Diphenoxylate and Atropine (Systemic)

Brand Names : Lofene, Logen, Lomocot, Lomotil, Lonox, Vi-Atro

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 diphenoxylate and atropine, the following should be considered:

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

Pregnancy - Studies have not been done in humans. In animal studies this medicine given in larger doses than the usual human dose has not been shown to cause birth defects. However, some studies in rats have shown that this medicine reduces the weight gain of the pregnant rat and lessens the chance of conceiving or becoming pregnant when given in doses many times the usual human dose.

Breast-feeding - Although both diphenoxylate and atropine pass into the breast milk, this medicine has not been shown to cause problems in nursing babies.

Children - This medicine should not be used in children. Children, especially very young children, are very sensitive to the effects of diphenoxylate 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 especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of diphenoxylate. 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 diphenoxylate 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. Diphenoxylate 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 diphenoxylate 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], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Taking diphenoxylate 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

• Opioid (narcotic) antagonists (naltrexone [e.g., ReVia]) - Withdrawal side effects may occur in patients who have become addicted to the diphenoxylate 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 diphenoxylate and atropine

Other medical problems - The presence of other medical problems may affect the use of diphenoxylate 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 will 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 serious breathing problems in patients who have any of these conditions

• Enlarged prostate or
• Urinary tract blockage or difficult urination - Severe 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 small

• 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 small

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

• 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