CV: tachycardia.
Derm: flushing.
EENT: blurred vision, dry eyes.
GI: constipation, dry mouth, epigastric distress, ileus, nausea, vomiting.
GU: urinary retention.
Neuro: dizziness, confusion, drowsiness, headache, insomnia, nervousness.
Difenoxin/Atropine
Doses given are in terms of difenoxin—each tablet contains 1 mg difenoxin with 0.025 mg of atropine
- PO (Adults): 2 tablets initially, then 1 tablet after each loose stool or every 3–4 hr as needed (not to exceed 8 tablets/day).
Diphenoxylate/Atropine
Adult doses given are in terms of diphenoxylate—each tablet contains 2.5 mg diphenoxylate with 0.025 mg of atropine; pediatric doses are given in mg of diphenoxylate and in mL of diphenoxylate/atropine liquid; each 5 mL of liquid contains 2.5 mg diphenoxylate with 0.025 mg of atropine
- PO (Adults): 5 mg 3–4 times daily initially, then 5 mg once daily as needed (not to exceed 20 mg/day).
- PO (Children): use liquid only: 0.3–0.4 mg/kg/day in 4 divided doses.
Lomotil
difenoxin/atropine: Motofen
Therapeutic Classification: antidiarrheals
Pharmacologic Classification: anticholinergics
Absorption: Well absorbed from the GI tract.
Distribution: Enters breast milk.
Metabolism/Excretion: Diphenoxylate: mostly metabolized by the liver with some conversion to an active antidiarrheal compound (difenoxin). Difenoxin: metabolized by the liver. Minimal excretion in urine.
Half-life: Diphenoxylate: 2.5 hr; difenoxin: 4.5 hr.
Schedule V (C-V)(diphenoxylate/atropine)
Schedule IV (C-IV)(difenoxin/atropine)
dye-fen-OX-i-late/A-troe-peen
difenoxin/atropine: dye-fen-OX-in/A-troe-peen 