion of intestinal contents such as hyoscyamine, antihistamines, opiate agonists, some phenothiazine antipsychotics, and some tricyclic antidepressants may exaggerate the effects of diphenoxylate and cause constipation.
- Taking diphenoxylate with alcohol or other chemicals or medications that can depress the central nervous system such as barbiturates, benzodiazepines, zolpidem, narcotics, and tricyclic antidepressants may cause excessive sedation.
Adequate studies of diphenoxylate in pregnant women have not been done, so diphenoxylate should be used during pregnancy only when clearly needed.
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.
What are the important side effects of Lomotil (diphenoxylate and atropine)?
The most common side effects reported in persons taking diphenoxylate include:
Other important side effects include:
- numbness of extremities,
- loss of
- appetite, and
- abdominal pain.
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.
Lomotil (diphenoxylate and atropine) side effects list for healthcare professionals
The following serious adverse reactions are described elsewhere in labeling:
- Respiratory and/or CNS depression
- Anticholinergic and opioid-toxicities, including atroponism
- Dehydration and electrolyte imbalance
- GI Complications in patients with infectious diarrhea
- Toxic megacolon in patients with acute ulcerative colitis
At therapeutic doses of Lomotil, the following other adverse reactions have been reported; they are listed in decreasing order of severity, but not of frequency:
- Nervous system: numbness of extremities, euphoria, depression, malaise/lethargy, confusion, sedation/drowsiness, dizziness, restlessness, headache, hallucination
- Allergic: anaphylaxis, angioneurotic edema, urticaria, swelling of the gums, pruritus
- Gastrointestinal system: megacolon, paralytic ileus, pancreatitis, vomiting, nausea, anorexia, abdominal discomfort
The following adverse reactions related to atropine sulfate are listed in decreasing order of severity, but not of frequency:
- urinary retention,
- dryness of the skin and mucous membranes.
What drugs interact with Lomotil (diphenoxylate and atropine)?
- Alcohol may increase the CNS depressant effects of Lomotil and may cause drowsiness. Avoid concomitant use of Lomotil with alcohol.
Other Drugs That Cause CNS Depression
- The concurrent use of Lomotil with other drugs that cause CNS depression (e.g., barbiturates, benzodiazepines, opioids, buspirone, antihistamines, muscle relaxants), may potentiate the effects of Lomotil.
- Either Lomotil or the other interacting drug should be chosen, depending on the importance of the drug to the patient.
- If CNS-acting drugs cannot be avoided, monitor patients for CNS adverse reactions.
- Diphenoxylate may interact with monoamine oxidase inhibitors (MAOIs) and precipitate a hypertensive crisis.
- Avoid use of Lomotil in patients who take MAOIs and monitor for signs and symptoms of hypertensive crisis (headache, hyperthermia, hypertension).
Does Lomotil (diphenoxylate and atropine) cause addiction or withdrawal symptoms?
Drug Abuse And Dependence
- Lomotil is classified as a Schedule V controlled substance by federal regulation. Diphenoxylate hydrochloride is chemically related to the narcotic analgesic meperidine.
Drug Abuse And Dependence
- In doses used for the treatment of diarrhea, whether acute or chronic, diphenoxylate has not produced addiction.
- Diphenoxylate hydrochloride is devoid of morphine-like subjective effects at therapeutic doses.
- At high doses it exhibits codeine-like subjective effects.
- The dose which produces antidiarrheal action is widely separated from the dose which causes central nervous system effects.
- The insolubility of diphenoxylate hydrochloride in commonly available aqueous media precludes intravenous self-administration.
- A dose of 100 to 300 mg/day, which is equivalent to 40 to 120 tablets, administered to humans for 40 to 70 days, produced opiate withdrawal symptoms.
- Since addiction to diphenoxylate hydrochloride is possible at high doses, the recommended dosage should not be exceeded.
Lomotil (diphenoxylate and atropine) is a combination of a man-made narcotic and an anticholinergic used to treat acute diarrhea (diarrhea of limited duration). Common side effects of Lomotil include drowsiness, headache, nausea, vomiting, dry mouth, euphoria, depression, lethargy, restlessness, numbness of extremities, loss of appetite, and abdominal pain. Adequate studies of diphenoxylate in pregnant women have not been done, so diphenoxylate should be used during pregnancy only when clearly needed. 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.
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Stomach Flu (Gastroenteritis)
Stomach flu (gastroenteritis) is a term referred used to describe a variety of gastrointestinal problems. The most common signs and symptoms of gastroenteritis are nausea, vomiting, diarrhea, and abdominal pain. The most common cause of gastroenteritis in the United States is Norovirus. Other causes of gastroenteritis include Rotavirus, Astrovirus, Adenovirus, and Sapovirus. There are bacterial causes of gastroenteritis such as Salmonella, Shigella, Campylobacter Aeromonas, E. coli, Clostridium, Vibrio, Campylobacter, and Yersinia spp. Parasites that cause gastroenteritis include Giardia, Cryptosporidium, Cyclospora, and Entamoeba. Treatment for gastroenteritis is generally home remedies such as keeping hydrated to prevent dehydration. At times, hospitalization may be necessary if dehydration occurs.
Stomach Flu vs. Food Poisoning
The stomach flu (viral gastroenteritis) and food poisoning are not the same infections. However, they do have a few similar symptoms, for example: Nausea Vomiting Diarrhea Fever Abdominal (stomach) pain and cramping. Symptoms and signs of food poisoning show up earlier (2 hours up to a couple of days) in comparison to the stomach flu in which symptoms may take 4 hours up to 48 hours (2 days) before symptoms begin. Medical treatment for the stomach flu and food poisoning generally is not necessary. A bland diet, drinking plenty of fluids, and rest may be the only treatment necessary.
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Stomach pains are a common human ailment, but stomach pains that wake you up at night should be taken seriously. Learn about stomach pains, their causes, and how to treat them. An upset stomach is most likely to get better with simple home remedies, such as drinking the following herbal beverages.
Peptic Ulcer (Stomach Ulcer)
Peptic or stomach ulcers are ulcers in the lining of the stomach, duodenum, or esophagus. Learn about symptoms, causes, diet, and treatment.
Is it Normal to Bloat Every Day?
What is bloating in the stomach is it normal to have it daily? Learn the signs and causes of stomach bloating and what to do if your abdomen is distended.
What Settles an Upset Stomach Quickly?
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Is the Stomach Flu Contagious?
The stomach flu or gastroenteritis is caused by bacteria, viruses, and parasites. Symptoms include vomiting, diarrhea, nausea, and abdominal pain. Learn about how it is spread and how you can prevent infection.
IBS-D (Irritable Bowel Syndrome with Diarrhea)
IBS-D or irritable bowel syndrome with diarrhea refers to IBS with diarrhea. Symptoms of IBS-D include intestinal gas (flatulence), loose stools, frequent stools, abdominal pain, diarrhea, and nausea. New non-FDA approved IBS tests may help diagnose IBS and IBS-D. Treatment of IBS-D is geared to toward managing symptoms with diet, medication, and lifestyle changes.
Are Sharp Pains in Your Stomach Normal During Pregnancy?
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How Do You Stop Stomach Cramps?
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How Long Does the Stomach Flu Last?
Stomach flu or viral gastroenteritis is an infection caused by a virus that infects your stomach. Although the term has flu in it, it is not a true flu. Symptoms that include vomiting and diarrhea, fever and stomach pain can last for one to three days depending on the cause. Diarrhea may persist longer, for up to 10 days, after the disappearance of other symptoms.
How Do You Get Rid of Diarrhea?
Diarrhea is characterized as loose or runny stools that happen an abnormally high number of times throughout the day. Diarrhea can be linked to autoimmune diseases like Crohn’s or irritable bowel syndrome but is more often a sign of food intolerance (lactose is common), viral infection, food poisoning or other infectious diseases of varying severity.
How Do You Know if You Have a Stomach Ulcer?
Stomach ulcer or gastric ulcer is a painful open sore that develops on the lining of your stomach due to the damage to the inner stomach lining. This is a type of peptic ulcer disease. Stomach ulcers often can be easily cured; however, it can be fatal if not treated properly. It occurs mostly in men are than in women.
Stomach Pain: Causes, Types and Prevention
Sometimes, you may have pain/discomfort in a particular part of your belly or all over the belly for a short or long period of time. Stomach pain may result from a variety of conditions including irritable bowel syndrome, inflammatory bowel disease, food allergies, constipation, stomach flu, gallstones, kidney stones and a variety of other conditions.
Is It a Stomach Virus or Food Poisoning?
A stomach virus is also called stomach flu or gastroenteritis. It is a viral infection that infects the tummy and the gut. Food poisoning is also often called gastroenteritis and may present symptoms like stomach virus/stomach flu. However, food poisoning is caused by consuming food or drinks that may be contaminated with bacteria.
How Do I Get Rid of the Stomach Flu?
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What Can Diarrhea Be a Sign Of?
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Treatment & Diagnosis
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Medications & Supplements
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.
Professional side effects, drug interactions, and addiction sections courtesy of the U.S. Food and Drug Administration.