Medication Guide App

Diphenoxylate Hydrochloride / Atropine Sulfate

Pronunciation

Pronunciation: 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

Lomanate
- Liquid 2.5 mg diphenoxylate hydrochloride and 0.025 mg atropine sulfate per 5 mL

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

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.

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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.

Adults

Initial dose: PO 5 mg 4 times daily. Individualize dose.

Children 2 to 12 yr of age

PO 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, tranquilizers

May increase depressant action

MAOIs

May 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

Monitor

Assess 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.

Copyright © 2009 Wolters Kluwer Health.

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