Diphenoxylate + Atropine (antidiarrheal agent)

Diphenoxylate + atropine is used to treat diarrhea. It helps to decrease the number and frequency of bowel movements. Diphenoxylate works by slowing the movement of the intestines. Diphenoxylate is similar to narcotic pain relievers, but it acts mainly to slow the gut. Atropine belongs to a class of drugs known as anticholinergics, which help to dry up body fluids and also slow gut movement.

Know the basics

What is diphenoxylate + atropine used for?

• Acute diarrhea
• Chronic diarrhea

How should I take diphenoxylate + atropine?

Read the directions on the packaging for complete information. Check the label and expiration date.

For oral tablets, swallow it whole without chewing, crushing, or dissolving it in liquid. Take it with or without meals.

For oral syrup or suspensions, shake the bottle well and measure the dose using the included measuring cup. Do not use a household spoon.

How do I store diphenoxylate + atropine?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using diphenoxylate + atropine?

Before using this drug, tell your doctor if you are/have:

• Pregnant or breastfeeding.
• Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
• An allergy to any of the ingredients of this product.
• Any other illnesses, disorders, or medical conditions.

Is it safe to take during pregnancy or breastfeeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. However, it is likely safe to take. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

This medication is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

• A=No risk
• B=No risk in some studies
• C=There may be some risk
• D=Positive evidence of risk
• X=Contraindicated
• N=Unknown

Know the side effects

What are the side effects of diphenoxylate + atropine?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

• Drowsiness, dizziness
• Headache
• Tired or restless feeling
• Nausea, vomiting
• Upset stomach
• Loss of appetite
• Skin rash or itching
• Stomach pain or bloating
• Ongoing or worsening diarrhea
• Diarrhea that is watery or bloody
• Numbness in your hands or feet
• Depressed mood
• Confusion, unusual thoughts or behavior
• Fast heart rate
• Urinating less than usual or not at all

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with diphenoxylate + atropine?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

• MAOIs **potentially fatal
• CNS depressants
• Anxiolytics

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with diphenoxylate + atropine?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Do not consume alcohol while taking this drug. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with diphenoxylate + atropine?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

• Alcoholism or dependency
• Drug addiction
• Colitis
• Down’s syndrome
• Dysentery
• Emphysema, asthma, bronchitis, or other chronic lung disease
• Enlarged prostate
• Urinary tract blockage or difficult urination
• Gallbladder disease or gallstones
• Glaucoma
• Heart disease
• Hiatal hernia
• High blood pressure (hypertension)
• Intestinal blockage
• Kidney disease
• Liver disease
• Myasthenia gravis
• Overactive or underactive thyroid
• Overflow incontinence

Understand the Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Diarrhea

Initially, 5 mg (2 tablets or 10mL) by mouth 4 times per day; discontinue as soon as possible. Do not exceed 20 mg/day PO. 

After initial control has been achieved, reduce dosage to meet individual requirements. Control may often be maintained with 2 tablets per day. Discontinue after 10 days if clinical improvement is not observed.

What is the dose for a child?

Diarrhea

Initially, 5 mg (2 tablets or 10mL) by mouth 4 times per day; discontinue as soon as possible. Do not exceed 20 mg/day PO. 

After initial control has been achieved, reduce dosage to meet individual requirements. Control may often be maintained with 2 tablets per day. Discontinue after 10 days if clinical improvement is not observed.

Not recommended for use in children aged 6 to 12 years old; never give to children under 6 years.

How is diphenoxylate + atropine available?

Diphenoxylate + atropine is available in the following dosage forms and strengths:

• Solution, Oral: Diphenoxylate Hydrochloride 2.5 mg and Atropine sulfate 0.025 mg per 5 mL (5 mL, 10 mL, 60 mL)
• Lomotil: Diphenoxylate hydrochloride 2.5 mg and Atropine sulfate 0.025 mg per 5 mL (60 mL)
• Tablet, Oral: 2.5 mg and Atropine sulfate 0.025 mg
• Lomotil: 2.5 mg and Atropine sulfate 0.025 mg per 5 mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

Symptoms of overdose may include the following:

• Dryness of the skin, nose, or mouth
• Dilation of pupils (black circles in the middle of the eyes)
• Uncontrollable eye movements
• Restlessness
• Flushing
• Fever
• Fast heart beat
• Decreased reflexes
• Excessive tiredness
• Difficulty breathing
• Loss of consciousness

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.