Diphenoxylate Hydrochloride / Atropine Sulfate
Pronouncation: (die-fen-OX-ih-late HIGH-droe-KLOR-ide/AT-troe-peen SULL-fate)Class: Antidiarrheal
Trade Names:
Logen
- Tablets 2.5 mg diphenoxylate hydrochloride and 0.025 mg atropine sulfate
Trade Names:
Lomanate
- Liquid 2.5 mg diphenoxylate hydrochloride and 0.025 mg atropine sulfate per 5 mL
Trade Names:
Lomotil
- Liquid 2.5 mg diphenoxylate hydrochloride and 0.025 mg atropine sulfate per 5 mL
- Tablets 2.5 mg diphenoxylate hydrochloride and 0.025 mg atropine sulfate
Trade Names:
Lonox
- Tablets 2.5 mg diphenoxylate hydrochloride and 0.025 mg atropine sulfate
Pharmacology
Diphenoxylate, related to meperidine, decreases motility of GI tract. Atropine discourages deliberate overdosage of diphenoxylate.
Indications and Usage
Adjunctive therapy in treatment of diarrhea.
Contraindications
Obstructive jaundice; diarrhea associated with pseudomembranous enterocolitis or enterotoxin-producing bacteria; narrow-angle glaucoma; use in children younger than 2 yr of age.
Dosage and Administration
Tablets may be crushed and administered with fluid.
AdultsInitial dose: PO 5 mg 4 times daily. Individualize dose.
Children 2 to 12 yr of agePO 0.3 to 0.4 mg/kg/day in 4 divided doses.
Storage/Stability
Store in tightly closed, light-resistant container at room temperature.
Drug Interactions
Alcohol, barbiturates, CNS depressants, tranquilizersMay increase depressant action
MAOIsMay precipitate hypertensive crisis.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Tachycardia.
CNS
Dizziness; drowsiness; sedation; headache; malaise; lethargy; restlessness; euphoria; depression; numbness of extremities; confusion.
Dermatologic
Pruritus; angioneurotic edema; urticaria; dry skin and mucous membranes; flushing.
GI
Dry mouth; anorexia; nausea; vomiting; abdominal discomfort; paralytic ileus; toxic megacolon; pancreatitis; constipation.
Genitourinary
Urinary retention.
Miscellaneous
Swelling of gums; anaphylaxis; hyperthermia.
Precautions
MonitorAssess frequency and consistency of stools before and throughout therapy. Monitor for signs of dehydration and toxic megacolon. |
Pregnancy
Category B .
Lactation
Excreted in breast milk.
Children
Contraindicated in children younger than 2 yr of age. Greater risk of atropinism, especially with Down syndrome.
Hepatic Function
Use with extreme caution; may precipitate hepatic coma.
Diarrhea
Do not give for diarrhea associated with organisms that penetrate the intestinal mucosa (ie, Salmonella , Shigella ), acute Crohn disease or pseudomembranous colitis caused by antibiotic therapy. Notify health care provider and discontinue therapy for abdominal distention or other untoward symptoms.
Fluid/electrolyte imbalance
Dehydration may contribute to adverse effects, especially in young children. If dehydration or electrolyte imbalance occurs, may need to discontinue therapy until condition is corrected.
Overdosage
Symptoms
Dry skin and mucous membranes, mydriasis, restlessness, flushing, hyperthermia, tachycardia, lethargy, coma, nystagmus, pinpoint pupils, respiratory depression.
Patient Information
- Advise patient to continue taking drug until diarrhea has stopped for 24 to 36 h. Discontinuing medication earlier may result in relapse or return of diarrhea.
- Instruct patient to notify health care provider if fever and palpitations occur or when diarrhea persists or becomes malodorous or bloody.
- Tell patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
- Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
- Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
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