Know the basics
What is diphenoxylate used for?
Diphenoxylate + atropine is used to treat diarrhea. It helps to decrease the number and frequency of bowel movements. Diphenoxylate works by slowing the movement of the intestines. Diphenoxylate is similar to narcotic 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.
How should I take diphenoxylate?
Take diphenoxylate + atropine by mouth, usually 4 times a day or as directed by your doctor. Dosage is based on your medical condition and response to therapy. In children, dosage is also based on weight. If you need to continue treatment once your diarrhea controlled, your doctor may direct you to lower your dosage. Do not increase your dose, take it more often, or use it for longer than prescribed.
A liquid formulation is available for use in children. Use only the dropper that comes with the bottle to carefully measure out each dose.
It is important that you drink the proper amount of fluids and minerals (electrolytes) to prevent loss of body water (dehydration). Tell your doctor immediately if you develop signs of dehydration (e.g., extreme thirst, decreased urination, muscle cramps, weakness, fainting). You may also need to change to a bland diet during this time to reduce irritation to your stomach/intestines. Consult your doctor or pharmacist for more information.
Diphenoxylate + atropine may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as stomach cramps, nausea, vomiting) may occur if you suddenly stop using diphenoxylate + atropine. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.
Inform your doctor if your condition does not improve after 2 days.
How do I store diphenoxylate?
Diphenoxylate + atropine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store diphenoxylate + atropine in the bathroom or the freezer. There may be different brands of diphenoxylate + atropine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush diphenoxylate + atropine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Know the precautions & warnings
What should I know before using diphenoxylate?
Before taking diphenoxylate + atropine ,
- tell your doctor and pharmacist if you are allergic to diphenoxylate + atropine , atropine, any other medications, or any of the other ingredients in diphenoxylate + atropine tablets or solution. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: barbiturates such as phenobarbital or secobarbital (Seconal); or tranquilizers. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar) or tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with diphenoxylate + atropine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
- tell your doctor if you have jaundice (yellowing of the skin or eyes caused by liver problems); bloody diarrhea; diarrhea along with a fever, mucus in your stool, or abdominal cramps, pain, or swelling; or diarrhea that happens during or shortly after taking antibiotics. Your doctor will probably tell you not to take diphenoxylate + atropine.
- tell your doctor if you have Down syndrome (an inherited condition causing a range of developmental and physical problems), or if you have or have ever had ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum), liver, or kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking diphenoxylate + atropine, call your doctor.
- before having surgery, including dental surgery, tell the doctor or dentist that you are taking this medicine.
- you should know that this drug may make you drowsy and dizzy. Do not drive a car or operate machinery until you know how this drug affects you.
- ask your doctor about the safe use of alcoholic beverages while you are taking diphenoxylate + atropine . Alcohol can make the side effects from diphenoxylate + atropine
Is it safe to take diphenoxylate during pregnancy or breast-feeding?
There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category C according to the US Food and Drug Administration (FDA).
FDA pregnancy risk category reference below:
- A=No risk,
- B=No risk in some studies,
- C=There may be some risk,
- D=Positive evidence of risk,
Know the side effects
What are the side effects of diphenoxylate?
Common side effects include drowsiness, dizziness, headache, tiredness, blurred vision, dry mouth, and loss of appetite.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using this medication and call your doctor at once if you have any of these serious side effects:
- Stomach pain or bloating;
- Ongoing or worsening diarrhea;
- Diarrhea that is watery or bloody;
- Numbness in your hands or feet;
- Depressed mood;
- Confusion, unusual thoughts or behavior;
- Fast heart rate;
- Urinating less than usual or not at all.
Less serious side effects may include:
- Drowsiness, dizziness, headache;
- Tired or restless feeling;
- Nausea, vomiting, upset stomach, loss of appetite;
- Skin rash, or itching.
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
Know the interactions
What drugs may interact with diphenoxylate?
Diphenoxylate + atropine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Ambenonium, Naltrexone, Potassium.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acrivastine, Buprenorphine, Bupropion, Carbinoxamine, Clorgyline, Digoxin, Fentanyl, Furazolidone, Hydrocodone, Iproniazid, Isocarboxazid, Meclizine, Methadone, Moclobemide, Morphine, Morphine Sulfate Liposome, Nialamide, Oxycodone, Oxymorphone, Pargyline, Phenelzine, Procarbazine, Rasagiline, Selegiline, Sodium Oxybate, Suvorexant, Tapentadol, Toloxatone, Tranylcypromine, Umeclidinium.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Arbutamine, Perampanel.
Does food or alcohol interact with diphenoxylate?
Diphenoxylate + atropine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with diphenoxylate?
Diphenoxylate + atropine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:
- Alcohol abuse (or history of);
- Drug abuse (history of)—There is a greater chance that this medicine will become habit-forming;
- Colitis (severe)—A more serious problem of the colon may develop if you use this medicine;
- Down’s syndrome—Side effects may be more likely and severe in these patients;
- Dysentery—This condition may get worse; a different kind of treatment may be needed;
- Emphysema, asthma, bronchitis, or other chronic lung disease—There is a greater chance that this medicine may cause serious breathing problems in patients who have any of these conditions.
- Enlarged prostate;
- Urinary tract blockage or difficult urination—Severe problems with urination may develop with the use of this medicine.
- Gallbladder disease or gallstones—Use of this medicine may cause spasms of the biliary tract and make the condition worse.
- Glaucoma—Severe pain in the eye may occur with the use of this medicine; however, the chance of this happening is small.
- Heart disease—This medicine may have some effects on the heart, which may make the condition worse.
- Hiatal hernia—The atropine in this medicine may make this condition worse; however, the chance of this happening is small.
- High blood pressure (hypertension)—The atropine in this medicine may cause an increase in blood pressure; however, the chance of this happening is small.
- Intestinal blockage—This medicine may make the condition worse.
- Kidney disease—The atropine in this medicine may build up in the body and cause side effects.
- Liver disease—The chance of central nervous system (CNS) side effects, including coma, may be greater in patients who have this condition.
- Myasthenia gravis—This medicine may make the condition worse.
- Overactive or underactive thyroid—Unwanted effects on breathing and heart rate may occur.
- Overflow incontinence—This medicine may make the condition worse.
Understand the Dosage
The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before using this medication.
What is the dose of diphenoxylate + atropine for an adult?
Usual Adult Dose for Diarrhea
Initial dose: 2 tablets (or 10 mL of liquid) orally 4 times a day.
Maintenance dose: 2 tablets (or 10 mL of liquid) once a day.
What is the dose of diphenoxylate + atropine for a child?
Usual Pediatric Dose for Diarrhea
>= 2 years, < 3 years: 1.5 to 3 mL orally 4 times a day
>= 3 years, < 4 years: 2 to 3 mL orally 4 times a day
>= 4 years, < 5 years: 2 to 4 mL orally 4 times a day
>= 5 years, <6 years: 2.5 to 4.5 mL orally 4 times a day
>= 6 years, < 9 years: 2.5 to 5 mL orally 4 times a day
>= 9 years, < 13 years: 3.5 to 5 mL orally 4 times a day
>= 13 years, < 18 years: 10 mL orally 3 times a day, or 2 tablets orally 3 times a day
as low as one-fourth of the initial daily dose.
The liquid formulation should be used for children under 13 years of age.
How is diphenoxylate + atropine available?
Diphenoxylate + atropine is available in the following dosage forms and strengths:
- Solution, Oral: Diphenoxylate Hydrochloride 2.5 mg and Atropine sulfate 0.025 mg per 5 mL (5 mL, 10 mL, 60 mL)
- Lomotil: Diphenoxylate hydrochloride 2.5 mg and Atropine sulfate 0.025 mg per 5 mL (60 mL)
- Tablet, Oral: 2.5 mg and Atropine sulfate 0.025 mg
- Lomotil: 2.5 mg and Atropine sulfate 0.025 mg per 5 mL
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.
Symptoms of overdose may include the following:
- Dryness of the skin, nose, or mouth;
- Changes in the size of pupils (black circles in the middle of the eyes);
- Uncontrollable eye movements;
- Fast heart beat;
- Decreased reflexes;
- Excessive tiredness;
- Difficulty breathing;
- Loss of consciousness.
What should I do if I miss a dose?
If you miss a dose of diphenoxylate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017
Diphenoxylate. http://www.webmd.com/drugs/2/drug-2326/diphenoxylate- atropine-oral/details. Accessed July 16, 2016.
Diphenoxylate. https://www.drugs.com/mtm/atropine-and- diphenoxylate.html. Accessed July 16, 2016.
Diphenoxylate. http://www.mayoclinic.org/drugs-supplements/diphenoxylate- and-atropine- oral-route/description/drg-20061751. Accessed July 16, 2016.