Lomotil (diphenoxylate/atropine) is an oral tablet prescribed to treat diarrhea. The usual starting dosage is two tablets of Lomotil taken four times per day, with a decrease in dosage as symptoms improve.

Lomotil is typically used to treat acute (short-term) diarrhea that’s been resistant to other medications. 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 is 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.

Is Lomotil a controlled substance?

Lomotil is a Schedule V controlled substance, which means it has a medical use but may be misused. It contains 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 type and severity of the condition you’re using Lomotil to treat
  • your age
  • other medical conditions you may have

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.

Drug forms and strengths

Lomotil comes as a tablet. Each tablet contains 2.5 milligrams (mg) of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate.

Dosage for diarrhea

When you start using Lomotil, your doctor will prescribe 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 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.

Pediatric dosage

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.

What if I miss a dose?

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.

Will I need to use this drug long term?

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.

More common side effects

The more common side effects of Lomotil can include:

  • headache
  • feeling dizzy or drowsy
  • itchy skin or rash
  • stomach pain, nausea, or vomiting
  • dry skin or mouth
  • feeling restless
  • malaise (general feeling of weakness or discomfort)
  • loss of appetite

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

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:

  • Mood changes. Symptoms can include:
    • feeling depressed (sad or hopeless)
    • feeling euphoric (extremely happy or excited)
  • Hallucinations. Symptoms can include:
    • seeing or hearing something that’s not really there
  • Poisoning from atropine (an ingredient in Lomotil) or opioid side effects from diphenoxylate (another ingredient in Lomotil). Symptoms may include:
    • increased heart rate
    • feeling very hot
    • trouble urinating
    • dry skin and mouth
  • Allergic reaction. See “Side effect details” below to learn more.
  • Respiratory depression (slowed breathing) or central nervous system depression* (loss of brain function) in children younger than 6 years old. See “Side effect details” below to learn more.

* Central nervous system depression can also occur in people of any age taking Lomotil, but it’s only been reported during overdose.

Side effect details

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:

  • skin rash
  • itchiness
  • flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, throat, or gums
  • trouble breathing

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 prescribed 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 prescribed 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

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 for diarrhea

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). 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 and children

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.

For diarrhea, short-term or long-term

Medications are available to treat less serious forms of diarrhea. Some medications are even available over the counter (without a prescription), including:

  • Imodium (loperamide). Imodium is used to treat acute diarrhea, including “traveler’s diarrhea” (diarrhea from consuming contaminated food or water, usually when traveling to another country). Imodium can also be used off-label for diarrhea caused by cancer medications.
  • Pepto Bismol (bismuth subsalicylate). Pepto Bismol is used to treat acute diarrhea, including traveler’s diarrhea. It can be used off-label to treat a bacterial infection called Helicobacter pylori.
  • Metamucil (psyllium). Metamucil can be used off-label to treat diarrhea. Its main use is to treat constipation. It can also be used off-label for irritable bowel syndrome (IBS).

For diarrhea caused by a medical condition

Certain conditions such as IBS can cause diarrhea. Medications such as Viberzi (eluxadoline) can be used to treat IBS with diarrhea.

For diarrhea caused by a bacterial infection

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:

  • ciprofloxacin (Cipro)
  • vancomycin (Vancocin)
  • metronidazole (Flagyl)

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.

For diarrhea caused by medications for serious medical conditions

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 for diarrhea caused by cancer medications. (Off-label use of a medication means that the drug’s FDA-approved for one purpose and is used for a different purpose that has not been approved.)

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.

Uses

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). 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 for diarrhea caused by cancer medications. (Off-label use of a medication means that the drug’s FDA-approved for one purpose and is used for a different purpose that has not been approved.)

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 with 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).

Drug forms and administration

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.

Side effects and risks

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).

  • Can occur with Lomotil:
    • headache
    • itchy skin or rash
    • dry skin or mouth
    • feeling restless
    • malaise (general feeling of weakness or discomfort)
    • loss of appetite
  • Can occur with Imodium:
  • Can occur with both Lomotil and Imodium:
    • feeling dizzy or drowsy
    • stomach pain, nausea, or vomiting

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).

  • Can occur with Lomotil:
    • mood changes, such as depression or euphoria (extreme happiness)
    • hallucinations (seeing or hearing something that’s not really there)
    • poisoning from atropine (ingredient in Lomotil) or opioid side effects from diphenoxylate (ingredient in Lomotil)
    • respiratory depression (slowed breathing) or central nervous system depression (loss of brain function) in children younger than 6 years old
  • Can occur with both Lomotil and Imodium:
    • allergic reaction
    • trouble urinating

Effectiveness

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.

Costs

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).

The actual price you’ll pay for Lomotil or Imodium 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 drink alcohol and you’re concerned about drinking it 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.

Lomotil and other medications

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:

  • barbiturates, such as butabarbital (Butisol), which treat sleeping disorders
  • anxiolytics, such as buspirone and benzodiazepines (alprazolam, or Xanax), which treat anxiety
  • opioids, such as oxycodone (Oxycontin), which treat pain
  • antihistamines, such as diphenhydramine (Benadryl), which treat allergies
  • muscle relaxants, such as carisoprodol (Soma), which treat muscle spasms

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.

Lomotil and herbs and supplements

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.

Financial and insurance assistance

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 professional’s instructions.

When to take

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.

Taking Lomotil with food

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.

Can Lomotil be crushed, split, or chewed?

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.

How long does it take to work?

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.

Can I use Lomotil to treat diarrhea from IBS?

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.

Will Lomotil make me feel sleepy?

Yes, you may feel tired while taking Lomotil. This is because the drug can cause drowsiness as a side effect.

Drowsiness is described as feeling sleepy or lethargic. Mild drowsiness was reported in clinical studies by some people who took a prescribed dose of Lomotil. But more severe drowsiness was reported by people who took more than the typical dosage.

It’s important to follow the dosage prescribed by your doctor. Taking more than this can lead to serious side effects, like severe drowsiness. 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.

Is Lomotil addictive?

No, Lomotil is not considered addictive when it’s taken at the recommended dosage for diarrhea. (With addiction, it’s difficult to stop taking a drug, even if it’s causing harmful effects.)

However, Lomotil can cause addiction if it’s taken in very high doses. It’s important not to take more Lomotil than your doctor prescribes.

For more information about Lomotil and addiction, see “Is Lomotil a controlled substance?” under “What is Lomotil?” at the beginning of the article.

Does Lomotil help treat gas and bloating?

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.

Will Lomotil cause cramping or pain in my belly?

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.

Should I take Lomotil if I have diarrhea from the stomach flu?

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.

Can Imodium and Lomotil be used together?

Talk with your doctor before taking Imodium and Lomotil together. Using these drugs together might increase some side effects such as dizziness and drowsiness. If you drink alcohol, avoid drinking it 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:

  • Age. Lomotil tablets should only be used by adults and children ages 13 years and older. Lomotil can cause serious side effects in children under age 6 years. See information about respiratory depression and central nervous system depression in the “Side effect details” section above.
  • Down syndrome (in children). Lomotil contains the drug atropine. It can cause atropine poisoning in children with Down syndrome. Your doctor can tell you more.
  • Stomach infections. Lomotil should not be used for diarrhea caused by certain bacterial infections (for example, Clostridium difficile). Taking Lomotil when you have this type of bacterial stomach infection can cause sepsis, a very serious and life threatening infection.
  • Ulcerative colitis. If you have ulcerative colitis (a type of inflammatory bowel disease), talk with your doctor before using Lomotil. Lomotil use in someone with ulcerative colitis can cause a rare but very serious infection called toxic megacolon.
  • Liver or kidney disease. If you have kidney disease or liver disease, talk with your doctor before using Lomotil.
  • Severe allergy. You should not take Lomotil if you’re allergic to either of its ingredients (diphenoxylate or atropine).
  • Dehydration. If you have severe dehydration (water loss from the body), you should not take Lomotil. The way Lomotil works in your intestines may cause your body to retain fluid, which could make dehydration worse.
  • Pregnancy. There isn’t enough data from human or animal studies to know if it’s safe to take Lomotil during pregnancy. For more information, see the “Lomotil and pregnancy” section above.
  • Breastfeeding. There isn’t enough data from human or animal studies to know if it’s safe to take Lomotil while breastfeeding. For more information, see the “Lomotil and breastfeeding” section above.

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. Do not take more Lomotil than your doctor prescribes.

Overdose symptoms

Symptoms of an overdose can include:

  • having trouble breathing
  • extreme tiredness and weakness
  • feeling warm
  • high heart rate
  • dry skin
  • feeling overheated
  • having trouble thinking and speaking
  • changes in the size of your pupils (dark dot in the center of the eyes)

What to do in case of overdose

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 its online tool if it’s not an emergency.

Naloxone: A lifesaver

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 with your pharmacist about whether you might still be able to use it.

Storage

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.

Disposal

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.

Indications

Lomotil tablets are indicated for diarrhea in addition to other treatments in people ages 13 years and older.

Mechanism of action

Lomotil slows down gastrointestinal movement and bowel function. It also relaxes the gastrointestinal muscles to prevent spasms.

Pharmacokinetics and metabolism

It takes about two hours to reach peak plasma levels, and the elimination half-life is about 12 to 14 hours.

Contraindications

Lomotil is contraindicated in:

  • patients under 6 years of age, as it can cause respiratory distress and central nervous system depression
  • patients with diarrhea due to enterotoxin-producing bacteria such as Clostridium difficile, as it can cause gastrointestinal issues such as sepsis
  • patients with an allergy or hypersensitivity to diphenoxylate or atropine
  • patients with obstructive jaundice

Misuse and dependence

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.

Storage

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 another 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.

Lomotil Images