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| {{CMG}}
| | #REDIRECT[[Diphenoxylate hydrochloride and atropine sulfate]] |
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| ==Overview==
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| {{Drugbox
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| | type = combo
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| | component1 = Diphenoxylate
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| | class1 = mu [[opiate]] receptor [[agonist]]
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| | component2 = Atropine
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| | class2 = muscarinic [[acetylcholine receptors]] [[Competitive antagonist|antagonist]]
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| | CAS_number =
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| | ATC_prefix =
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| | ATC_suffix =
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| | PubChem =
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| | DrugBank =
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| | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
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| | pregnancy_US = <!-- A / B / C / D / X -->
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| | pregnancy_category=
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| | legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
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| | legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
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| | legal_UK = POM
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| | legal_US = Schedule V
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| | legal_status =
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| | routes_of_administration = Oral
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| }}
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| {{SI}}
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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'''.
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| 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.
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| 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]].
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| Other trade names for the same therapeutic combination are Lofene, Logen,
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| Lomanate and Lonox, among others. In other countries, Lomotil may have other names.
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| 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>
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| ==Contraindications==
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| Absolute [[contraindication]]s for Lomotil are:
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| * [[Allergy]] to diphenoxylate or atropine
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| * Presence of [[jaundice]]
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| * Diarrhea associated with [[pseudomembranous enterocolitis]], diarrhea caused by [[antibiotic]] treatment, or diarrhea caused by [[enterotoxin]]-producing [[bacteria]].
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| ==Interactions==
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| Interactions with other drugs:
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| * [[Sedative]]s
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| * [[Barbiturate]]s
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| * [[Antidepressant]]s (e.g., Elavil, Prozac, Paxil)
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| * [[Tranquilizers]] (e.g., Valium, Xanax)
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| * [[Monoamine oxidase inhibitors]] (e.g., Nardil, Parnate)
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| [[Diarrhea]] that is caused by some [[antibiotic]]s such as [[cefaclor]], [[erythromycin]] or [[tetracycline]] can worsen with Lomotil.
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| ==Safety==
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| 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.
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| 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.
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| ==Toxicity==
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| 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.
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| 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]]).
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| 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.
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| ==References==
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| {{Reflist}}
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| ==External links==
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| * [http://www.rxlist.com/cgi/generic3/diphenoxylate_ids.htm Diphenoxylate and Atropin]. RxList.
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| ==Source==
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| * [http://www.nlm.nih.gov/medlineplus/ency/article/002668.htm Lomotil overdose]. MedlinePlus Medical Encyclopedia. Public domain.
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| [[Category:Antidiarrhoeals]]
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| [[Category:Gastroenterology]]
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| {{WH}}
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| {{WS}}
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