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atropine/diphenoxylate (Lomotil, Lonox)
2.5 mg diphenoxylate + 0.025 mg atropine per tab or 5 mL. DEA controlled substance. Class 5.
Indications: treatment of diarrhea
Contraindications:
Caution:
1) reduction in intestinal motility may be deleterious in diarrhea associated with Shigella, Salmonella, toxigenic E. coli, & pseudomembranous colitis due to broad-spectrum antibiotic use
2) children may develop symptoms of atropine toxicity at recommended doses
Caution: patients with hepatic disease or renal disease.
pregnancy-category C
safety in lactation -
Dosage:
1) 2 tabs or 10 mL PO QID
2) max: 8 tabs/day
3) pediatrics: 0.3-0.4 mg/kg/day divided QID.
Tabs: (see above)
Solution: (oral) (60 mL).
Pharmacokinetics: elimination: liver.
Adverse effects:
1) not common (1-10%)
- paralytic ileus, respiratory depression, nervousness, restlessness, blurred vision, difficult urination, dry mouth, dizziness, drowsiness, headache, mental depression
2) uncommon (< 1%)
- stomach cramps, muscle cramps, nausea/vomiting, increased sweating, tachycardia, sedation, euphoria, weakness, pruritus, urticaria, pancreatitis, hyperthermia
3) other
- dry skin, mucous membranes & mouth
General
antidiarrheal combination
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Physician's Desk Reference (PDR) 52st edition, Medical
Economics, 1998
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998 - not on National VA formulary
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
Components
atropine (Atropair, Atropine-Care)
diphenoxylate