Unfavorable Effect of Atropine-Diphenoxylate (Lomotil) Therapy in Lincomycin-Caused Diarrhea

Ervin Novak, MD, PhD; John G. Lee, PhD; Clarence E. Seckman; J. Paul Phillips; Anthony R. DiSanto, PhD
JAMA. 1976;235(14):1451-1454. doi:10.1001/jama.1976.03260400017019.
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In this double-blind, randomized study, 200 normal subjects received a three-day course of one of five treatment regimens: lincomycin hydrochloride monohydrate injection (sterile solution, 300 mg/ml) with two tablets of either placebo, a mixture of atropine sulfate and diphenoxylate hydrochloride (Lomotil), an aspirin-phenacetin-caffeine (APC) combination or the latter with codeine, or an injection of saline with two placebo tablets. Gastrointestinal irritation was most prominent in subjects receiving lincomycin with atropine-diphenoxylate and lincomycin with APC plus codeine (P <.05). Decreased intestinal motility from atropine-diphenoxylate or codeine may increase the contact time between the lincomycin (or its metabolites) or some developing toxic substances and the mucosal epithelium. The use of atropine-diphenoxylate or codeine in treating lincomycin-induced diarrhea may be questionable.

(JAMA 235:1451-1454, 1976)


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