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Brand name:

Lomotil

Pronounced: loe-MOE-till
Generic ingredients: Diphenoxylate hydrochloride, Atropine sulfate

Why is this drug prescribed?

Lomotil is used, along with other drugs, in the treatment of diarrhea.

Most important fact about this drug

Lomotil is not a harmless drug, so never exceed your recommended dosage. An overdose could be fatal.

How should you take this medication?

Lomotil can be habit-forming. Take it exactly as prescribed. Be sure to drink plenty of liquids to replace lost body fluids. Eat bland foods, such as cooked cereals, breads and crackers.

Lomotil may cause dry mouth. Suck on a hard candy or chew gum to relieve this problem.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store away from heat, light, and moisture. Keep the liquid from freezing.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lomotil.

• Side effects may include:
  Abdominal discomfort, confusion, depression, difficulty urinating dizziness, dry mouth and skin, exaggerated feeling of elation, fever, flushing, general feeling of not being well, headache, hives, intestinal blockage, itching, lack or loss of appetite, nausea, numbness of arms and legs, rapid heartbeat, restlessness, sedation/drowsiness, severe allergic reaction, sluggishness, swelling due to fluid retention, swollen gums, vomiting

Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to the ingredients of Lomotil, diphenoxylate or atropine, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Unless you are directed to do so by your doctor, do not take Lomotil if you have obstructive jaundice (a disease in which bile made in the liver does not reach the intestines because of a bile duct obstruction such as gallstones). Do not take Lomotil if you have diarrhea associated with pseudomembranous enterocolitis (inflammation of the intestines) or an infection with enterotoxin-producing bacteria (an enterotoxin is a poisonous substance that affects the stomach and intestines).

Special warnings about this medication

Certain antibiotics such as Ceclor, Cleocin, PCE and Achromycin V may cause diarrhea. Lomotil can make this type of diarrhea worse and longer-lasting. Check with your doctor before using Lomotil while taking an antibiotic.

Lomotil may cause drowsiness or dizziness. Therefore, you should not drive a car, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you know how this drug affects you.

Lomotil slows activity of the digestive system; this can result in a buildup of fluid in the intestine, which may worsen the dehydration and imbalance in normal body salts that usually occur with diarrhea.

If you have severe ulcerative colitis (an inflammation of the intestines), your doctor will want to monitor your condition while you are taking this drug. If your abdomen becomes distended, or enlarged, notify your doctor.

Use Lomotil with extreme caution if you have kidney and liver disease or if your liver is not functioning normally.

Lomotil should be used with caution in children, since side effects may occur even with recommended doses, especially in children with Down's syndrome (congenital mental retardation).

Since addiction to diphenoxylate hydrochloride is possible at high doses, you should never exceed the recommended dosage.

Possible food and drug interactions when taking this medication

Lomotil may intensify the effects of alcohol. It's better not to drink alcohol while taking this medication.

If Lomotil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lomotil with the following:

Barbiturates (anticonvulsants and sedatives such as phenobarbital)
MAO inhibitors (antidepressants such as Nardil and Parnate)
Tranquilizers (such as Valium and Xanax)

Special information if you are pregnant or breastfeeding

The effects of Lomotil during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. Lomotil appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage

ADULTS

Once your diarrhea is under control, your doctor may reduce the dosage; you may need as little as 5 milligrams (2 tablets or 10 milliliters of liquid) per day.

You should see improvement within 48 hours. If your diarrhea persists after you have taken 20 milligrams a day for 10 days, the drug is not likely to work for you.

CHILDREN

Your doctor will take into account your child's nutritional status and degree of dehydration before prescribing this drug.

The recommended dose for children 13 to 16 years old is 2 tablets or 2 teaspoonfuls of liquid three times a day.

In children under 13 years of age, use only Lomotil liquid and administer with the plastic dropper. The recommended starting dosage is 0.3 to 0.4 milligram per 2.2 pounds of body weight per day, divided into 4 equal doses. The following table provides approximate starting dosage recommendations for children:

2 years (24-31 pounds):
   1.5-3.0 milligrams, 4 times daily
3 years (26-35 pounds):
   2.0-3.0 milligrams, 4 times daily
4 years (31-44 pounds):
   2.0-4.0 milligrams, 4 times daily
5 years (35-51 pounds):
   2.5-4.5 milligrams, 4 times daily
6-8 years (38-71 pounds):
   2.5-5.0 milligrams, 4 times daily
9-12 years (51-121 pounds):
   3.5-5.0 milligrams, 4 times daily

Your doctor may reduce the dosage as soon as symptoms are controlled. A maintenance dosage may be as low as one-quarter of the starting dose. If your child does not show improvement within 48 hours, Lomotil is unlikely to work.

Overdosage

An overdose of Lomotil can be dangerous and even fatal. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Lomotil overdose may include:
  Coma, dry skin and mucous membranes, enlarged pupils of the eyes, extremely high body temperature, flushing, involuntary eyeball movement, lower than normal muscle tone, pinpoint pupils, rapid heartbeat, restlessness, sluggishness, suppressed breathing

Suppressed breathing may be seen as late as 30 hours after an overdose.