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Antimotility (diphenoxylate + atropine)

Co-phenotrope

Brand names: Lomotil

Co-phenotrope is a combination antimotility preparation containing diphenoxylate hydrochloride with atropine sulfate, used as an adjunct to rehydration in the management of acute and chronic diarrhoea in adults.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Diphenoxylate is an opioid that reduces gastrointestinal motility by acting on intestinal opioid receptors; a subtherapeutic amount of atropine is added to deter deliberate overdose.

Prescribing in practice

  • Keep well out of the reach of children, as overdose is dangerous and may cause delayed, severe and possibly fatal respiratory depression.
  • Avoid in acute ulcerative colitis, antibiotic-associated colitis, and conditions where inhibition of peristalsis should be avoided because of the risk of toxic megacolon or ileus.
  • Do not use as the sole treatment in dehydrating diarrhoea; fluid and electrolyte replacement is the priority.

Monitoring

Monitor for signs of abdominal distension or ileus, ongoing fluid and electrolyte status, and any features of central nervous system or respiratory depression.

Counselling the patient

  • Store securely away from children and never exceed the prescribed amount.
  • Keep drinking fluids to replace what is lost.
  • Seek help if the abdomen becomes distended or symptoms worsen.

Evidence & guidelines

Its antidiarrhoeal efficacy is long established and described in current prescribing references and the SPC.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways