What is in Lomotil ?

Hi My doctor has me on Lomotil for diarreah (diarrhea) due to Irritable Bowel , and i've noticed it makes me rather dizzy and dopey when I take it ...I thought it was like Immodium which doesn't make me dizzy but the Lomotil works way better at controling my diarreah (diarrhea). And is there any long term side effects I should worry about ? BTW it's the first drug that has ever allowed me to take control of my IBS ..Thank you for any info you can give !!

[Jennifer R, RPh]

The main side effects that have been reported with diphenoxylate ( Lomotil) include drowsiness (4%), dizziness (5%), and headache (2.5%). Euphoria, depression, malaise/lethargy, restlessness, and numbness of extremities have been reported less frequently.
Here are a couple of the precautions listed by the manufacturer for you to take a look.

Diphenoxylate should not be administered to patients experiencing dehydration or electrolyte imbalance. Diphenoxylate and atropine may lead to retention of fluid in the intestine, due to inhibition of peristalsis. This may further aggravate dehydration and electrolyte imbalance. Rehydration should be undertaken before therapy is initiated and appropriate administration of fluid and electrolytes should accompany the use of diphenoxylate.

Diphenoxylate is classified as FDA pregnancy risk category C. Adequate studies in pregnant women have not been conducted, so diphenoxylate should be used during pregnancy only when clearly needed. The active metabolite of diphenoxylate, diphenoxylic acid, and atropine are excreted into breast milk. Incompatabilities with breast-feeding have not been reported, but the benefits to the mother should be weighed against the risks to the nursing infant.

Although symptoms of dependence have not been reported in patients receiving therapeutic dosages of diphenoxylate, opiate withdrawal can follow the cessation of higher dosage regimens. The drug should be prescribed cautiously to patients with a history of opiate substance abuse.

Diphenoxylate should be administered with extreme caution to patients with hepatic disease (e.g., cirrhosis), obstructive jaundice, hepatorenal syndrome, or abnormal liver-function tests because of the risk of developing hepatic coma. Reduced dosages of diphenoxylate have been recommended.

Diphenoxylate and other drugs that inhibit intestinal motility or prolong transit time can induce toxic megacolon in patients with acute ulcerative colitis. Patients with ulcerative colitis should be monitored closely and diphenoxylate therapy discontinued if signs of toxicity (e.g., abdominal distension) occur.

Diphenoxylate should not be used in cases of diarrhea caused by poisoning or infection with enterotoxin-producing bacteria (bacterial gastroenteritis) because expulsion of the toxic intestinal contents may be a necessary protective mechanism.
Diphenoxylate is contraindicated in cases of diarrhea caused by pseudomembranous colitis.

Diphenoxylate should not be administered to children under 2 years of age or patients with Down's syndrome because of the increased risk of toxicity in these groups. Signs of atropinism (e.g., dryness of the skin and mucous membranes, increased pupillary dilatation, and tachycardia) may become evident in children, even at recommended doses. In addition, infants and the elderly may have an increased susceptibility to the respiratory-depressant effects of diphenoxylate.

The concomitant administration of diphenoxylate and MAOI therapy may increase the risk of hypertensive crisis.

Wishing you the best,
Jennifer R RPh www.drugstore.com