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diphenoxylate (die fen OX al ate)
atropine (AT tro peen)
What is diphenoxylate/atropine?
This drug is a mixture of two medications, each of which can slow the bowel action. It has been around a long time and has a good safety record. However, diphenoxylate is derived from narcotics and, while it does not have any pain relieving or addiction problems, it is not recommended for chronic use.
What is it used for?
The drug is used to treat diarrhea. It does not cure any condition. It simply slows the bowel.
How do I take it?
Follow your physician’s instructions carefully. It may be taken on an empty stomach or with food or milk. Store in a tightly closed container away from light and moisture. Keep the liquid from freezing. Keep all medications away from children. Never share your medications with anyone else.
What do I do for a missed dose?
If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double up on this medication.
Are there interactions with food or beverages?
There are no interactions with food or beverages but caffeine, which is found in coffee, tea, cola and chocolate, can aggravate diarrhea and should be avoided. This medicine may intensify the effects of alcohol which should be avoided or used with caution.
Are there interactions with other drugs?
An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction.
Interactions with this drug may occur with the following:
- anti-depressants (Elavil, Prozac, Paxil)
- tranquilizers (Valium, Xanax)
- monoamine oxidase (MAO) inhibitors (Nardil, Parnate)
Is there a problem if I have another disorder or disease?
At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease. With this drug long-term use with severe chronic liver disease or cirrhosis may be a problem.
What about allergies?
People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives or itching. Of course, a person should not take diphenoxylate/atropine if there has been a previous reaction to this or a similar drug.
What if I’m pregnant, considering pregnancy or breast-feeding?
Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Diphenoxylate/atropine is ranked C. Always consult your physician before taking any drug during or when planning pregnancy.
What are the effects on sexual function?
There are no known adverse effects on sexual function.
Are there other precautions?
- Diphenoxylate/atropine may cause drowsiness or dizziness so do not drive or operate hazardous machinery until the effects of the drug have been determined.
- It is not recommended for children under two years of age.
- This drug can cause dry mouth. Sucking on hard candy or chewing gum may relieve this problem.
- Be sure to drink plenty of fluids to replace lost body fluids. Diarrhea that is caused by antibiotics such as Ceclor, erythromycin or tetracycline can worsen when taking these medications. Check with your physician before taking this drug if you are on an antibiotic.
- Avoid long-term use as diphenoxylate/atropine may cause mild dependency.
How long is it safe to take diphenoxylate/atropine?
Generally, it is safe to take this combination long-term although drug dependency may become a problem. Once the diarrhea is under control, the dosage should be reduced. Improvement should be seen within 48 hours. If diarrhea persists after you have taken four tablets daily for 10 days, the drug likely is not effective for you. Check with your physician.
How about side effects?
Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.
For diphenoxylate/atropine, the following are the observed side effects:
- blurred vision
- dry mouth
- difficult urination
- severe stomach pain
- severe nausea
A physician’s comment…
This drug is an old standby for treating diarrhea. It should be kept in mind that the cause of diarrhea should always be sought. Since the drug is derived from narcotics, it should not be used in high doses or for prolonged periods of time. For mild chronic diarrhea, a high fiber diet may be helpful.