Lomotil

Special warnings about Lomotil

Certain antibiotics such as cefaclor, clindamycin, erythromycin and tetracycline may cause diarrhea. Lomotil can make this type of diarrhea worse and longer-lasting. Check with your doctor before using Lomotil while taking an antibiotic.

Lomotil may cause drowsiness or dizziness. Therefore, you should not drive a car, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you know how this drug affects you.

Lomotil slows activity of the digestive system; this can result in a buildup of fluid in the intestine, which may worsen the dehydration and imbalance in normal body salts that usually occur with diarrhea.

If you have severe ulcerative colitis (an inflammation of the intestines), your doctor will want to monitor your condition while you are taking this drug. If your abdomen becomes distended, or enlarged, notify your doctor.

Use Lomotil with extreme caution if you have kidney and liver disease or if your liver is not functioning normally.

Lomotil should be used with caution in children, since side effects may occur even with recommended doses, especially in children with Down's syndrome (congenital mental retardation).

Since addiction to diphenoxylate hydrochloride is possible at high doses, you should never exceed the recommended dosage.

Possible food and drug interactions when taking Lomotil

Lomotil may intensify the effects of alcohol. It's better not to drink alcohol while taking this medication.

If Lomotil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lomotil with the following:

• Barbiturates (anticonvulsants and sedatives such as phenobarbital)
• MAO inhibitors (antidepressants such as phenelzine and tranylcypromine)
• Tranquilizers (such as alprazolam and diazepam)

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Special information if you are pregnant or breastfeeding

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The effects of Lomotil during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. Lomotil appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

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Recommended dosage for Lomotil

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ADULTS

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The recommended starting dosage is 2 tablets 4 times a day or 2 regular teaspoonfuls (10 milliliters) of liquid 4 times per day.

Once your diarrhea is under control, your doctor may reduce the dosage; you may need as little as 5 milligrams (2 tablets or 10 milliliters of liquid) per day.

You should see improvement within 48 hours. If your diarrhea persists after you have taken 20 milligrams a day for 10 days, the drug is not likely to work for you.

CHILDREN

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Lomotil is not recommended in children under 2 years of age.

Your doctor will take into account your child's nutritional status and degree of dehydration before prescribing this drug.

The recommended dose for children 13 to 16 years old is 2 tablets or 2 teaspoonfuls of liquid three times a day.

In children under 13 years of age, use only Lomotil liquid and administer with the plastic dropper. The recommended starting dosage is 0.3 to 0.4 milligram per 2.2 pounds of body weight per day, divided into 4 equal doses. The following table provides approximate starting dosage recommendations for children:

• 2 years (24-31 pounds):
• 1.5-3.0 milligrams, 4 times daily
• 3 years (26-35 pounds):
• 2.0-3.0 milligrams, 4 times daily
• 4 years (31-44 pounds):
• 2.0-4.0 milligrams, 4 times daily
• 5 years (35-51 pounds):
• 2.5-4.5 milligrams, 4 times daily
• 6-8 years (38-71 pounds):
• 2.5-5.0 milligrams, 4 times daily
• 9-12 years (51-121 pounds):
• 3.5-5.0 milligrams, 4 times daily

Your doctor may reduce the dosage as soon as symptoms are controlled. A maintenance dosage may be as low as one-quarter of the starting dose. If your child does not show improvement within 48 hours, Lomotil is unlikely to work.

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Overdosage

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An overdose of Lomotil can be dangerous and even fatal. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Lomotil overdose may include:
  Coma, dry skin and mucous membranes, enlarged pupils of the eyes, extremely high body temperature, flushing, involuntary eyeball movement, lower than normal muscle tone, pinpoint pupils, rapid heartbeat, restlessness, sluggishness, suppressed breathing

Suppressed breathing may be seen as late as 30 hours after an overdose.