difenoxin hcl/atropine (Rx)

Brand and Other Names:Motofen
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

difenoxin hcl/atropine

tablets: Schedule IV

  • 1 mg/0.025 mg

Diarrhea

Initially 2 mg (2 tab) PO then 1 mg (1 tab) q3-4hr PRN loose stool; no more than 8 mg/day

Safety & efficacy not established

Diarrhea

Initially 2 mg (2 tab) PO then 1 mg (1 tab) q3-4hr PRN loose stool; no more than 8 mg/day

Next:

Interactions

Interaction Checker

and difenoxin hcl/atropine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (1)

            • alvimopan

              alvimopan, difenoxin 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 (25)

            • buprenorphine

              buprenorphine, difenoxin 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, difenoxin 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, difenoxin 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

              difenoxin 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 difenoxin 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 difenoxin 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 difenoxin 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

              difenoxin 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, difenoxin 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.

            • pentazocine

              pentazocine, difenoxin 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 difenoxin 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.

            • revefenacin

              revefenacin and atropine both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

            • 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 difenoxin hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death.

            • selegiline transdermal

              selegiline transdermal increases toxicity of difenoxin hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death.

            • sodium oxybate

              difenoxin 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, difenoxin 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 difenoxin 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 (241)

            • 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.

            • albuterol

              difenoxin hcl increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              alfentanil and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • alprazolam

              alprazolam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • amantadine

              atropine, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

            • amitriptyline

              difenoxin hcl and amitriptyline both increase sedation. Use Caution/Monitor.

              atropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

            • amobarbital

              amobarbital and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • amoxapine

              atropine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • amoxapine

              difenoxin 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

              difenoxin hcl and apomorphine both increase sedation. Use Caution/Monitor.

            • arformoterol

              difenoxin hcl increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aripiprazole

              difenoxin hcl and aripiprazole both increase sedation. Use Caution/Monitor.

              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.

            • armodafinil

              difenoxin 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.

            • azelastine

              azelastine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • baclofen

              baclofen and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • belladonna alkaloids

              atropine and belladonna alkaloids both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna and opium

              atropine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              difenoxin hcl and belladonna and opium both increase sedation. 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.

              difenoxin hcl and benperidol both increase sedation. Use Caution/Monitor.

              benperidol increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              atropine decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

            • benzphetamine

              difenoxin hcl increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. 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.

            • bethanechol

              bethanechol increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • brompheniramine

              brompheniramine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • buprenorphine

              buprenorphine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal and difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • butorphanol

              butorphanol and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • caffeine

              difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • carisoprodol

              carisoprodol and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • cenobamate

              cenobamate, difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              difenoxin hcl and chlorpromazine both increase sedation. Use Caution/Monitor.

              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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • cisatracurium

              atropine and cisatracurium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • cinnarizine

              cinnarizine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • clemastine

              clemastine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • clomipramine

              difenoxin hcl and clomipramine both increase sedation. Use Caution/Monitor.

              atropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • clonazepam

              clonazepam and difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • clozapine

              difenoxin hcl and clozapine both increase sedation. Use Caution/Monitor.

            • codeine

              codeine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • cyclizine

              cyclizine and difenoxin hcl both increase sedation. Use Caution/Monitor.

              atropine and cyclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • cyclobenzaprine

              atropine and cyclobenzaprine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              cyclobenzaprine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • darifenacin

              atropine and darifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • dantrolene

              dantrolene and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • desipramine

              difenoxin hcl and desipramine both increase sedation. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              difenoxin hcl increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmedetomidine

              dexmedetomidine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              difenoxin hcl increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              difenoxin hcl increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextromoramide

              dextromoramide and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • diamorphine

              diamorphine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • diazepam

              diazepam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • dicyclomine

              atropine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • diethylpropion

              difenoxin hcl increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • digoxin

              atropine increases levels of digoxin by unknown mechanism. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              atropine and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              diphenhydramine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • diphenoxylate hcl

              difenoxin hcl and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

            • donepezil

              donepezil increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dipipanone

              difenoxin hcl and dipipanone both increase sedation. Use Caution/Monitor.

            • dobutamine

              difenoxin hcl increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopamine

              difenoxin hcl increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopexamine

              difenoxin hcl increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dosulepin

              difenoxin hcl and dosulepin both increase sedation. Use Caution/Monitor.

              atropine and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • doxepin

              difenoxin hcl and doxepin both increase sedation. Use Caution/Monitor.

              atropine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • doxylamine

              doxylamine and difenoxin 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

              difenoxin 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

              difenoxin hcl increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine

              difenoxin hcl increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine racemic

              difenoxin hcl increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • estazolam

              estazolam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • ethanol

              difenoxin hcl and ethanol both increase sedation. Use Caution/Monitor.

            • etomidate

              etomidate and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • fenfluramine

              difenoxin 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.

              difenoxin hcl and fluphenazine both increase sedation. Use Caution/Monitor.

              atropine decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • flurazepam

              flurazepam and difenoxin 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

              difenoxin hcl increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. 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

              difenoxin hcl and haloperidol both increase sedation. Use Caution/Monitor.

              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.

            • henbane

              atropine and henbane both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • hydromorphone

              difenoxin 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 difenoxin 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

              difenoxin hcl and iloperidone both increase sedation. Use Caution/Monitor.

              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.

              atropine decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

            • imipramine

              atropine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              difenoxin 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

              difenoxin 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

              difenoxin hcl increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketamine

              ketamine and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • ketotifen, ophthalmic

              difenoxin hcl and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

            • levalbuterol

              difenoxin hcl increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levorphanol

              difenoxin hcl and levorphanol both increase sedation. Use Caution/Monitor.

            • linezolid

              difenoxin hcl, linezolid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.

            • lisdexamfetamine

              difenoxin 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.

              difenoxin hcl and lofepramine both increase sedation. Use Caution/Monitor.

            • lofexidine

              difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • lorazepam

              lorazepam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • lormetazepam

              lormetazepam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • loxapine

              difenoxin 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.

              difenoxin hcl and loxapine inhaled both increase sedation. Use Caution/Monitor.

              atropine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

            • maprotiline

              atropine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              difenoxin hcl and maprotiline both increase sedation. Use Caution/Monitor.

            • marijuana

              difenoxin hcl and marijuana both increase sedation. Use Caution/Monitor.

            • meclizine

              atropine and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • melatonin

              difenoxin hcl and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              difenoxin hcl and meperidine both increase sedation. Use Caution/Monitor.

            • meprobamate

              difenoxin hcl and meprobamate both increase sedation. Use Caution/Monitor.

            • metaproterenol

              difenoxin hcl increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              metaxalone and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • methadone

              difenoxin hcl and methadone both increase sedation. Use Caution/Monitor.

            • methamphetamine

              difenoxin hcl increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methocarbamol

              methocarbamol and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • methscopolamine

              atropine and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, difenoxin 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

              difenoxin hcl increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mirtazapine

              difenoxin hcl and mirtazapine both increase sedation. Use Caution/Monitor.

            • modafinil

              difenoxin hcl increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              difenoxin hcl and morphine both increase sedation. Use Caution/Monitor.

            • motherwort

              difenoxin hcl and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              difenoxin hcl and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              difenoxin hcl and nabilone both increase sedation. Use Caution/Monitor.

            • nalbuphine

              difenoxin 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

              difenoxin hcl increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nortriptyline

              difenoxin hcl and nortriptyline both increase sedation. Use Caution/Monitor.

              atropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • olanzapine

              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.

              difenoxin hcl and olanzapine both increase sedation. 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

              difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • oxazepam

              oxazepam and difenoxin 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

              difenoxin hcl and oxycodone both increase sedation. Use Caution/Monitor.

            • oxymorphone

              difenoxin hcl and oxymorphone both increase sedation. Use Caution/Monitor.

            • paliperidone

              difenoxin hcl and paliperidone both increase sedation. Use Caution/Monitor.

              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.

              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

              difenoxin hcl and papaveretum both increase sedation. Use Caution/Monitor.

            • papaverine

              difenoxin hcl and papaverine both increase sedation. Use Caution/Monitor.

            • pegvisomant

              difenoxin hcl decreases effects of pegvisomant by unknown mechanism. Use Caution/Monitor.

            • pentazocine

              difenoxin hcl and pentazocine both increase sedation. Use Caution/Monitor.

            • pentobarbital

              pentobarbital and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • perphenazine

              difenoxin hcl and perphenazine both increase sedation. Use Caution/Monitor.

              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.

            • phendimetrazine

              difenoxin 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

              difenoxin hcl, phenelzine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.

            • phenobarbital

              phenobarbital and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • phentermine

              difenoxin hcl increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine

              difenoxin hcl increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine PO

              difenoxin hcl increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • pholcodine

              difenoxin 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.

            • pilocarpine ophthalmic

              pilocarpine ophthalmic increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              difenoxin hcl and pimozide both increase sedation. Use Caution/Monitor.

              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.

              atropine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

            • pirbuterol

              difenoxin 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • prochlorperazine

              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.

              difenoxin hcl and prochlorperazine both increase sedation. Use Caution/Monitor.

              atropine decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • promethazine

              promethazine and difenoxin hcl both increase sedation. Use Caution/Monitor.

              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.

              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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • propylhexedrine

              difenoxin hcl increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protriptyline

              atropine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              difenoxin hcl and protriptyline both increase sedation. 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 difenoxin hcl both increase sedation. Use Caution/Monitor.

            • quetiapine

              atropine decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

              difenoxin hcl and quetiapine both increase sedation. 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

              difenoxin hcl and ramelteon both increase sedation. Use Caution/Monitor.

            • rapacuronium

              atropine and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • rasagiline

              rasagiline increases toxicity of difenoxin hcl by unknown mechanism. Use Caution/Monitor. Chemical structure of difenoxin is similar to meperidine, concurrent use with MAOIs may, in theory, precipitate a hypertensive crisis. Risk of hypotension, hyperpyrexia, somnolence, or death.

            • 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

              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.

              difenoxin hcl and risperidone both increase sedation. 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

              difenoxin 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

              difenoxin hcl and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • sevoflurane

              sevoflurane and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • shepherd's purse

              difenoxin 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, difenoxin 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

              difenoxin hcl and sufentanil both increase sedation. Use Caution/Monitor.

            • tapentadol

              difenoxin hcl and tapentadol both increase sedation. Use Caution/Monitor.

            • temazepam

              temazepam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • terbutaline

              difenoxin hcl increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thioridazine

              difenoxin hcl and thioridazine both increase sedation. Use Caution/Monitor.

              thioridazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              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

              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.

              difenoxin hcl and thiothixene both increase sedation. Use Caution/Monitor.

              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

              difenoxin hcl and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tolterodine

              atropine and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • tramadol

              difenoxin hcl and tramadol both increase sedation. Use Caution/Monitor.

            • tranylcypromine

              difenoxin hcl, tranylcypromine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.

            • trazodone

              difenoxin hcl and trazodone both increase sedation. Use Caution/Monitor.

            • triazolam

              triazolam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • triclofos

              triclofos and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • trifluoperazine

              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.

              difenoxin hcl and trifluoperazine both increase sedation. Use Caution/Monitor.

            • trihexyphenidyl

              atropine and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

            • trimipramine

              difenoxin hcl and trimipramine both increase sedation. Use Caution/Monitor.

            • trimipramine

              atropine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • triprolidine

              triprolidine and difenoxin 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

              difenoxin hcl increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • yohimbine

              difenoxin hcl increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziconotide

              difenoxin hcl and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              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.

              difenoxin hcl and ziprasidone both increase sedation. 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.

              atropine decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              difenoxin hcl and zotepine both increase sedation. 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 difenoxin 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 difenoxin 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

              difenoxin 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 difenoxin 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

              difenoxin 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, difenoxin hcl. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Additive decreased GI motility. Additive analgesia. Ziconotide does NOT potentiate opioid induced respiratory depression.

            Previous
            Next:

            Adverse Effects

            1-10%

            Nausea (6.7%)

            Somnolence (4%)

            Vomiting (3.3%)

            Xerostomia (3.3%)

            Headache (2.5%)

            Frequency Not Defined

            Dizziness

            Lightheadedness

            Abdominal discomfort

            Anticholinergic effects

            Previous
            Next:

            Warnings

            Contraindications

            <2 years old

            Hypersensitivity, infectious diarrhea, jaundice

            GI obstruction, hemorrhage, intestinal atony, myasthenia gravis, obstructive uropathy, reflux esophagitis, ulcerative colitis

            Cautions

            Closed-angle glaucoma, esophageal achalasia

            Hepatorenal disease, abnormal liver function

            Improvement of symptoms within 48 hr, if not, unlikely to be effective

            Do not exceed recommended dosage; reduce initial dosage for maintenance

            Pregnancy, breastfeeding

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: enters breast milk/not recommended

            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.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Difenoxin: Acts on smooth muscle of intestinal tract, inhibiting GI motility & excessive GI propulsion

            Atropine: Subtherapeutic quantity of atropine is added to discourage deliberate overdose of diphenoxylate

            Pharmacokinetics

            Half-life elimination: 4.4 hr

            Onset: 45 min-1 hr

            Duration: 3-4 hr

            Peak Plasma Time: 40-60 min

            Excretion: Feces and urine as conjugates

            Previous
            Next:

            Images

            No images available for this drug.
            Previous
            Next:

            Patient Handout

            A Patient Handout is not currently available for this monograph.
            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            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.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.