Lomotil (diphenoxylate HCl/atropine sulfate)

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Last reviewed · Source: First Databank (FDB) drug data

Overview

Diphenoxylate hydrochloride, a synthetic phenylpiperidine-derivative opiate agonist, is an antiperistaltic antidiarrhea agent.

USES: This medication is used to treat diarrhea. It helps to decrease the number and frequency of bowel movements. It works by slowing the movement of the intestines.

Diphenoxylate is similar to opioid 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. This medication should not be used to treat diarrhea caused by certain types of infection (such as C. difficile-associated diarrhea following antibiotic therapy).

Talk to your doctor for more details. This medication is not recommended for use in children younger than 6 years due to an increased risk of serious side effects (such as breathing problems).

Generic name: diphenoxylate HCl/atropine sulfate
Pronunciation: (DYE-fen-OX-i-late/AT-roe-peen)

Reference product & biosimilars

No reference, biosimilar or interchangeable associated with this drug.

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Indications

The following indications are listed for Lomotil:

  • Diarrhea

Dosing

Dosage of diphenoxylate preparations is expressed in terms of diphenoxylate hydrochloride. In antidiarrheal efficacy, 2.5 mg of the drug is equivalent to about 5 mL of paregoric.

The initial adult dosage of diphenoxylate hydrochloride for treatment of diarrhea is 5 mg 4 times daily. The initial dosage of diphenoxylate hydrochloride in children 13-16 years of age is 5 mg 3 times daily. The initial dosage in children 2-12 years of age is 0.3-0.4 mg/kg daily, given in 4 divided doses. Approximate initial dosages for children 2-12 years of age based on patient weight are as follows (see Table):

Table. Initial Dosages for Pediatric Patients 2-12 Years of Age.

Age Approximate Weight Dosage of diphenoxylate hydrochloride in mg (mL of oral solution) 2 years 11-14 kg 0.75-1.5 mg (1.5-3 mL) 4 times daily 3 years 12-16 kg 1-1.5 mg (2-3 mL) 4 times daily 4 years 14-20 kg 1-2 mg (2-4 mL) 4 times daily 5 years 16-23 kg 1.25-2.25 mg (2.5-4.5 mL) 4 times daily 6-8 years 17-32 kg 1.25-2.5 mg (2.5-5 mL) 4 times daily 9-12 years 23-55 kg 1.75-2.5 mg (3.5-5 mL) 4 times daily

Pediatric dosage schedules are approximations of an average dosage recommendation and should be adjusted downward according to overall nutritional status and degree of dehydration. Use in children younger than 2 years of age is not recommended. (See Cautions: Pediatric Precautions.)

Recommended adult and pediatric dosages of diphenoxylate hydrochloride should not be exceeded. Dosage should be continued at initial levels until symptoms are controlled and then reduced for maintenance as required. Maintenance dosage may be as low as one-fourth (e.g., 5 mg daily in adults) the initial daily dosage. If no clinical improvement of acute diarrhea in adult or pediatric patients occurs within 48 hours, the drug is not likely to be effective. If no clinical improvement of chronic diarrhea occurs following treatment for 10 days with a maximum dosage of 20 mg daily in adults, symptoms are unlikely to be controlled by further administration of the drug.

Drug interactions

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Contraindications

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Adverse reactions

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Precautions

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ICD codes

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Last reviewed · Source: First Databank (FDB) drug data