View source for Lomotil

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==Overview==
{{Drugbox
| type              = combo
| component1        = Diphenoxylate
| class1            = mu [[opiate]] receptor [[agonist]] 
| component2        = Atropine
| class2            = muscarinic [[acetylcholine receptors]] [[Competitive antagonist|antagonist]]
| CAS_number        = 
| ATC_prefix        = 
| ATC_suffix        = 
| PubChem           = 
| DrugBank          = 
| pregnancy_AU      =  <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US      =  <!-- A / B            / C / D / X -->
| pregnancy_category=  
| legal_AU          =  <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
| legal_CA          =  <!--             / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK          =  POM
| legal_US          =  Schedule V
| legal_status      = 
| routes_of_administration = Oral
}}
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'''Lomotil''' is the [[trade name]] of a popular oral [[anti-diarrheal]] [[medication|drug]] in the [[United States]], manufactured by [[Pfizer]]. Its UK [[British Approved Name|BAN]] generic name is '''Co-phenotrope'''.

Its active ingredients are [[diphenoxylate]] and [[atropine]]. Diphenoxylate is anti-diarrheal and atropine is [[anticholinergic]]. Diphenoxylate is chemically related to the [[narcotic]] drug [[meperidine]]. A subtherapeutic amount of atropine sulfate is present to discourage deliberate overdosage. Atropine has no anti-diarrheal properties, but will cause [[tachycardia]] when overused. The medication [[diphenoxylate]] works by slowing down the movement of the [[intestine]]s. 

The inactive ingredients of Lomotil (as a liquid - it comes in pill form as well) are [[cherry]] flavor, [[citric acid]], [[ethyl alcohol]] 15%, FD&C Yellow No. 6, [[glycerin]], [[Trisodium phosphate|sodium phosphate]], [[sorbitol]], and [[water]].

Other trade names for the same therapeutic combination are Lofene, Logen, 
Lomanate and Lonox, among others. In other countries, Lomotil may have other names. 

In the United States, Lomotil (Diphenoxylate HCl and atropine sulfate) is classified as a Schedule V controlled substance by federal law, and is available only for a medical purpose.<ref>http://www.usdoj.gov/dea/pubs/csa/829.htm#c</ref>

==Contraindications==
Absolute [[contraindication]]s for Lomotil are:
* [[Allergy]] to diphenoxylate or atropine 
* Presence of [[jaundice]] 
* Diarrhea associated with [[pseudomembranous enterocolitis]], diarrhea caused by [[antibiotic]] treatment, or diarrhea caused by [[enterotoxin]]-producing [[bacteria]].

==Interactions==
Interactions with other drugs: 
* [[Sedative]]s 
* [[Barbiturate]]s 
* [[Antidepressant]]s (e.g., Elavil, Prozac, Paxil) 
* [[Tranquilizers]] (e.g., Valium, Xanax) 
* [[Monoamine oxidase inhibitors]] (e.g., Nardil, Parnate) 

[[Diarrhea]] that is caused by some [[antibiotic]]s such as [[cefaclor]], [[erythromycin]] or [[tetracycline]] can worsen with Lomotil.

==Safety==

The drug combination is generally safe in short-term use and with recommended [[Effective dose|dosage]]. Long-term use may present problems of mild [[drug dependency]]. The dosage should be reduced after 48 h.

Lomotil may cause several [[Adverse effect (medicine)|side-effects]], such as [[dry mouth]], [[headache]], [[constipation]] and [[blurred vision]]. Since it may cause also [[drowsiness]] or [[dizziness]], Lomotil should not be used by motorists, operators of hazardous machinery, etc. It is not recommended for children under two years of age. In rare cases lomotil may cause paresthesia.

==Toxicity==

Lomotil may cause serious health problems when [[overdosed]]. [[Medical sign|Sign]]s and [[symptom]]s of [[adverse effect (medicine)|adverse effects]] may include any or several of the following: [[convulsion]]s, [[respiratory depression]] (slow or stopped breathing), pinpoint or dilated [[eye pupil]]s, [[nystagmus]] (rapid side-to-side [[eye]] movements), [[erythema]] (flushed skin), gastrointestinal [[constipation]], [[nausea]], [[vomiting]], [[paralytic ileus]], [[tachycardia]] (rapid pulse), [[drowsiness]], [[coma]] and [[hallucination]]s. Symptoms of [[toxicity]] may take up to 12 hours to appear.

Treatment of Lomotil overdose must be initiated immediately after [[diagnosis]] and may include the following: [[emesis]] (induced vomiting), [[gastric lavage]], ingestion of [[activated charcoal]], [[laxative]] and a counteracting medication (narcotic [[antagonist]]).

Prompt and thorough treatment of overdose leads to a favorable [[outcome]]. After a narcotic antagonist is given, recovery is usually within 24 to 48 hours. Children are at risk of a very poor outcome and must be kept for observation.

==References==
{{Reflist}}

==External links==
* [http://www.rxlist.com/cgi/generic3/diphenoxylate_ids.htm Diphenoxylate and Atropin]. RxList.

==Source==
* [http://www.nlm.nih.gov/medlineplus/ency/article/002668.htm Lomotil overdose]. MedlinePlus Medical Encyclopedia. Public domain.



[[Category:Antidiarrhoeals]]
[[Category:Gastroenterology]]

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