atropine/diphenoxylate (Lomotil, Lonox)

Introduction

2.5 mg diphenoxylate + 0.025 mg atropine per tab or 5 mL. DEA controlled substance. Class 5.

Indications

treatment of diarrhea

Contraindications

Caution:

• reduction in intestinal motility may be deleterious in diarrhea associated with Shigella, Salmonella, toxigenic E. coli, & pseudomembranous colitis due to broad-spectrum antibiotic use
• children may develop symptoms of atropine toxicity at recommended doses

Caution: patients with hepatic disease or renal disease.

pregnancy-category C

safety in lactation -

Dosage

• 2 tabs or 10 mL PO QID
• max: 8 tabs/day
• pediatrics: 0.3-0.4 mg/kg/day divided QID.

Tabs: (see above)

Solution: (oral) (60 mL).

Pharmacokinetics

elimination: liver

Adverse effects

• not common (1-10%)
  • paralytic ileus, respiratory depression, nervousness, restlessness, blurred vision, difficult urination, dry mouth, dizziness, drowsiness, headache, mental depression
• uncommon (< 1%)
  • stomach cramps, muscle cramps, nausea/vomiting, increased sweating, tachycardia, sedation, euphoria, weakness, pruritus, urticaria, pancreatitis, hyperthermia
• other
  • dry skin, mucous membranes & mouth

More general terms

• antidiarrheal combination

Components

• atropine (Atropair, Atropine-Care)
• diphenoxylate

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=64662
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=19650