Diphenoxylate
Pronunciation:dye-fen-OCK-see-lait
Chemical Abstracts Service Registry Number:915-30-0. (Hydrochloride form
3810-80-8)
Formal Names:Diarphen, Eldox, Logen, Lomotil, Lonox, Protector, Reasec, Re-
tardinr, Topergan
Type:Depressant (opioid class).Seepage 24
Federal Schedule Listing:Schedule II or V, depending on product formulation
(DEA no. 9170)
USA Availability:Prescription and nonprescription
Pregnancy Category:C
Uses.Diphenoxylate was developed in the 1950s but did not see much use
until the next decade. The drug is related tomeperidine. When used alone at
high dosage levels, diphenoxylate produces effects reminiscent ofmorphine,
although pain relief capability is nil. Experimental rubbing of diphenoxylate
on patches of psoriasis has helped that skin condition. The drug is a standard
remedy for diarrhea and is commonly combined with atropine for that pur-
pose. Another purpose of the combination format is to deter recreational use
of the controlled substance, by forcing a would-be misuser to experience the
simultaneous unpleasant actions of atropine (such as dry mouth, fever, excited
behavior, and fuzzy eyesight).
Drawbacks.Diphenoxylate can reduce alertness and speed of movements,
making operation of dangerous machinery (such as cars) inadvisable. Other
effects of normal doses may include nausea, vomiting, dizziness, numbness,
despondency, or euphoria. The drug should be avoided by persons who
are prone to intestinal blockage because the compound can aggravate that
condition. Pancreatitis is associated with the drug, but a cause and effect
relationship is unconfirmed. Because diphenoxylate is available in a nonpres-
cription format, some people do not realize how dangerous an overdose can
be; breathing trouble leading to brain injury and death can occur; those con-
sequences mostly involve accidental overdose in children. Overdose on the
atropine component of a diphenoxylate combination product is also possible;
atropine poisoning can include fever, agitation, irregularity in heartbeat and
breathing, and psychosis involving hallucinations and delirium.
Abuse factors.Addiction to the diphenoxylate-atropine combination is un-