1 What Is Lomotil?

Brand: Lomotil

Generic: Diphenoxylate + Atropine

Lomotil is an effective drug that is a combination of two others, generally diphenoxylate and atropine. The drug is used mainly to treat acute diarrhea, which is also called diarrhea of limited duration. Diphenoxylate is a sedative that is chemically related to meperidine. Like many other sedatives, diphenoxylate works effectively and controls diarrhea with the help of propulsion of intestinal contents through the intestines. Although diphenoxylate is chemically related to sedatives, it does not reduce pain, as it is does not have the chemicals for it. 


Approved by the FDA

Like many other medications, diphenoxylate can be abused for euphoria (elevation of mood) along with physical dependence. In order to prevent abuse of diphenoxylate, atropine is combined with diphenoxylate in small quantities. Positive results are possible if Lomotil is taken exactly as per instructions. If the drug is taken at a larger dosage, it can have unpleasant side effects due to the greater quantity of atropine. Lomotil was tested and approved by the FDA in the year 1960. Brand names available for diphenoxylate and atropine are Lomotil, Lofene, and Lonox; diphenoxylate and atropine are the generic names. A prescription is needed for drugs like diphenoxylate and atropine. Diphenoxylate and atropine are highly effective, but have certain side effects, so one has to be careful while taking them. The drugs should be taken under medical supervision, and one should consult a doctor in case of an emergency. The common side effects are:

Other important side effects include:

  • Feeling of excitement
  • Sleepiness
  • Increasing impatience
  • Numbness in the extremities
  • Memory loss
  • Reduced appetite
  • Severe abdominal pain

The dosage of atropine in Lomotil is not enough to cause any side effects on its own. When the medicine is taken at the recommended dose, the side effects of atropine may include dryness of the skin and mucous membranes. It also increases heart rate, body temperature, and urinary retention. These are the common side effects, and they are mainly observed in children under two years of age who suffer from down syndrome. Children may also suffer pancreatitis and toxic megacolon, which have been reported.

Most adults take about 5mg, or 2 tablets, of diphenoxylate as a dose. The medication should be taken at least three to four times per day, initially. The dosage can be reduced to 2.5mg, or 1 tablet, taken two to three times a day. The dosage for children ages 2 to 12 years can be 0.3 to 0.4 mg/kg/day and is divided into four doses. If the diarrhea is not controlled within forty-eight hours, diphenoxylate is not likely to be effective with prolonged use. 

Combination of Medicines

The combination of diphenoxylate and monoamine oxidase inhibitors (MAOs) includes isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). These will help control symptoms such as severe high blood pressure with the possibility of a cerebrovascular accident or stroke. The drugs can also increase the propulsion of intestinal contents, which, theoretically, can reduce the effectiveness of diphenoxylate. Such drugs include bethanechol (Urecholine), cisapride (Propulsid), metoclopramide (Reglan), and erythromycin.

Drugs can decrease the propulsion of intestinal contents and may overstress the effects of diphenoxylate, which can cause constipation. These drugs include hyoscyamine (Levsin; Cystospaz), antihistamines, hydroxyzine (Vistaril, Atarax) and opiate agonists such as oxycodone (Percocet), diphenhydramine (Benadryl), and hydrocodone (Vicodin, Norco, etc.). Phenothiazine antipsychotics like chlorpromazine (Thorazine), thioridazine (Mellaril), and triflupromazine (Stelazine), some tricyclic antidepressants, as well as amitriptyline (Elavil, Endep), amoxapine (Asendin), clomipramine (Anafranil), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil) are the various medications which are part of the medication combination with diphenoxylate. 

Most doctors will suggest the treating medication based on the causal condition. Not all forms of medications may be available for all the different conditions. One should discuss the problem or the side effects you face while consuming the medications. Always talk to a doctor before deciding to take any medication. In case of an emergency, consult a doctor. Even if you experience any of the side effects, you should continue to take the medicines. Talk to your doctor and make sure you are taking the medicine correctly, under the doctor’s supervision.

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