Lomotil is a brand-name prescription drug that’s used to treat diarrhea. It’s prescribed as an add-on treatment for people who are still having diarrhea even though they’ve already been treated for it.
Diarrhea causes loose or watery stools that may be frequent. Lomotil is typically used to treat acute diarrhea. This is diarrhea that lasts for a short time (one to two days). Acute diarrhea may be related to a short-term illness such as a stomach bug.
Lomotil can also be used to treat chronic diarrhea (lasting four weeks or longer). This type of diarrhea may be related to a digestive (stomach) condition.
Lomotil comes as an oral tablet. It’s approved for use in adults and children ages 13 years and older.
Lomotil belongs to a class of medications called anti-diarrheals. It contains two active drugs: diphenoxylate and atropine.
Lomotil is a Schedule V controlled substance, which means it has a medical use but may be misused. It contain small quantities of narcotics (powerful pain relievers also called opioids).
Diphenoxylate, one of the ingredients in Lomotil, is itself a Schedule II controlled substance. However, when it’s combined with atropine, the other ingredient in Lomotil, the risk of misuse is lower.
Lomotil is not considered addictive at the doses recommended for diarrhea. However, it’s important not to take more Lomotil than your doctor prescribes.
Lomotil tablets are available as a brand-name and a generic medication. The generic version is called diphenoxylate/atropine, and it also comes as a liquid solution you take by mouth.
Lomotil contains two active drug ingredients: diphenoxylate and atropine. Neither drug is available as a generic on its own.
The Lomotil dosage your doctor prescribes will depend on several factors. These include:
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Lomotil comes as a tablet. Each tablet contains 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate.
When you start using Lomotil, your doctor will prescribe two tablets four times a day. Don’t take more than eight tablets (20 mg of diphenoxylate) a day. Continue this dosage until your diarrhea starts to improve (stools become firmer), which should happen within 48 hours.
Once your diarrhea starts to improve, your doctor may lower your dosage to as low as two tablets a day. You’ll stop taking Lomotil once your diarrhea is completely gone.
If you’re taking Lomotil and your diarrhea doesn’t improve within 10 days, let your doctor know. They may have you stop using Lomotil and try another treatment.
Children ages 13 to 17 years old can take Lomotil. The dosage is the same as for adults (see “Dosage for diarrhea” section above).
Note: Children under 13 years old should not take Lomotil tablets. (Although this drug isn’t approved for children under 13 years old, there’s a special warning for children under 6 years old. See “Side effect details” for more information.)
Children ages 2 years and older can take the oral liquid solution of diphenoxylate/atropine, which is only available as a generic. If you’d like your child to try the diphenoxylate/atropine liquid solution, talk with their doctor.
If you miss a dose and it’s close to the time you should’ve taken it, take the dose. If it’s close to your next dose, skip that dose and take your next dose at the regularly scheduled time.
To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
If you and your doctor determine that Lomotil is safe and effective for you, you may take it short term or long term, depending on the type of diarrhea you have.
Tell your doctor if you’re taking Lomotil and your diarrhea doesn’t improve within 10 days. They may ask you to stop using Lomotil and try another treatment.
Lomotil can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Lomotil. These lists do not include all possible side effects.
For more information on the possible side effects of Lomotil, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
The more common side effects of Lomotil can include:
Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.
Serious side effects from Lomotil aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
* Central nervous system depression can also occur in people of any age taking Lomotil, but it’s only been cited during overdose.
You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on some of the side effects this drug may or may not cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Lomotil. Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
Call your doctor right away if you have a severe allergic reaction to Lomotil. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Drowsiness
You may feel drowsy while taking Lomotil. If you take a normal dose of Lomotil, any drowsiness you have should be mild. Drowsiness can be more severe if you take more Lomotil than your doctor prescribes.
It’s important not to take more medication than prescribed because it can lead to serious side effects. Taking certain medications along with Lomotil or drinking alcohol while taking Lomotil can make drowsiness worse.
Until you know how you feel while taking Lomotil, don’t drive while taking it or do other activities that require alertness or concentration. For more information, see the “Lomotil and alcohol,” “Lomotil interactions,” and “Lomotil overdose” sections below.
Call your doctor right away if you feel very drowsy while taking Lomotil. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Nausea
You may experience some nausea or vomiting while taking Lomotil. Vomiting multiple times a day for more than one or two days may lead to dehydration (water loss from the body) and weight loss. These side effects of vomiting can be serious.
To help avoid dehydration from vomiting, drink plenty of water and other fluids such as juice. Drinks with electrolytes (vitamins and minerals), like Gatorade for adults or Pedialyte for children, may also help.
Your doctor or pharmacist can tell you which medications may be safe to take for your nausea while you’re taking Lomotil. Call your doctor right away if you lose weight or vomit multiple times a day for more than two days while taking Lomotil. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Respiratory depression or central nervous system depression
Lomotil can cause respiratory depression (slowed breathing) or central nervous system depression (loss of brain function) in children younger than 6 years old. This can lead to trouble breathing, coma, and death. Lomotil is only approved for children ages 13 years and older.
If your child is taking Lomotil and starts to have any symptoms of respiratory depression (such as slowed breathing) or central nervous system depression (such as feeling drowsy), talk with their doctor. If their symptoms are severe, call 911 or go to the nearest emergency room.
Constipation (not a side effect)
Constipation is not a side effect of Lomotil. Atropine, one of the ingredients in Lomotil, may cause constipation at higher doses. However, the amount of atropine is so low in the normal Lomotil dose that you’re not likely to get constipated.
If you feel constipated while taking Lomotil, talk with your doctor. They may lower your dose.
Side effects in children are similar to side effects in adults. Lomotil tablets are approved for people ages 13 years and older. Lomotil should not be used in children under 6 years old because it can cause very serious side effects. These include difficulty breathing, coma, and death.
The Food and Drug Administration (FDA) approves prescription drugs such as Lomotil to treat certain conditions.
Lomotil (diphenoxylate/atropine) treats diarrhea. It’s prescribed as an add-on treatment when a person is still having diarrhea even though they’re already taking something to treat it. Lomotil is approved for adults and for children ages 13 years and older.
Diarrhea causes loose or watery stools that may be frequent. When diarrhea lasts for a short time (one to two days), it’s considered acute and may be related to a short-term illness such as a stomach bug. Lomotil is typically used for acute diarrhea.
Lomotil can also be used to treat chronic diarrhea (lasting four weeks or longer). This type of diarrhea may be related to a digestive (stomach) condition.
When you have diarrhea, your digestive muscles contract too quickly. This causes food to move quickly through the stomach and intestines, and your body can’t absorb water or electrolytes (vitamins and minerals). As, stools are large and watery, which can lead to dehydration (water loss in the body).
Lomotil works by slowing down digestion and relaxing the digestive muscles. This allows food to move more slowly through the stomach and intestines. Your body can absorb water and electrolytes, which makes stools less watery and less frequent.
Lomotil is approved for use in children ages 13 years and older. Children under 13 years old should not take Lomotil. Although this drug isn’t approved for children under 13 years old, there’s a special warning for children under 6 years old. See “Side effect details” for more information.
There is an oral liquid solution of diphenoxylate/atropine (only available as a generic) that can be used to treat diarrhea in children ages 2 years and older.
If you’d like your child to try the diphenoxylate/atropine liquid solution, talk with their doctor.
Lomotil is prescribed as an add-on treatment when a person is still having diarrhea even though they’re already taking something to treat it.
Lomotil may cause vomiting, which can lead to dehydration (water loss in the body). Diarrhea, the condition Lomotil treats, may also cause dehydration.
To help avoid dehydration, drink plenty of water and other fluids such as juice. Drinks with electrolytes (vitamins and minerals), like Gatorade for adults or Pedialyte for children, may also help.
Talk with your doctor or pharmacist if you’re worried about getting dehydrated while taking Lomotil. They may also be able to suggest medications to prevent vomiting while you’re taking Lomotil.
Other drugs are available that can treat diarrhea. Some may be better a better fit for you than others depending on the cause of your diarrhea. If you’re interested in finding an alternative to Lomotil, talk with your doctor. They can tell you about other medications that may work well for you.
Note: Some of the drugs listed here are used off-label to treat different types of diarrhea. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.
Medications are available to treat less serious forms of diarrhea. Some medications are even available over the counter (without a prescription), including:
Certain conditions such as IBS can cause diarrhea. Medications such as Viberzi (eluxadoline) can be used to treat IBS with diarrhea.
If your diarrhea is from bacterial infections in your stomach or intestines, such as H. pylori or Clostridioides difficile, your doctor may prescribe you an antibiotic. Examples of antibiotics include:
If the antibiotics are causing diarrhea, your doctor may lower your dose or change your medication. Some anti-diarrhea medications may cause the illness to last longer, so you may need to manage your symptoms through your diet. Talk with your doctor or pharmacist about what medications may be safe to use to help relieve your symptoms.
Certain medications (for example, drugs for cancer or HIV) can cause diarrhea as a side effect. Some medications can be used to treat diarrhea in these cases. For example, crofelemer (Mytesi) is used to treat diarrhea in people with HIV who are receiving treatment. Loperamide (Imodium) can be used off-label (nonapproved use) for diarrhea caused by cancer medications.
You may wonder how Lomotil compares to other medications that are prescribed for similar uses. Here we look at how Lomotil and Imodium are alike and different.
Both Lomotil (diphenoxylate/atropine) and Imodium (loperamide) treat diarrhea.
Lomotil is prescribed as an add-on treatment for people who still have diarrhea even though they’re already taking something to treat it. Lomotil is typically used for acute diarrhea, but it may be used to treat chronic diarrhea as well.
Imodium is used to treat both acute and chronic diarrhea. It can also be used to treat traveler’s diarrhea (diarrhea from consuming contaminated food or water, usually when traveling to another country). In addition, it can be used to reduce the output of stool from an ileostomy (a surgical opening connecting your intestine to the stomach wall to release stool or waste).
Imodium is used off-label (nonapproved use) for diarrhea caused by cancer medications.
Lomotil is approved for adults and for children ages 13 years and older.
Imodium can be used by adults and by children ages 2 years and older. However, for children ages 2 to 5 years old, it’s recommended you talk to a doctor before giving them Imodium liquid. And children 2 to 5 years old should not be given Imodium capsules.
Lomotil is only available with a prescription. Imodium is only available over the counter (without a prescription).
Both Lomotil and Imodium come as a pill you take by mouth. Lomotil is a tablet, and Imodium is a liquid-filled capsule (softgel and caplet). Imodium also comes as a liquid.
Lomotil and Imodium have some similar side effects and others that differ. Below are examples of these side effects.
More common side effects
These lists contain examples of more common side effects that can occur with Lomotil, with Imodium, or with both drugs (when taken individually as part of a diarrhea treatment plan).
Serious side effects
These lists contain examples of serious side effects that can occur with Lomotil or with both Lomotil and Imodium (when taken individually as part of a diarrhea treatment plan).
Diarrhea is the only condition both Lomotil and Imodium are used to treat.
These drugs haven’t been directly compared in clinical studies, but individual studies have found both Lomotil and Imodium to be effective for treating diarrhea.
Lomotil tablets and Imodium are both available as brand-name and generic drugs. The generic version of Lomotil (diphenoxylate/atropine) also comes as a liquid solution you take by mouth. Brand-name medications usually cost more than generics.
Lomotil is only available with a prescription. Imodium is only available over the counter (without a prescription).
According to estimates on GoodRx.com and other sources, with similar usage, Lomotil and Imodium generally cost about the same. The actual price you’ll pay for Lomotil will depend on your insurance plan, your location, and the pharmacy you use.
Lomotil can cause drowsiness or dizziness. Drinking alcohol while taking Lomotil can make these side effects much worse. Avoid drinking alcohol while taking Lomotil.
If you’re concerned about drinking alcohol while taking Lomotil, talk with your doctor.
Lomotil can interact with several other medications.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.
Below is a list of medications that can interact with Lomotil. This list does not contain all drugs that may interact with Lomotil.
Before taking Lomotil, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
Drugs that cause central nervous system depression
In some cases, taking Lomotil may cause central nervous system (CNS) depression (loss of brain function). Taking Lomotil with other medications that can also cause CNS depression may make that side effect stronger.
Examples of medication classes that can cause CNS depression include:
If you take one of these other medications that could cause CNS depression, your doctor may have you stop taking it and switch to a different drug when you start taking Lomotil. Or they may prescribe a different add-on treatment for you instead of Lomotil. Depending on which medication you take, your doctor may have you keep taking both drugs and monitor you regularly for side effects.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Monoamine oxidase inhibitors
Monoamine oxidase inhibitors (MAOIs) such as isocarboxazid (Marplan) or phenelzine (Nardil) are used to treat depression. Diphenoxylate, an ingredient in Lomotil, interacts with these drugs and can cause hypertensive crisis (extremely high blood pressure).
If you take an MAOI, your doctor may have you stop taking it and switch to a different drug when you start taking Lomotil. Or they may prescribe a different add-on treatment for you instead of Lomotil. Depending on the medication you take, your doctor may have you keep taking both drugs and monitor you regularly for side effects.
There aren’t any herbs or supplements that have been specifically reported to interact with Lomotil. However, you should still check with your doctor or pharmacist before using any of these products while taking Lomotil.
There isn’t enough data from human or animal studies to know if it’s safe to take Lomotil during pregnancy. However, it’s important to note that this medication contains a narcotic ingredient (diphenoxylate), and narcotics have been shown to cause harm during pregnancy.
If you’re pregnant or planning a pregnancy, talk with your doctor about the potential benefits and risks of using Lomotil while pregnant.
There isn’t enough data from human or animal studies to know if it’s safe to take Lomotil while breastfeeding. However, both ingredients (diphenoxylate and atropine) can pass into human breast milk.
This medication contains a narcotic ingredient (diphenoxylate), so it’s important not to take more Lomotil than your doctor prescribes.
If you’re breastfeeding or planning to breastfeed, talk with your doctor about the potential benefits and risks of using Lomotil while breastfeeding.
As with all medications, the cost of Lomotil can vary.
The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
If you need financial support to pay for Lomotil, or if you need help understanding your insurance coverage, help is available.
Pfizer Inc., the manufacturer of Lomotil, offers a program called Pfizer RxPathways. For more information and to find out if you’re eligible for support, call 844-989-PATH (844-989-7284) or visit the program website.
You should take Lomotil according to your doctor or healthcare provider’s instructions.
When you start using Lomotil, take two tablets four times a day. Do not take more than eight tablets (20 mg of diphenoxylate) a day. Continue this dosage until your diarrhea starts to improve (stools become firmer), which should happen within 48 hours. Once your diarrhea starts to improve, your dosage may be lowered to as low as two tablets a day. You’ll stop taking Lomotil once your diarrhea is completely gone.
Diarrhea can cause dehydration (water loss in the body), so you can take Lomotil with a glass of water to help replace fluids in your body.
If your diarrhea doesn’t stop within 10 days, talk with your doctor. They may have you stop taking Lomotil and try another treatment.
You can take Lomotil with or without food. Taking Lomotil with food may prevent an upset stomach, especially in children. Diarrhea can cause dehydration, so you can take Lomotil with a glass of water to help replace fluids in your body.
Lomotil’s prescribing information doesn’t mention whether the tablets can be crushed, split, or chewed. So, it’s probably best to swallow them whole. If you can’t swallow tablets, you could take the oral liquid solution, which is only available as a generic. Your doctor or pharmacist can tell you more.
Lomotil belongs to a class of medications called anti-diarrheals. It works by slowing down digestion in the stomach and also relaxes the digestive (stomach) muscles.
Diarrhea causes loose or watery stools that may be frequent. When diarrhea lasts for a short time (one to two days), it’s considered acute. This may be related to a short-term illness such as a stomach bug. Lomotil is typically used for acute diarrhea.
Lomotil can also be used to treat chronic diarrhea (lasting four weeks or longer). This type of diarrhea may be related to a digestive (stomach) condition.
When you have diarrhea, your digestive muscles contract too quickly. This causes food to move quickly through the stomach and intestines, and your body can’t absorb water or electrolytes (vitamins and minerals). Therefore, stools are large and watery, which can lead to dehydration (water loss in the body).
Lomotil works by slowing down digestion and relaxing the digestive muscles. This allows food to move slowly through the stomach and intestines. Your body can then absorb water and electrolytes, which makes stools less watery and less frequent.
Diarrhea should improve within 48 hours of starting Lomotil. This means you should have firmer and less frequent stools. If diarrhea hasn’t improved within 10 days for adults or 48 hours for children, talk with your doctor. They may have you stop taking Lomotil and try another treatment.
Here are answers to some frequently asked questions about Lomotil.
Lomotil is not approved to treat gas and bloating. However, these may be symptoms of diarrhea, which Lomotil can treat. By treating diarrhea, Lomotil may also treat the gas and bloating that can happen when you have diarrhea.
Lomotil can cause stomach pain and discomfort. Diarrhea, the condition that Lomotil treats, can also cause cramping and stomach pain. If your stomach pain gets worse and doesn’t go away after a few days, call your doctor. They can let you know if you need to take another medication or if they need to see you.
No, Lomotil should not be used for diarrhea caused by a bacterial stomach infection (for example, Clostridioides difficile). Taking Lomotil when you have this type of bacterial stomach infection can cause sepsis, a very serious and life-threatening infection.
If you take Lomotil when you have a milder stomach virus, it may make the infection last longer. Call your doctor if you think you may have the stomach flu. They can tell you how you to treat it at home or if they need to see you.
Yes, Lomotil may be used to treat diarrhea caused by irritable bowel syndrome (IBS). However, Lomotil should be used very cautiously if you have inflammatory bowel disease (IBD).
IBS can be caused by stress, certain foods, or medications and is usually not very serious. IBD includes serious conditions such as Crohn’s disease and ulcerative colitis. If you have ulcerative colitis, taking Lomotil can cause toxic megacolon, a rare but very serious infection.
Talk with your doctor about your treatment options if you have diarrhea caused by IBS or IBD. If Lomotil is right for you, they can monitor your treatment.
Talk with your doctor before taking Imodium and Lomotil together. Using these drugs together might increase some side effects such as dizziness and drowsiness. Avoid drinking alcohol or doing activities that require alertness or concentration (for example, driving) until you know how you feel while taking both medications.
Before taking Lomotil, talk with your doctor about your health history. Lomotil may not be right for you if you have certain medical conditions or other factors affecting your health. These include:
Note: For more information about the potential negative effects of Lomotil, see the “Lomotil side effects” section above.
Using more than the recommended dosage of Lomotil can lead to serious side effects, including seizures, coma, or even death.
Symptoms of an overdose can include:
If you think you’ve taken too much of this drug, call your doctor. But if your symptoms are severe, call 911 or go to the nearest emergency room right away. If you have certain symptoms such as respiratory depression (slowed breathing), you may be given a medication called naloxone (Narcan). You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool if it’s not an emergency.
Naloxone (Narcan, Evzio) is a drug that can quickly reverse overdoses from opioids, including heroin. An opioid overdose can make it hard to breathe. This can be fatal if not treated in time.
If you or someone you love is at risk for an opioid overdose, talk with your doctor or pharmacist about naloxone. Ask them to explain the signs of an overdose and show you and your loved ones how to use naloxone.
In most states, you can get naloxone at a pharmacy without a prescription. Keep the drug on hand so you can easily access it in case of an overdose.
When you get Lomotil from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date they dispensed the medication.
The expiration date helps guarantee the medication will be effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.
How long a medication remains good can depend on many factors, including how and where you store the medication.
Lomotil tablets should be stored at room temperature in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.
If you no longer need to take Lomotil and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.
The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.
The following information is provided for clinicians and other healthcare professionals.
Lomotil tablets are indicated for diarrhea in addition to other treatments in people ages 13 years and older.
Lomotil slows down gastrointestinal movement and bowel function. It also relaxes the gastrointestinal muscles to prevent spasms.
It takes about two hours to reach peak plasma levels, and the elimination half-life is about 12 to 14 hours.
Lomotil is contraindicated in:
Lomotil is a Schedule V controlled substance. Diphenoxylate, an ingredient in Lomotil, is a Schedule II controlled substance (related to the narcotic meperidine), but atropine helps lower the risk of misuse. Lomotil is not addictive at the doses recommended for diarrhea but can cause addiction and codeine-like effects in very high doses.
Store Lomotil below 77˚F (25˚C).
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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