| Drug Index |
| GENERIC NAME : |
| diphenoxylate |
| BRAND NAMES : |
| Lomotil, Lofene, Logen, Lomanate, Lonox (all containing 2.5 mg diphenoxylate combined with 0.0025 mg atropine sulphate) |
| STREET NAMES : |
| BRIEF DESCRIPTION : |
| Diphenoxylate, a drug that is related to meperidine, decreases motility of gastrointestinal tract. It is considered a mild opiate. Plasma peak concentration on average is achieved 2 hours after a 2.5 mg dose. The elimination half-life is approximately 12 to 14 hours. After oral administration, 4% of the drug plus its metabolites was excreted in the urine and 49% in the feces over a four-day period. Atropine discourages deliberate overdosage of diphenoxylate |
| INDICATIONS FOR USE : |
| Adjunctive therapy in treatment of diarrhea. |
| ABUSE AND ADDICTIVE POTENTIAL : |
| Diphenoxylate is not known to be addictive at the recommended therapeutic dosage. But at high doses it produces a "codeine-like" effect. If taken at higher than recommended doses, it can be abused for its euphoric ("high") effect. When taken for more than a couple weeks at higher than recommended dosages, it can have the same addictive potential as other opiates and when stopped abruptly can produce withdrawal symptoms similar to withdrawal from other opiates. |
| OVERDOSAGE : |
| Initial signs of overdosage may include dryness of the skin and mucous membranes, mydriasis (large pupils), restlessness, flushing, hyperthermia (fever), and tachycardia (abnormally rapid heart rate) followed by lethargy or coma, hypotonic reflexes, nystagmus (abnormal side-to-side eye movements), pinpoint pupils, and respiratory depression. Respiratory depression may be evidenced as late as 30 hours after ingestion and may recur despite an initial response to narcotic antagonists. TREAT ALL POSSIBLE dephenoxylate/atrophine OVERDOSAGES AS SERIOUS AND MAINTAIN MEDICAL OBSERVATION FOR AT LEAST 48 HOURS, PREFERABLY UNDER CONTINUOUS HOSPITAL CARE. |
| CAUTIONS : |
| Diphenoxylate is contraindicated in patients with obstructive jaundice. Antiperistaltic agents may prolong and/or worsen diarrhea associated with organisms that penetrate the intestinal mucosa (toxigenic E. coli, Salmonella, Shigella), and pseudomembranous enterocolitis associated with broad-spectrum antibiotics. Antiperistaltic agents should not be used in these conditions. In some patients with acute ulcerative colitis, agents that inhibit intestinal motility or prolong intestinal transit time have been reported to induce toxic megacolon. Consequently, patients with acute ulcerative colitis should be carefully observed and Lomotil therapy should be discontinued promptly if abdominal distention occurs or if other untoward symptoms develop. Diphenoxylate hydrochloride may potentiate the action of barbiturates, tranquilizers, and alcohol. Therefore, the patient should be closely observed when any of these are used concomitantly. Caution should be exercised when Lomotil is administered to a nursing woman, since the physicochemical characteristics of the major metabolite, diphenoxylic acid, are such that it may be excreted in breast milk and since it is known that atropine is excreted in breast milk. |
| SIDE EFFECTS : |
| At therapeutic doses, the following have been reported; they are listed in decreasing order of severity, but not of frequency: Nervous system: numbness of extremities, euphoria, depression, malaise/lethargy, confusion, sedation/drowsiness, dizziness, restlessness, headache. Allergic: severe systemic allergic reaction, urticaria (rash/hives), swelling of the gums, pruritus (itching). Gastrointestinal system: toxic megacolon, paralytic ileus (paralyzed bowel), pancreatitis, vomiting, nausea, anorexia (loss of appetite), abdominal discomfort. The following atropine sulfate effects are listed in decreasing order of severity, but not of frequency: hyperthermia, tachycardia, urinary retention, flushing, dryness of the skin and mucous membranes. These effects may occur, especially in children. |
| FOR MORE INFORMATION : |
*This is a condensed description of this medication. For more details check with your physician, pharmacist, or resources such as The Physicians' Desk Reference (PDR) or http://www.rxlist.com/script/main/hp.asp |
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