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- Language:English Provider:Diphenoxylate
Diphenoxylate Usage And Synthesis
Diphenoxylate (marketed in combination with atropine as Lomotil in the United States) is chemically related to both analgesic and anticholinergic compounds. It is as effective in the treatment of diarrhea as the opium derivatives, and at the doses usually employed, it has a low incidence of central opioid actions. Diphenoxylate is rapidly metabolized by ester hydrolysis to the biologically active metabolite difenoxylic acid.
ChEBI: A piperidinecarboxylate ester that is the ethyl ester of difenoxin.
World Health Organization (WHO)
Diphenoxylate, a derivative of pethidine without analgesic activity, is used in the symptomatic treatment of acute and chronic diarrhoea to reduce intestinal motility. There is no clear evidence that it has any beneficial effect in diminishing fluid losses and it has been associated with central nervous system toxicity, particularly in children, which results in anorexia, nausea and vomiting, headache, drowsiness, confusion, insomnia, dizziness, restlessness, euphoria and depression. The World Health Organization recommends that diphenoxylate should not be used for the management of diarrhoea in children and many countries have since withdrawn products containing this compound indicated for paediatric use. (Reference: (WHORUD) The Rational Use of Drugs, , , 1990)
Diphenoxylate is a weak opioid agonist and isavailable combined with atropine (Lomotil) for use as an antidiarrhealagent. At low doses, the opioid effect is minimal,and the atropine is added to dissuade abuse. One studyfound both codeine and loperamide to be superior to diphenoxylatefor treating chronic diarrhea.83 The manufacturerhas strict dosing guidelines for pediatric use because opioidintoxication and deaths from diphenoxylate have beenreported.
Lomotil is recommended as adjunctive therapy in the management of diarrhea. It is contraindicated in children under 2 years old and in patients with obstructive jaundice.
Adverse reactions often caused by the atropine in the preparation include anorexia, nausea, pruritus, dizziness, and numbness of the extremities.
Diphenoxylate Preparation Products And Raw materials
- Ethyl cyanoformate
- Ethyl acrylate
- Ethyl acetate
- Diphenoxylate HCL (Subj To Narcotic Permit),DIPHENOXYLATE HYDROCHLORIDE METHANOL SOL UTION,DIPHENOXYLATE HYDROCHLORIDE ANTIPERISTAL TIC, ANTI,DIPHENOXYLATE HCL,DIPHENOXYLATE HYDROCHLORIDE
- 1-ETHYLPIPERIDINE-4-CARBOXYLIC ACID
- Triethyl orthoformate
- Ethyl benzoylformate
- Ethyl cellulose