Diphenoxylate and Atropine (Oral)

Diphenoxylate and Atropine is used as a complimentary therapy to treat severe acute diarrhea in adults over the age of 13. This medication works by slowing down the movement of the intestines to stop diarrhea.


Diphenoxylate and Atropine is a combination medication used as a complimentary therapy to treat adults with severe acute diarrhea. It is recommended only for use by adults, and is generally not prescribed to children under the age of 13. Diphenoxylate and Atropine interferes with the propulsion of intestinal contents, stopping diarrhea.

Because of its chemical relationship to certain narcotics, Diphenoxylate has the potential to become habit-forming, if not taken as prescribed. For this reason, Diphenoxylate and Atropine is manufactured as a combination medication. A small amount of Atropine is added to this medication to prevent possible abuse. Diphenoxylate does not produce the same pain-relieving effects of some narcotics. If taken in large doses, however, a sense of euphoria may occur. If high doses of the combination including Atropine are taken, unpleasant side effects will occur.

Conditions Treated

Type Of Medicine

  • Antidiarrheal

Side Effects

Side effects have been known to occur with the use of Diphenoxylate and Atropine. Not all side effects occur in all patients, but if unwanted effects occur, immediate medical attention may be necessary. Some side effects will subside as the body adjusts to treatment. A physician may provide suggestions for reducing the risk of side effects. Because Diphenoxylate and Atropine is prescribed in low doses, side effects are rare. The following side effects are less common, but may occur:

Once medication is stopped, certain side effects may occur. The prescribing physician should be notified if any of the following side effects occur after treatment is completed:

  • Muscle cramps
  • Nausea or vomiting
  • Shivering or trembling
  • Stomach cramps
  • Sweating

Additional side effects, not listed may also occur in certain patients. Any unusual effects or medical concerns should be discussed with the prescribing physician.


As with any medication, Diphenoxylate and Atropine should only be used by the person it is prescribed to and should be used as directed. Side effects may occur if not taken as directed. This medication is available both as a solution and a tablet and should be administered orally. Diphenoxylate and Atropine is available as a cherry flavored oral solution and as a tablet. Allergies should be discussed with a prescribing physician, as each type contains different inactive ingredients.

Diphenoxylate and Atropine dosage will vary from patient to patient. Specific instructions will be including on the label. A physician may prescribe a dosage that is not typical, and if so, all instructions should be adhered to, unless the physician makes changes. The amount prescribed depends on the strength of the medication, along with the number of doses taken each day, the time allotted between doses and the length of time that the medication will be taken. General dosages are listed below.

Oral dosage for severe diarrhea in adults and teenagers (liquid solution): The first dose is 5 mg (2 teaspoons) three or four times per day. The dose is then 5 mg, once per day, as needed.

Oral dosage for severe diarrhea in adults and teenagers (tablet): The first dose is 5 mg (2 tablets) three or four times per day. The dose is then 5 mg, once per day, as needed. Clinical improvement of acute diarrhea is usually achieved within 48 hours. If the condition does not improve within 10 days, this medication is usually discontinued, as further administration will likely not control symptoms.

Children up to 12 years of age should not use this medication, unless specifically prescribed by a physician.

If a dose of this medication is missed, it should be taken as soon as possible. If it is almost time for another dose, the missed dose should be skipped and the regular dosing schedule resumed. Double doses can lead to side effects and should not be taken.

Major Drug Interactions

Taking another drug along with Diphenoxylate and Atropine can lead to medical problems. Any over the counter or prescription medications should be discussed with the prescribing physician, along with any herbs or dietary supplements. The prescribing physician may ask the patient to change the dosage of current medications, or discontinue use during treatment. Use of this medication along with the following medications is not recommended:

  • Ambenonium
  • Naltrexone
  • Potassium

Taking Diphenoxylate and Atropine with any of the following medications is generally not recommended, though it may be required in certain cases. When both medications are prescribed together, the prescribing physician may change the dosage, or how often the medication is used.

  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Bupropion
  • Butorphanol
  • Carbinoxamine
  • Codeine
  • Dihydrocodeine
  • Donepezil
  • Doxylamine
  • Fentanyl
  • Flibanserin
  • Furazolidone
  • Hydrocodone
  • Iproniazid
  • Isocarboxazid
  • Linezolid
  • Lorazepam
  • Meclizine
  • Meperidine
  • Methadone
  • Methylene Blue
  • Moclobemide
  • Morphine
  • Morphine Sulfate Liposome
  • Oxycodone
  • Oxymorphone
  • Pentazocine
  • Periciazine
  • Phenelzine
  • Procarbazine
  • Rasagiline
  • Remifentanil
  • Safinamide
  • Selegiline
  • Sodium Oxybate
  • Sufentanil
  • Tapentadol
  • Tiotropium
  • Tramadol
  • Tranylcypromine
  • Zolpidem

Taking Diphenoxylate and Atropine with Arbutamine may cause an increased risk of certain side effects, but using the treatment may be indicated. If both medications are prescribed together, dosage of one or the other may be changed.


Diphenoxylate and Atropine should not be used by children. Children with severe diarrhea should be evaluated by a physician and given solutions of carbohydrates and electrolytes to replace the water, sugars and important salts that the body loses with diarrhea.

When deciding if this medication should be used, the risks and benefits should be discussed with the prescribing physician. A physician should monitor treatment progress with regular visits during the course of taking this medication. If diarrhea does not stop after two days, or if a fever develops, a physician should be notified immediately.

This medication will increase side effects of alcohol and medications that slow down the nervous system, known as CNS depressants. Examples of CNS depressants include antihistamines and other medications prescribed for allergies, colds or hay fever, sedatives, tranquilizers, sleeping medications, prescription pain medications, narcotics, barbiturates, seizure medications, muscle relaxers and anesthetics, including dental anesthetics. A physician should be consulted before taking any of these medications.

In the case of an overdose, immediate emergency medical attention should be sought. An overdose of this medication could lead to severe injury, unconsciousness and possibly death. Signs and symptoms of an overdose of Diphenoxylate and Atropine include severe drowsiness, shortness of breath, trouble breathing, increased heartbeat and unusual warmth, flushing and dryness of the skin.

Before any surgery or medical treatment, including dental procedures, the physician or dentist in charge should be notified that this medication is being taken.

Diphenoxylate and Atropine may cause some individuals to become dizzy, drowsy or less alert. If taken at bedtime, this medication may still cause individuals to feel drowsy or less alert when awakening. Caution should be used when using this medication before driving, using machinery or doing anything that could be considered dangerous for someone who is not fully alert.

Any allergies should be discussed with the prescribing physician. Certain allergies to foods, dyes, preservatives or animals could be triggered by use of this medication. This medication is available in tablet and liquid solution form, and different inactive ingredients may be found in these different forms. Inactive ingredients of this medication include acacia, corn starch, magnesium sterate, sorbitol, sucrose and talc.

This medication should not be used by children under the age of 13. The effects of Diphenoxylate and Atropine are particularly strong, especially to young children. This could increase the risk of side effects when this medication is used. Delayed toxicity may also occur in this age group. Since the fluid loss caused by diarrhea can result in severe medical issues, it is particularly important that children receive sufficient amounts of replacement fluids. Any questions regarding pediatric use of Diphenoxylate and Atropine should be referred to a physician.

Elderly patients taking Diphenoxylate and Atropine are more likely to experience difficulty breathing and are generally more sensitive to its effects. Because severe fluid loss from diarrhea can cause severe medical concerns in geriatric patients, their condition should be closely monitored by a physician, during and after treatment with this medication. Sufficient amounts of fluids should be taken, along with this medication, to replace those lost with diarrhea.

Women who are pregnant, or who may become pregnant should consult with a physician before taking Diphenoxylate and Atropine. Animal studies have shown an adverse effect and there are no adequate studies completed in pregnant women. Both Diphenoxylate and Atropine are excreted in breast milk. There have been no reported incidents in the infants of women who breastfeed while taking this medication. Women who are breastfeeding should weigh the benefits and risks of taking this medication with their physician.

Using alcohol or tobacco while taking Diphenoxylate and Atropine can increase the effects and lead to medical complications. Before using alcohol or tobacco, the patient should discuss the risks with the prescribing physician.

Certain foods should be avoided while taking Diphenoxylate and Atropine. These should be discussed with the prescribing physician.

Patients with other medical conditions may experience complications when using Diphenoxylate and Atropine. It is particularly important to discuss any medical problems with the prescribing physician, including alcohol abuse and drug abuse or the history of, because there is a greater risk that this medication will become habit-forming.

Patients with colitis should inform their physician before taking this medication. A serious problem of the colon could occur if this medication is used. For some patients with acute ulcerative colitis, agents that slow mobility or prolong the intestinal transit time have caused megacolon. If abdominal distention occurs, immediate medical attention should be sought.

Those with emphysema, asthma, bronchitis or other chronic lung diseases may have a greater change of serious breathing problems if taking this medication.

Down's syndrome patients may experience severe side effects if Diphenoxylate and Atropine is taken. Patients with dysentery may experience worsening symptoms, and a different type of treatment may be indicated.

Patients with an enlarged prostate or urinary tract blockage could experience severe problems with urination with the use of this medication. Diphenoxylate and Atropine could cause spasms of the bilary tract, making gallbladder disease or gallstones worse.

Severe pain may be experienced by patients with com/health/coma/">glaucoma; however, this risk is relatively minor. This medication may have some effects on the heart, which could increase the risks for those with heart disease. The atropine found in this medication may make a hiatal hernia worse, but the chances of this happening is small. Atropine may also increase blood pressure, so those with hypertension should use with caution.

Since atropine can build up in the body and cause adverse effects, this medication may cause problems for those with kidney disease. The chance of developing central nervous system side effects, including coma, may be greater for those with liver disease.

Diphenoxylate and Atropine may make Myasthenia gravis worse. Unwanted effects on breathing and heart rate may occur in those with overactive or underactive thyroid. Those with overflow incontinence may experience increased symptoms with use of this medication.

This medication should be part of complimentary treatment. Adults using Diphenoxylate and Atropine should also take adequate fluids and electrolytes to replace those lost with diarrhea. Severe dehydration could result from loss of fluid. Diphenoxylate and Atropine may be withheld until an acceptable fluid balance is achieved.

Using Diphenoxylate and Atropine along with MAO (monoamine oxidase) inhibitors may lead to a hypertensive crisis.


Diphenoxylate and Atropine should be stored in a closed container, at room temperature below 77°, away from heat sources, moisture and direct light. This medication should not be frozen.

Because of the potential of toxicity in children, it is particularly important to keep this medication out of reach.

Outdated medication should not be kept and any outdated medication should be disposed of properly.


Diphenoxylate and Atropine is an oral medication used to treat severe diarrhea in adults. It is available in both a cherry flavored liquid solution and in a tablet form. The use of Diphenoxylate and Atropine is recommended only for adults and teenagers. Increased potency and life-threatening affects have been reported in children ages 12 and younger. This medication is generally prescribed to those age 13 and older.

This medication is considered to be a complimentary therapy. Along with use of Diphenoxylate and Atropine, adults should replace fluids and electrolytes lost with diarrhea, as ordered by a physician. Diphenoxylate and Atropine should only be used as prescribed. It is a combination drug. The Diphenoxylate is closely related to certain medications that are known to cause dependency. Atropine is added to reduce the risk of addiction and will cause adverse effects if this medication is taken in a higher dosage than prescribed. Dosage instructions should be followed precisely and if a dose is missed, a double dose should not be taken.

Side effects may occur and should be reported to the prescribing physician. If muscle cramps, nausea or vomiting, shivering or trembling, stomach cramps or sweating occur after the medication is stopped, a physician should be notified.

The medication dosage will vary based on the patient and the symptoms experienced. This medication should not be taken unless prescribed by a physician.

In patients with certain medical conditions, taking Diphenoxylate and Atropine can worsen symptoms or cause serious health concerns. Those with a history of chemical dependence should inform the prescribing physician before taking this medication. Since the effects of alcohol, tobacco and depressant medications are amplified when used along with Diphenoxylate and Atropine, they should only be used under a physician's supervision.

Colitis patients should inform their physician before taking Diphenoxylate and Atropine. A serious problem of the colon is possible if this medication is used. If any abdominal distention occurs, this should be reported to a physician and immediate medical attention sought.

This medication may cause complications for those with specific medical conditions including, Down's syndrome, dysentery, chronic lung diseases, urinary tract blockages, gall bladder disease, gallstones, glaucoma, kidney disease, overflow incontinence, Myasthenia gravis heart disease and high blood pressure.

Major drug interactions have occurred with Diphenoxylate and Atropine. The prescribing physician should be informed of any medications, herbs or dietary supplements taken along with this medication. This medication should not be stopped without a physician's approval. Certain foods may interact with this medication.

Because this medication is available in both tablet and liquid solution form, it is important to discuss any allergies with the prescribing physician. The inactive ingredients may differ based on the form prescribed.

This medication is usually discontinued after control of diarrhea, which generally happens within 48 hours. Using this medication for longer than 10 days is not recommended.