Antimotility (diphenoxylate + atropine)
Co-phenotrope
Brand names: Lomotil
Adult dose
Dose: Initial 4 tabs, then 2 tabs every 6h until controlled (max 16 tabs/day)
Route: PO
Frequency: PRN
Clinical pearls
- Severe diarrhoea after exclusion of infectious cause
- Loperamide preferred for most indications now
Contraindications
- Children <4
- Acute UC/pseudomembranous colitis
- Diarrhoea due to antibiotic-associated/invasive infection
- Jaundice
Side effects
- Anticholinergic effects
- Drowsiness
- Atropine toxicity in overdose
- Dependence with prolonged use
Interactions
- MAOIs
- CNS depressants
Reference: BNF; https://bnf.nice.org.uk/drugs/co-phenotrope/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021