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Diphenoxylate-Atropine
Diphenoxylate-Atropine is a combination medication used to treat diarrhea. Diphenoxylate is an opioid that works by slowing down intestinal movement, while atropine is added in small amounts to discourage misuse. Together, they help to reduce the frequency of bowel movements and provide relief from diarrhea, typically when other treatments like hydration and dietary changes are insufficient.
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Frequently Asked Questions
How quickly does Diphenoxylate-Atropine start working?
Relief from diarrhea usually begins within 1 to 2 hours after taking the medication, but full control may take up to 48 hours.
Can I take Diphenoxylate-Atropine for long-term diarrhea?
No, this medication is intended for short-term use. If diarrhea persists for more than 48 hours or frequently recurs, consult your healthcare provider to identify the underlying cause.
What should I do if I miss a dose?
Take the missed dose as soon as you remember unless it’s close to the time for your next scheduled dose. Do not double the dose to make up for a missed one.
Can I take Diphenoxylate-Atropine with other diarrhea medications?
It is not recommended to combine Diphenoxylate-Atropine with other antidiarrheal medications unless instructed by your healthcare provider, as this could increase the risk of side effects.
Is Diphenoxylate-Atropine safe during pregnancy?
Use of Diphenoxylate-Atropine during pregnancy should only occur if clearly needed, and its safety has not been fully established. Consult your healthcare provider before using it during pregnancy.
Comprehensive Drug Guide
How Does Diphenoxylate-Atropine Work?
Diphenoxylate: Acts on the mu-opioid receptors in the intestines, slowing down gastrointestinal motility and allowing more time for water absorption, which helps form more solid stools.
Atropine: Added to prevent overdose or abuse by causing unpleasant side effects if taken in large amounts, such as dry mouth, blurred vision, and rapid heart rate.
What is Diphenoxylate-Atropine Used For?
- Treatment of acute and chronic diarrhea, when other treatments are ineffective.
Common Dosages
Diphenoxylate-Atropine is available in:
- Tablets: 2.5 mg of diphenoxylate and 0.025 mg of atropine per tablet
- Oral solution: 2.5 mg of diphenoxylate and 0.025 mg of atropine per 5 mL
Typical Dosing
FDA Approved Indications
- The usual starting dose for adults is 2 tablets or 10 mL of oral solution taken four times daily until control of diarrhea is achieved. The dose may be reduced as diarrhea improves.
- Pediatric dosing is determined by weight and should be closely supervised by a healthcare provider.
Who Shouldn't Take Diphenoxylate-Atropine?
Diphenoxylate-Atropine should not be used in individuals with:
- Known hypersensitivity to diphenoxylate or atropine
- Obstructive jaundice
- Diarrhea caused by infection (e.g., C. difficile) or pseudomembranous colitis
- Severe liver disease
Advice From The Pharmacist
- Take Diphenoxylate-Atropine exactly as prescribed. Do not exceed the recommended dose, as this increases the risk of serious side effects, including drowsiness and difficulty breathing.
- Drink plenty of fluids to stay hydrated, especially if you have severe diarrhea. Dehydration is a common risk with diarrhea.
- If symptoms do not improve after 48 hours, contact your healthcare provider. This medication is not intended for long-term use.
- Avoid alcohol or other central nervous system depressants while taking this medication, as it may enhance drowsiness or dizziness.
Side Effects of Diphenoxylate-Atropine
Common Side Effects
- Drowsiness
- Dizziness
- Dry mouth
- Nausea
- Constipation
Uncommon/Severe Side Effects
- Respiratory depression (especially in children or in overdose)
- Severe allergic reactions (rash, itching, swelling)
- Pancreatitis
- Confusion or hallucinations (due to atropine)
Risks and Warnings of Diphenoxylate-Atropine
Abuse and Dependence: Diphenoxylate, an opioid, can lead to dependence or abuse. Atropine is added to discourage misuse, but use should be monitored, particularly in patients with a history of substance abuse.
Pediatric Risk: Diphenoxylate-Atropine can cause severe respiratory depression in children, especially those under two years of age. Use with caution in pediatric patients and only under close supervision.
Severe Diarrhea: If diarrhea is caused by an infection or antibiotics (such as C. difficile), Diphenoxylate-Atropine may worsen the condition. Always check with a healthcare provider to determine the cause of diarrhea before starting this medication.
Interactions with Diphenoxylate-Atropine
Common Drug Interactions
- CNS depressants (e.g., alcohol, benzodiazepines): Increase the risk of sedation, dizziness, and respiratory depression.
- MAO inhibitors: May increase the risk of serious drug interactions, including hypertensive crisis.
- Anticholinergic drugs: May increase the effects of atropine, leading to enhanced side effects such as dry mouth, blurred vision, and difficulty urinating.
Alternatives to Diphenoxylate-Atropine
- Loperamide (Imodium): An over-the-counter antidiarrheal medication that slows intestinal movement and is often used for mild to moderate diarrhea.
- Bismuth subsalicylate (Pepto-Bismol): A common antidiarrheal that helps reduce inflammation and bacterial growth in the intestines.
- Probiotics: Used to restore normal gut flora, especially after antibiotic use.
- Electrolyte solutions: Important for managing dehydration associated with diarrhea.
