Dosing & Uses
Dosage Forms & Strengths
diphenoxylate/atropine (Schedule V)
tablet
- 2.5mg/0.025mg
solution
- 2.5mg/0.025mg/5mL
Diarrhea
5 mg diphenoxylate/0.05 mg atropine (2 tablets) PO q6hr; not to exceed 20 mg diphenoxylate daily until initial control of diarrhea achieved (usually 48 hr)
Contact physician if diarrhea continues beyond 48 hr; discontinue use if clinical improvement not seen within 10 days of dosing with maximum dose
Maintenance: As low as 25% of initial daily dosage
Dosage Forms & Strengths
diphenoxylate/atropine (Schedule V)
tablet
- 2.5mg/0.025mg
solution
- 2.5mg/0.025mg/5mL
Diarrhea
<2 years
- Safety and efficacy not established
2-13 years (liquid formulation only)
- Initial: 0.3 to 0.4 mg diphenoxylate/kg/day in 4 divided doses
- 2 years (11-14 kg): 1.5-3 mL PO q6hr
- 3 years (12-16 kg): 2-3 mL PO q6hr
- 4 years (14-20 kg ): 2-4 mL PO q6hr
- 5 years (16-23 kg): 2.5-4.5 mL PO q6hr
- 6-8 years (17-32 kg): 2.5-5 mL PO q6hr
- 9-12 years (23 to 55 kg): 3.5-5 mL PO q6hr
≥13 years
- 5 mg diphenoxylate/0.05 mg atropine PO q6hr; not to exceed 20 mg diphenoxylate daily until initial control of diarrhea achieved (ususally 48 hr)
- Contact physician if diarrhea continues beyond 48 hr; discontinue use if clinical improvement not seen within 10 days of dosing with maximum dose
- Maintenance: As low as 25% of initial dosage
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- alvimopan
alvimopan, diphenoxylate hcl. receptor binding competition. Contraindicated. Contraindicated in opioid tolerant patients (ie, those who have taken therapeutic doses of opioids for >7 consecutive days immediately prior to taking alvimopan). Patients recently exposed to opioids are expected to be more sensitive to the effects of alvimopan and therefore may experience abdominal pain, nausea and vomiting, and diarrhea.
Serious - Use Alternative (28)
- buprenorphine
buprenorphine, diphenoxylate hcl. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- buprenorphine buccal
buprenorphine buccal, diphenoxylate hcl. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- butorphanol
butorphanol, diphenoxylate hcl. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- calcium/magnesium/potassium/sodium oxybates
diphenoxylate hcl, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- cimetidine
cimetidine increases effects of diphenoxylate hcl by decreasing metabolism. Avoid or Use Alternate Drug.
- eluxadoline
atropine, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions. .
- glucagon
glucagon increases effects of atropine by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .
- glucagon intranasal
glucagon intranasal increases effects of atropine by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .
- glycopyrronium tosylate topical
glycopyrronium tosylate topical, atropine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- isocarboxazid
isocarboxazid increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- linezolid
linezolid increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- macimorelin
atropine, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that may blunt the growth hormone (GH) response to macrimorelin may impact the accuracy of the diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.
- metoclopramide intranasal
diphenoxylate hcl, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- nalbuphine
nalbuphine, diphenoxylate hcl. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- olopatadine intranasal
diphenoxylate hcl and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- pentazocine
pentazocine, diphenoxylate hcl. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- phenelzine
phenelzine increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- pramlintide
pramlintide, atropine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- rasagiline
rasagiline increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Chemical structure of diphenoxylate is similar to meperidine, concurrent use may precipitate hypertensive crises.
- revefenacin
revefenacin and atropine both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and diphenoxylate hcl both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- secretin
atropine decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.
- selegiline
selegiline increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death.
- selegiline transdermal
selegiline transdermal increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death.
- sodium oxybate
diphenoxylate hcl, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tramadol
tramadol, diphenoxylate hcl. Other (see comment). Avoid or Use Alternate Drug. Comment: Tramadol may reinitiate opiate dependence in pts. previously addicted to other opiates; it may also provoke withdrawal Sx. in pts. who are currently opiate dependent.
- tranylcypromine
tranylcypromine increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- umeclidinium bromide/vilanterol inhaled
atropine, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Concomitant use with other anticholinergic-containing drugs may lead to additive anticholinergic adverse effects.
Monitor Closely (261)
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .
- aclidinium
atropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- acrivastine
acrivastine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- albuterol
diphenoxylate hcl increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- alprazolam
alprazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- amantadine
atropine, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.
- amisulpride
amisulpride and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- amitriptyline
atropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.
diphenoxylate hcl and amitriptyline both increase sedation. Use Caution/Monitor. - amobarbital
amobarbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- amoxapine
atropine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
diphenoxylate hcl and amoxapine both increase sedation. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and atropine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- apomorphine
diphenoxylate hcl and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
diphenoxylate hcl increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
atropine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
aripiprazole increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
diphenoxylate hcl and aripiprazole both increase sedation. Use Caution/Monitor. - armodafinil
diphenoxylate hcl increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atracurium
atracurium and atropine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- asenapine
asenapine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- avapritinib
avapritinib and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- azelastine
azelastine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- belladonna alkaloids
atropine and belladonna alkaloids both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
diphenoxylate hcl and belladonna and opium both increase sedation. Use Caution/Monitor.
atropine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor. - benperidol
atropine decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
benperidol increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
diphenoxylate hcl and benperidol both increase sedation. Use Caution/Monitor.
atropine decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor. - benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- benztropine
atropine and benztropine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.
- benzphetamine
diphenoxylate hcl increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bethanechol
bethanechol increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brexanolone
brexanolone, diphenoxylate hcl. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of buprenorphine with anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.
- butabarbital
butabarbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- caffeine
diphenoxylate hcl increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbachol
carbachol increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate, diphenoxylate hcl. Either increases effects of the other by sedation. Use Caution/Monitor.
- cevimeline
cevimeline increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- chlorpromazine
diphenoxylate hcl and chlorpromazine both increase sedation. Use Caution/Monitor.
chlorpromazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor. - chlorzoxazone
chlorzoxazone and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- cisatracurium
atropine and cisatracurium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cinnarizine
cinnarizine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- clemastine
clemastine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- clomipramine
diphenoxylate hcl and clomipramine both increase sedation. Use Caution/Monitor.
atropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. - clonazepam
clonazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- clozapine
atropine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - clorazepate
clorazepate and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- clozapine
diphenoxylate hcl and clozapine both increase sedation. Use Caution/Monitor.
- codeine
codeine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
atropine and cyclizine both decrease cholinergic effects/transmission. Use Caution/Monitor. - cyclobenzaprine
cyclobenzaprine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
atropine and cyclobenzaprine both decrease cholinergic effects/transmission. Use Caution/Monitor. - cyproheptadine
cyproheptadine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- darifenacin
atropine and darifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dantrolene
dantrolene and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- daridorexant
diphenoxylate hcl and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- desipramine
diphenoxylate hcl and desipramine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
dexchlorpheniramine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dexfenfluramine
diphenoxylate hcl increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
diphenoxylate hcl increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
diphenoxylate hcl increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromoramide
dextromoramide and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dicyclomine
atropine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diethylpropion
diphenoxylate hcl increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- digoxin
atropine increases levels of digoxin by unknown mechanism. Use Caution/Monitor.
diphenoxylate hcl will increase the level or effect of digoxin by unspecified interaction mechanism. Use Caution/Monitor. Measure serum digoxin concentrations before initiating concomitant drugs; continue monitoring and reduce digoxin dose as necessary - dimenhydrinate
dimenhydrinate and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- diphenhydramine
atropine and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dipipanone
diphenoxylate hcl and dipipanone both increase sedation. Use Caution/Monitor.
- dobutamine
diphenoxylate hcl increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil
donepezil increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal, atropine. Either decreases effects of the other by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.
- dopamine
diphenoxylate hcl increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
diphenoxylate hcl increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
diphenoxylate hcl and dosulepin both increase sedation. Use Caution/Monitor.
atropine and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor. - doxepin
diphenoxylate hcl and doxepin both increase sedation. Use Caution/Monitor.
atropine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. - doxylamine
doxylamine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- droperidol
atropine decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - droperidol
diphenoxylate hcl and droperidol both increase sedation. Use Caution/Monitor.
- echothiophate iodide
echothiophate iodide increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ephedrine
diphenoxylate hcl increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
diphenoxylate hcl increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
diphenoxylate hcl increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, diphenoxylate hcl. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
estazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- ethanol
diphenoxylate hcl and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- fenfluramine
diphenoxylate hcl increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fentanyl
fentanyl, atropine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fentanyl intranasal
fentanyl intranasal, atropine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fentanyl transdermal
fentanyl transdermal, atropine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fentanyl transmucosal
fentanyl transmucosal, atropine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fesoterodine
atropine and fesoterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
atropine and flavoxate both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fluphenazine
atropine decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
diphenoxylate hcl and fluphenazine both increase sedation. Use Caution/Monitor. - flurazepam
flurazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- galantamine
galantamine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- formoterol
diphenoxylate hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ganaxolone
diphenoxylate hcl and ganaxolone both increase sedation. Use Caution/Monitor.
- glycopyrrolate
atropine and glycopyrrolate both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
atropine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
atropine decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
haloperidol increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
diphenoxylate hcl and haloperidol both increase sedation. Use Caution/Monitor. - henbane
atropine and henbane both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hydromorphone
diphenoxylate hcl and hydromorphone both increase sedation. Use Caution/Monitor.
- homatropine
atropine and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- hyoscyamine
atropine and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
atropine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
atropine decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
iloperidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
diphenoxylate hcl and iloperidone both increase sedation. Use Caution/Monitor.
atropine decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor. - imipramine
atropine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
diphenoxylate hcl and imipramine both increase sedation. Use Caution/Monitor. - incobotulinumtoxinA
atropine, incobotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.
- isocarboxazid
diphenoxylate hcl, isocarboxazid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.
- ipratropium
atropine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.
- isoproterenol
diphenoxylate hcl increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketamine
ketamine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
diphenoxylate hcl and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lasmiditan
lasmiditan, diphenoxylate hcl. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, diphenoxylate hcl. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levalbuterol
diphenoxylate hcl increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
diphenoxylate hcl and levorphanol both increase sedation. Use Caution/Monitor.
- linezolid
diphenoxylate hcl, linezolid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.
- lisdexamfetamine
diphenoxylate hcl increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lofepramine
atropine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
diphenoxylate hcl and lofepramine both increase sedation. Use Caution/Monitor. - lofexidine
diphenoxylate hcl and lofexidine both increase sedation. Use Caution/Monitor.
- loxapine
atropine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loprazolam
loprazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- lormetazepam
lormetazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- loxapine
diphenoxylate hcl and loxapine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
diphenoxylate hcl and loxapine inhaled both increase sedation. Use Caution/Monitor.
atropine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - lurasidone
lurasidone, diphenoxylate hcl. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
atropine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- maprotiline
diphenoxylate hcl and maprotiline both increase sedation. Use Caution/Monitor.
- marijuana
diphenoxylate hcl and marijuana both increase sedation. Use Caution/Monitor.
- meclizine
atropine and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- melatonin
diphenoxylate hcl and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
diphenoxylate hcl and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
diphenoxylate hcl and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
diphenoxylate hcl increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- methadone
diphenoxylate hcl and methadone both increase sedation. Use Caution/Monitor.
- methamphetamine
diphenoxylate hcl increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- methscopolamine
atropine and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylenedioxymethamphetamine
diphenoxylate hcl increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoclopramide intranasal
atropine will decrease the level or effect of metoclopramide intranasal by Other (see comment). Use Caution/Monitor. Coadministration of metoclopramide intranasal with drugs that impair GI motility may decrease systemic absorption of metoclopramide. Monitor for reduced therapeutic effect.
- midazolam
midazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, diphenoxylate hcl. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
diphenoxylate hcl increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
diphenoxylate hcl and mirtazapine both increase sedation. Use Caution/Monitor.
- modafinil
diphenoxylate hcl increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
diphenoxylate hcl and morphine both increase sedation. Use Caution/Monitor.
- motherwort
diphenoxylate hcl and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
diphenoxylate hcl and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
diphenoxylate hcl and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
diphenoxylate hcl and nalbuphine both increase sedation. Use Caution/Monitor.
- neostigmine
neostigmine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- norepinephrine
diphenoxylate hcl increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
diphenoxylate hcl and nortriptyline both increase sedation. Use Caution/Monitor.
atropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. - olanzapine
diphenoxylate hcl and olanzapine both increase sedation. Use Caution/Monitor.
atropine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
atropine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
olanzapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oliceridine
atropine increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.
- opium tincture
diphenoxylate hcl and opium tincture both increase sedation. Use Caution/Monitor.
- onabotulinumtoxinA
atropine and onabotulinumtoxinA both decrease cholinergic effects/transmission. Use Caution/Monitor.
- orphenadrine
atropine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
orphenadrine and diphenoxylate hcl both increase sedation. Use Caution/Monitor. - oxazepam
oxazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- oxybutynin
atropine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
atropine and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
atropine and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
diphenoxylate hcl and oxycodone both increase sedation. Use Caution/Monitor.
- oxymorphone
diphenoxylate hcl and oxymorphone both increase sedation. Use Caution/Monitor.
- paliperidone
atropine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
diphenoxylate hcl and paliperidone both increase sedation. Use Caution/Monitor.
paliperidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
atropine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- papaveretum
diphenoxylate hcl and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
diphenoxylate hcl and papaverine both increase sedation. Use Caution/Monitor.
- pegvisomant
diphenoxylate hcl decreases effects of pegvisomant by unknown mechanism. Use Caution/Monitor.
- pentazocine
diphenoxylate hcl and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- perphenazine
atropine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
perphenazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
diphenoxylate hcl and perphenazine both increase sedation. Use Caution/Monitor. - phendimetrazine
diphenoxylate hcl increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- physostigmine
physostigmine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenelzine
diphenoxylate hcl, phenelzine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.
- phenobarbital
phenobarbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- phentermine
diphenoxylate hcl increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
diphenoxylate hcl increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
diphenoxylate hcl increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
diphenoxylate hcl and pholcodine both increase sedation. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
atropine decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pimozide increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
diphenoxylate hcl and pimozide both increase sedation. Use Caution/Monitor.
atropine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. - pirbuterol
diphenoxylate hcl increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- prabotulinumtoxinA
atropine, prabotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.
- pralidoxime
atropine and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.
- primidone
primidone and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- prochlorperazine
diphenoxylate hcl and prochlorperazine both increase sedation. Use Caution/Monitor.
atropine decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. - promethazine
atropine decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
promethazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
promethazine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
atropine decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor. - propantheline
atropine and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- propofol
propofol and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- propylhexedrine
diphenoxylate hcl increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
diphenoxylate hcl and protriptyline both increase sedation. Use Caution/Monitor.
atropine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. - pyridostigmine
pyridostigmine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quazepam
quazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- quetiapine
diphenoxylate hcl and quetiapine both increase sedation. Use Caution/Monitor.
atropine decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
atropine decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
quetiapine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - ramelteon
diphenoxylate hcl and ramelteon both increase sedation. Use Caution/Monitor.
- rapacuronium
atropine and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- rimabotulinumtoxinB
atropine, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- risperidone
diphenoxylate hcl and risperidone both increase sedation. Use Caution/Monitor.
atropine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rocuronium
atropine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- salmeterol
diphenoxylate hcl increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scopolamine
atropine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scullcap
diphenoxylate hcl and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- sevoflurane
sevoflurane and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- shepherd's purse
diphenoxylate hcl and shepherd's purse both increase sedation. Use Caution/Monitor.
- solifenacin
atropine and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- stiripentol
stiripentol, diphenoxylate hcl. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- succinylcholine
succinylcholine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sufentanil
diphenoxylate hcl and sufentanil both increase sedation. Use Caution/Monitor.
- tapentadol
diphenoxylate hcl and tapentadol both increase sedation. Use Caution/Monitor.
- temazepam
temazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- terbutaline
diphenoxylate hcl increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
thioridazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
diphenoxylate hcl and thioridazine both increase sedation. Use Caution/Monitor.
atropine decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor. - thiothixene
diphenoxylate hcl and thiothixene both increase sedation. Use Caution/Monitor.
atropine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. - tiotropium
atropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- topiramate
diphenoxylate hcl and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tolterodine
atropine and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tramadol
diphenoxylate hcl and tramadol both increase sedation. Use Caution/Monitor.
- tranylcypromine
diphenoxylate hcl, tranylcypromine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.
- trazodone
diphenoxylate hcl and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
triazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- triclofos
triclofos and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- trifluoperazine
diphenoxylate hcl and trifluoperazine both increase sedation. Use Caution/Monitor.
atropine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trifluoperazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. - trihexyphenidyl
atropine and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimipramine
diphenoxylate hcl and trimipramine both increase sedation. Use Caution/Monitor.
- trimipramine
atropine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- triprolidine
triprolidine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- trospium chloride
atropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- umeclidinium bromide
umeclidinium bromide and atropine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents
- vecuronium
atropine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- xylometazoline
diphenoxylate hcl increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
diphenoxylate hcl increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
diphenoxylate hcl and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
diphenoxylate hcl and ziprasidone both increase sedation. Use Caution/Monitor.
atropine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
atropine decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
diphenoxylate hcl and zotepine both increase sedation. Use Caution/Monitor.
atropine decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
Minor (31)
- amitriptyline
amitriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- amoxapine
amoxapine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- atenolol
atropine increases levels of atenolol by unknown mechanism. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of diphenoxylate hcl by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- chlorpromazine
chlorpromazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- clomipramine
clomipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- desipramine
atropine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.
desipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown. - dextroamphetamine
dextroamphetamine increases effects of diphenoxylate hcl by unspecified interaction mechanism. Minor/Significance Unknown.
- dimenhydrinate
dimenhydrinate increases toxicity of atropine by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of atropine by pharmacodynamic antagonism. Minor/Significance Unknown.
- doxepin
doxepin increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- eucalyptus
diphenoxylate hcl and eucalyptus both increase sedation. Minor/Significance Unknown.
- fluphenazine
fluphenazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- galantamine
galantamine decreases effects of atropine by pharmacodynamic antagonism. Minor/Significance Unknown.
- imipramine
imipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- levodopa
atropine, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .
- lidocaine
lidocaine increases toxicity of diphenoxylate hcl by pharmacodynamic synergism. Minor/Significance Unknown. Risk of increased CNS depression.
- lofepramine
lofepramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- maprotiline
maprotiline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- nortriptyline
nortriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- perphenazine
perphenazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- prochlorperazine
prochlorperazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- promazine
promazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- promethazine
promethazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- protriptyline
protriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- sage
diphenoxylate hcl and sage both increase sedation. Minor/Significance Unknown.
- thioridazine
thioridazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- trazodone
atropine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
trazodone increases levels of atropine by unknown mechanism. Minor/Significance Unknown. - trifluoperazine
trifluoperazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.
- trimipramine
trimipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- ziconotide
ziconotide, diphenoxylate hcl. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Additive decreased GI motility. Additive analgesia. Ziconotide does NOT potentiate opioid induced respiratory depression.
Adverse Effects
1-10%
Anticholinergic effects
Blurred vision
Sedation
Nausea
Vomiting
Abdominal discomfort
Dryness of skin or mouth
Frequency Not Defined
Pancreatitis
Toxic megacolon
Warnings
Contraindications
Hypersensitivity to diphenoxylate or atropine
Children aged <6 years owing to risks of respiratory and CNS depression (tablets only)
Obstructive jaundice
Diarrhea associated with pseudomembranous enterocolitis or infectious enterotoxin-producing bacteria
Cautions
Cases of severe respiratory depression and coma, leading to permanent brain damage or death reported in children aged <6 years administered tablets (see Contraindications)
May cause CNS depression; may impair physical or mental abilities; patients should use caution when performing tasks requiring mental alertness, including operating heavy machinery or driving
Use should be accompanied by appropriate fluid and electrolyte therapy, when indicated; if severe dehydration or electrolyte imbalance present, drug should be withheld until appropriate corrective therapy initiated; drug-induced inhibition of peristalsis may result in fluid retention in intestine, which may further aggravate dehydration and electrolyte imbalance
Use with extreme caution in patients with advanced hepatorenal disease and in all patients with abnormal liver function; hepatic coma may be precipitated
Therapy may slow GI motility and may enhance bacterial overgrowth and the release of bacterial endotoxins, which have been reported to result in serious GI complications, including sepsis and prolonged and/or worsening diarrhea
In patients with acute ulcerative colitis, agents that inhibit intestinal motility or prolong intestinal transit time reported to induce toxic megacolon; patients with acute ulcerative colitis should be carefully observed and therapy discontinued promptly if abdominal distention occurs or if other untoward symptoms develop
Improvement of symptoms expected within 48 hours; if no improvement within this time, drug is unlikely to be effective
Do not exceed recommended dosage; reduce initial dosage for maintenance
Give consideration to development of adverse reactions associated with use of atropine; therapy has caused atropinism (hyperthermia, tachycardia, urinary retention, flushing, dryness of the skin and mucous membranes) particularly in pediatric patients with Down’s syndrome; therapy is not indicated for use in pediatric patients; monitor patients for signs of atropinism
Diphenoxylate hydrochloride may potentiate action of other drugs that cause dizziness or drowsiness, including barbiturates, benzodiazepines and other sedatives/hypnotics, anxiolytics, and tranquilizers, muscle relaxants, general anesthetics, antipsychotics, other opioids, and alcohol; patient should be closely observed when any of these are used concomitantly
Renal impairment
Hepatic impairment
Coadministration with opioids increases risk of anticholinergic and opioid toxicities; initial presenting symptoms may be delayed by up to 30 hr due to prolonged gastric emptying time induced by diphenoxylate
Therapy contraindicated in patients with diarrhea associated with organisms that penetrate the GI mucosa; antiperistaltic agents, slow gastrointestinal motility and may enhance bacterial overgrowth and release of bacterial exotoxins; drug has been reported to result in serious GI complications in patients with infectious diarrhea, including sepsis, prolonged and/or worsened diarrhea; prolonged fever and the delay in resolution of stool pathogens reported in study of Shigellosis in adults
Since chemical structure of diphenoxylate hydrochloride is similar to that of meperidine hydrochloride, concurrent use with monoamine oxidase (MAO) inhibitors may, in theory, precipitate hypertensive crisis
Pregnancy & Lactation
Pregnancy
There are no adequate and well-controlled studies in pregnant women; drug should be used during pregnancy only if anticipated benefit justifies potential risk to fetus; diphenoxylate hydrochloride shown to have effect on fertility in rats when given in doses 50 times human dose; a decrease in maternal weight gain of 30% at 20 mg/kg/day and of 10% at 4 mg/kg/day; at 10 times human dose (4 mg/kg/day), average litter size was slightly reduced
Lactation
Exercise caution when drug is administered to nursing woman, since physicochemical characteristics of major metabolite, diphenoxylic acid, are such that it may be excreted in breast milk and since it is known that atropine is excreted in breast milk
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Diphenoxylate: Acts on smooth muscle of intestinal tract, inhibiting GI motility and excessive GI propulsion (like morphine)
Atropine: Subtherapeutic quantity of atropine is added to discourage deliberate overdose of diphenoxylate
Absorption
Onset: 45 min-1 hr
Duration: 3-4 hr
Peak plasma time: 2 hr
Bioavailability: 90%
Distribution
Vd: 324.2 L
Metabolism
Extensively metabolized in liver to active metabolite, diphenoxylic acid (difenoxin), which is 5 times more potent than diphenoxylate
Metabolites: Diphenoxylic acid (active), hydroxydiphenoxylic acid (inactive)
Elimination
Half-life: 2.5 hr (diphenoxylate); 3-14 hr (diphenoxylic acid)
Renal clearance: 1483 mL/min
Excretion: Feces via bile (49%), urine (14%)
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Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
