Difenoxin and Atropine (Systemic)

Brand Names : Motofen

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For difenoxin and atropine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to difenoxin or atropine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Difenoxin and atropine combination has not been studied in pregnant women. However, studies in rats have shown that difenoxin and atropine combination, when given in doses many times the human dose, increases the delivery time and the chance of death of the newborn.

Breast-feeding - Both difenoxin and atropine pass into the breast milk. Although it is not known how much of these drugs pass into the breast milk, difenoxin and atropine combination could cause serious effects in the nursing baby. Be sure you have discussed the risks and benefits of this medicine with your doctor.

Children - This medicine should not be used in children. Children, especially very young children, are very sensitive to the effects of difenoxin and atropine. This may increase the chance of side effects during treatment. Also, the fluid loss caused by diarrhea may result in a severe condition. For this reason, it is very important that a sufficient amount of liquids be given to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Older adults - Shortness of breath or difficulty in breathing may be more likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of difenoxin. Also, the fluid loss caused by diarrhea may result in a severe condition. For this reason, elderly persons should not take this medicine without first checking with their doctor. It is also very important that a sufficient amount of liquids be taken to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking difenoxin and atropine, it is especially important that your health care professional know if you are taking any of the following:

• Antibiotics, such as cephalosporins (e.g., Ceftin, Keflex), clindamycin (e.g., Cleocin), erythromycins (e.g., E.E.S., PCE), tetracyclines (e.g., Achromycin, Doryx) - These antibiotics may cause diarrhea. Difenoxin and atropine may make the diarrhea caused by antibiotics worse or make it last longer

• Central nervous system (CNS) depressants (medicines that cause drowsiness) - Effects, such as drowsiness, of CNS depressants or of difenoxin and atropine may become greater

• Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], tranylcypromine [e.g., Parnate]) - Taking difenoxin and atropine while you are taking or within 2 weeks of taking MAO inhibitors may cause severe side effects; these medicines should not be used together

• Naltrexone (e.g., Trexan) - Withdrawal side effects may occur in patients who have become addicted to the difenoxin in this combination medicine; also, naltrexone will make this medicine less effective against diarrhea

• Other anticholinergics (medicine to help reduce stomach acid and abdominal or stomach spasms or cramps) - Use of other anticholinergics with this combination medicine may increase the effects of the atropine in this combination; however, this is not likely to happen with the usual doses of difenoxin and atropine

Other medical problems - The presence of other medical problems may affect the use of difenoxin and atropine. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Drug abuse (history of) - There is a greater chance that this medicine may become habit-forming

• Colitis (severe) - A more serious problem of the colon may develop if you use this medicine

• Down's syndrome - Side effects may be more likely and severe in these patients

• Dysentery - This condition may get worse; a different kind of treatment may be needed

• Emphysema, asthma, bronchitis, or other chronic lung disease - There is a greater chance that this medicine may cause breathing problems in patients who have any of these conditions

• Enlarged prostate or
• Urinary tract blockage or difficult urination - Problems with urination may develop with the use of this medicine

• Gallbladder disease or gallstones - Use of this medicine may cause spasms of the biliary tract and make the condition worse

• Glaucoma - Severe pain in the eye may occur with the use of this medicine; however, the chance of this happening is low

• Heart disease - This medicine may have some effects on the heart, which may make the condition worse

• Hiatal hernia - The atropine in this medicine may make this condition worse; however, the chance of this happening is low

• High blood pressure (hypertension) - The atropine in this medicine may cause an increase in blood pressure; however, the chance of this happening is low

• Intestinal blockage - This medicine may make the condition worse

• Kidney disease - The atropine in this medicine may build up in the body and cause side effects

• Liver disease - The chance of central nervous system (CNS) side effects, including coma, may be greater in patients who have this condition

• Myasthenia gravis - This medicine may make the condition worse

• Overactive or underactive thyroid - Unwanted effects on breathing and heart rate may occur

• Overflow incontinence - This medicine may make the condition worse