Meds and you

Updated 11 February 2013

Diphenoxylate and atropine

This combination reduces gastrointestinal motility, the ability of the digestive tract to propel its contents.

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Diphenoxylate and atropine are the active ingredients in Lomotil.

General information

This combination reduces gastrointestinal motility, the ability of the digestive tract to propel its contents. It is commonly used for the short-term management of mild to moderate diarrhoea. It should be used in combination with – and not as a substitute for – oral rehydration solutions to ensure adequate fluid and electrolyte intake.

If used to treat acute diarrhoea, treatment with this combination should be continued for 24-36 hours before it can be deemed ineffective. If diarrhoea persists or worsens, the medication should be stopped and a doctor consulted.

How does it work?

This medication increase the transit time of intestinal contents. This prolonged transit time leads to an increased absorption of fluid throughout the intestinal tract, thereby relieving diarrhoea.

Fast facts

Drug schedule: Schedule 2

Available as: Tablets

What does it do? This combination has an anti-diarrhoeal effect

Overdose risk: Medium

Dependence risk: Low

Available as a generic ? No

Available on prescription only ? No

User information

Onset of effect: Within 2 hours

Duration of action: Up to 6 hours

Stopping this medicine: This medication can be safely stopped when no longer needed

Prolonged use: Physical dependence and tolerance to the anti-diarrhoeal effect may result.

Special precautions

Consult your doctor before using this drug if:

  • you have inflammatory bowel disease such as ulcerative colitis
  • you have an enlarged prostate
  • you have glaucoma
  • you have a thyroid disorder
  • you have liver or kidney disease
  • you have obstructive bowel disorder
  • you have myasthenia gravis
  • you have congestive heart failure
  • you have a history of respiratory conditions
  • you are taking any other medication

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Safe to use.

Infants and children: Not intended for use in children under the age of 4.

Elderly: Caution \ and a lower dose is advised as side effects may be more common.

Driving and hazardous work: Caution is advised as use may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Dry mouth

x

x

Sedation/ drowsiness

x

x

Confusion

x

x

Nausea/vomiting

x

x

Dizziness

x

x

Abdominal discomfort

x

x

Constipation

x

x

Loss of appetite

x

x

Flushing

x

x

Lethargy

x

x

Headache

x

x

Dilated pupils

x

x

Skin rash/ itch

x

x

Palpitations

x

x

Difficulty urinating

x

x

Swelling of gums

x

x

Euphoria

x

x

Depression

x

x

Difficulty breathing

x

x

Interactions

Drug interactions

Alcohol

Increased central nervous system depression

Barbiturates

Increased central nervous system depression

Drugs for anxiety

Increased central nervous system depression

Monoamine-oxidase inhibitors

Risk of dangerously high blood pressure

Drugs with anticholinergic effects

Increased anticholinergic effects (dry mouth, urinary retention, constipation, confusion in the elderly)

Digoxin

Risk of digoxin toxicity

Ketoconazole

Reduced effect of ketoconazole

Metoclopramide

Reduced effect of metoclopramide

Promethazine, chlorpromazine, haloperidol, imipramine

Increased anticholinergic effect

Sulphonamides

Risk of crystals forming in urine

Disease interactions

Consult your doctor before using this drug if you have inflammatory bowel disease such as ulcerative colitis, an enlarged prostate, glaucoma, a thyroid disorder, liver or kidney disease, obstructive bowel disorder, myasthenia gravis, congestive heart failure or if you have a history of respiratory conditions.

Overdose action

An overdose of this medication can be serious. Seek immediate emergency medical attention.

Recommended dosage

Adults: 10 mg at once followed by 5mg every 6 hours until diarrhoea is controlled.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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