Lomotil vs Imodium

Lomotil vs Imodium – comparison:


It is the brand name of a combination of atropine and diphenoxylate.

Atropine belongs to a class of medications known as anticholinergics, that help to slow gut movement and dry up body fluids. Diphenoxylate is similar to narcotic pain relievers, however, it acts mostly to slow the gut.

It was originally approved by the US Food and Drug Administration in 1960.


It is usually recommended as adjunctive therapy for the management of diarrhea in adults and children 13 years of age and older. The medication works by slowing the movement of the intestines.


The usual recommended dose for an adult is 2 tablets four times per day. After initial control has been achieved, the dose may be reduced to meet individual requirements.

Notes –  the maximum total daily dose is 20 mg a day. Also, it should be kept out of the reach of children because accidental overdose may cause severe adverse effects.

Side Effects and Precautions

Common side effects may include:

  • tired or restless feeling;
  • headaches;
  • skin rash, or itching;
  • dizziness;
  • loss of appetite;
  • drowsiness;
  • upset stomach;
  • vomiting;
  • nausea.

Rare side effects may include:

  • ongoing or worsening diarrhea;
  • stomach bloating or pain;
  • depressed mood;
  • urinating less than usual or not at all:
  • diarrhea which is bloody or watery;
  • fast heart rate;
  • unusual thoughts or behavior;
  • numbness in the hands or feet.

Before taking this medication, tell your healthcare provider if you are allergic to any medications, or if you have:

  • Crohn’s disease;
  • blocked intestines;
  • kidney disease;
  • ulcerative colitis;
  • liver disease;
  • glaucoma;
  • high blood pressure;
  • Down’s syndrome;
  • heart rhythm problems;
  • a thyroid disorder;
  • heart disease;
  • an enlarged prostate;
  • problems with urination;
  • if you are dehydrated;
  • asthma or other lung problems.

Pregnancy & Breast Feeding

There are no well-done clinical studies in women for determining infant risk when using the medication during breastfeeding. Therefore, consult your doctor regarding the potential benefits and risks before taking it while breastfeeding.

Since there are no conclusive studies to determine the effects of the medication on pregnant women, it is suggested to avoid it if you are pregnant or plan to fall pregnant.

Drug Interactions

This medication can negatively interact with other drugs, especially:

  • antihistamines;
  • barbiturates;
  • monoamine oxidase inhibitors, such as – Zelapar, Emsam, Eldepryl, Parnate (tranylcypromine sulfate), Nardil (phenelzine sulfate), and Marplan (isocarboxazid);
  • prescription painkillers;
  • potassium supplements;
  • naltrexone (ReVia);
  • ambenonium (Mytelase);
  • sedatives;
  • tranquilizers.


Avoid consuming alcoholic beverages while taking the medication since it will intensify the effects of alcohol and increase the risk of side effects.


One of the main reasons why people abuse this medication is because it is similar to Demerol, a narcotic opioid painkiller.

Opioids are among the most addictive drugs and they are highly susceptible to abuse. More importantly, opioids may cause a lifelong addiction.


It is the brand name of a drug called loperamide that works by affecting the nerves in the intestines to reduce stool frequency, reduce the amount of stool produced, reduce cramping, and make stools more solid.

This medicine was originally approved by the US FDA as a prescription medication in 1976.


It is typically used to relieve the symptoms of diarrhea which begin suddenly and last for several days.

In addition, the medication may be used to treat people with inflammatory bowel disease (a group of intestinal disorders which cause prolonged inflammation of the digestive tract) or to decrease the amount of discharge in sufferers who have undergone an ileostomy (a surgical procedure that commonly involves removing the whole of the large intestine).


The usual recommended dose for acute diarrhea in adult patients is 4 mg, taken straightaway, followed by 2 mg after each time the patient goes to the toilet with diarrhea.

Note – to keep you from getting dehydrated, take the medication with a full glass of water. The effect of loperamide can be observed within 1-3 hours after intake. It must not be taken by children under 12 years of age unless it is prescribed by a healthcare professional.

Side Effects and Precautions of Loperamide

Common side effects may include:

  • drowsiness;
  • constipation;
  • stomach cramps;
  • nausea;
  • dizziness.

Rare side effects may include:

  • stomach pain or bloating;
  • diarrhea which is watery or bloody;
  • sudden dizziness, a feeling like you might pass out;
  • shortness of breath;
  • fluttering in your chest;
  • fast or pounding heartbeats;
  • ongoing or worsening diarrhea.


Drinking alcoholic beverages while taking this medication may increase the drowsy effect of loperamide.


It contains a small quantity of opiates, and a growing number of scientific reports have established that ingesting large amounts of this medication can result in getting mild narcotic effects.


Since the medication can pass into breast milk and may negatively affect the infant, do not breastfeed while taking this medication or avoid it if you are nursing.

Also, there are no conclusive studies to determine the safety of the medication during pregnancy. Hence, consult with your healthcare provider if you are pregnant or might become pregnant.

Bottom Line – Lomotil vs Imodium

Lomotil is a combination of diphenoxylate and atropine and is used to treat diarrhea. Diphenoxylate is an opioid agonist that works by decreasing contraction of the intestines making the stools less frequent and more solid. To help prevent abuse, atropine has been added because if it’s used in higher than normal doses, the atropine will cause severe adverse effects.

Imodium (active ingredient – loperamide) slows the rhythm of digestion, hence, small intestines have more time to absorb nutrients and fluids from the foods you eat.

According to studies, there are no statistically substantial differences between these two drugs regarding their speed of action and efficacy in alleviating diarrhea.

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