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Lomotil
Lomotil is the brand name for a combination of diphenoxylate and atropine, a medication used to treat diarrhea. Diphenoxylate is an antidiarrheal agent that slows down bowel movements by acting on the opioid receptors in the intestines, reducing the frequency and urgency of bowel movements. Atropine is included in the formulation to discourage abuse of the diphenoxylate component, as it can have opioid-like effects at higher doses. Lomotil is typically used for short-term management of acute or chronic diarrhea.
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Frequently Asked Questions
How long does it take for Lomotil to work?
Lomotil usually begins to work within 45 to 60 minutes after taking a dose. Most people notice an improvement in their diarrhea within a few hours of the first dose.
Can Lomotil be used long-term?
Lomotil is generally used for short-term relief of diarrhea. Prolonged use can lead to side effects, dependency, or mask underlying conditions. It should not be used for more than 10 days without a doctor's recommendation.
Is Lomotil safe for children?
Lomotil is not recommended for children under 13 years and should not be used at all in children under 6 years due to the risk of serious side effects, including respiratory depression.
Can I take Lomotil with other medications for diarrhea?
Consult your doctor before combining Lomotil with other medications for diarrhea, especially over-the-counter treatments. Loperamide (Imodium) should not be used concurrently with Lomotil.
What should I do if I miss a dose of Lomotil?
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take extra doses to make up for the missed dose.
Comprehensive Drug Guide
How Does Lomotil Work?
Lomotil works by slowing the movement of the intestines. Diphenoxylate, the primary active ingredient, acts on opioid receptors in the intestinal wall to inhibit peristalsis (the wave-like muscle contractions that move food and waste through the digestive tract). This action increases the time it takes for stool to pass through the intestines, allowing for more water absorption and resulting in firmer stools. Atropine is included to reduce the risk of diphenoxylate abuse and causes unpleasant effects if taken in large amounts.
Common Dosages
- Tablets: Each tablet contains 2.5 mg of diphenoxylate and 0.025 mg of atropine.
- Liquid form: Contains 2.5 mg of diphenoxylate and 0.025 mg of atropine per 5 mL.
The typical dosing regimen is two tablets or 10 mL of the liquid taken four times a day until diarrhea is under control, after which the dose is reduced to maintain symptom relief.
Typical Dosing
- For adults: The initial dose is 2 tablets or 10 mL of the liquid formulation, taken four times daily. Once the diarrhea is controlled, the dose is reduced to maintain relief, usually down to 2 tablets once or twice a day as needed.
- For children aged 13 years and older: The dosing is typically adjusted based on weight, but the same general regimen applies.
Typical Dosing
FDA Approved Indications
- The treatment of acute and chronic diarrhea in adults and children aged 13 years and older.
Who Shouldn't Take Lomotil?
- Diarrhea caused by bacterial infections like Clostridioides difficile or Shigella.
- Jaundice (liver-related yellowing of the skin or eyes).
- Severe liver disease.
- Hypersensitivity to diphenoxylate, atropine, or any of the formulation components.
- Children under the age of 6 due to the risk of serious respiratory depression.
Advice From The Pharmacist
- Lomotil should be taken exactly as prescribed. Do not exceed the recommended dose, as higher doses can cause serious side effects, particularly due to the diphenoxylate component.
- Do not use Lomotil for more than 10 days unless directed by your doctor, as prolonged use can lead to dependency or mask underlying conditions.
- Stay hydrated while using Lomotil, as diarrhea can lead to dehydration. Drink plenty of fluids or electrolyte solutions.
- Avoid consuming alcohol or other sedatives while taking Lomotil, as it can enhance the sedative effects of the medication, leading to drowsiness or respiratory depression.
Side Effects of Lomotil
Common Side Effects
- Drowsiness
- Dry mouth
- Blurred vision
- Headache
- Nausea
- Constipation
Uncommon/Severe Side Effects
- Severe respiratory depression (especially in children or when taken in higher doses)
- Tachycardia (fast heart rate)
- Confusion
- Severe allergic reactions (rash, itching, swelling, difficulty breathing)
Risks and Warnings of Lomotil
- Respiratory Depression: Diphenoxylate, an opioid-like drug, can cause severe respiratory depression, especially in children and when taken in high doses. Children under the age of 6 should not use Lomotil due to this risk.
- Potential for Abuse: Although Lomotil contains low-dose diphenoxylate, it can be abused due to its opioid-like effects. Atropine is added to deter abuse, as higher doses cause unpleasant side effects.
- Liver Disease: Lomotil should be used with caution in patients with liver disease, as it can worsen liver function and cause toxic effects.
Interactions with Lomotil
Common Drug Interactions
- CNS depressants: Lomotil can enhance the sedative effects of other central nervous system depressants, such as alcohol, benzodiazepines, or opioids, increasing the risk of severe drowsiness or respiratory depression.
- MAO inhibitors: Combining Lomotil with monoamine oxidase inhibitors (MAOIs) can cause severe side effects like high blood pressure and hyperactivity.
- Anticholinergic medications: Atropine in Lomotil has anticholinergic effects, so caution is advised when combining it with other anticholinergic drugs (e.g., tricyclic antidepressants), as this can increase the risk of side effects like dry mouth, blurred vision, and urinary retention.
Alternatives to Lomotil
- Loperamide (Imodium): An over-the-counter antidiarrheal that works similarly to Lomotil by slowing intestinal movement.
- Bismuth subsalicylate (Pepto-Bismol): An over-the-counter medication used to treat diarrhea, upset stomach, and nausea.
- Probiotics: These are sometimes used to help restore the natural balance of gut bacteria and alleviate diarrhea, particularly after antibiotic use.
