Drug & supplement interaction

Choline + Atropine, Diphenoxylate

Atropine, Diphenoxylate brand names: Lomotil, Lofene.

Minor Interaction
The bottom line Minor

Choline has a minor interaction with Atropine, Diphenoxylate. Theoretically, choline might decrease the effects of atropine in the brain.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Choline and Atropine, Diphenoxylate

Here is the interaction we found between these two, with the evidence behind it.

Minor

ATROPINE

Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version. Lomotil contains a small amount of atropine, which works by blocking acetylcholine, one of your body's nerve-signaling chemicals. Choline is a building block your body uses to make acetylcholine. So in theory, taking extra choline could nudge things in the opposite direction and slightly blunt what the atropine is doing.

The honest truth is this concern comes only from animal lab research, not from people, and it's rated as minor. In the tiny doses found in Lomotil, the atropine is really just there to discourage misuse, so a choline supplement is very unlikely to cause a noticeable change. Everyday food choline almost certainly won't matter. If you take concentrated choline regularly, it's worth a quick mention to your pharmacist, but there's no need to worry.

References
  1. Schmidt, C., Abicht, A., Krampfl, K., Voss, W., Stucka, R., Mildner, G., Petrova, S., Schara, U., Mortier, W., Bufler, J., Huebner, A., and Lochmuller, H. Congenital myasthenic syndrome due to a novel missense mutation in the gene encoding choline acetyl

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Choline Also Interacts With Other Medications

Choline has 15 minor known drug interactions in our database — the Atropine, Diphenoxylate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Choline

Covers the 2,830 medications we’ve checked against Choline. Pick one to open its full report.

From our Q&A

Questions About Choline or Atropine, Diphenoxylate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Choline or Atropine, Diphenoxylate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Atropine, Diphenoxylate

This page covers Choline only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atropine, Diphenoxylate page lists 47 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Henbane (major), Scopolia (major), Angel's Trumpet (moderate) and Bacopa (moderate).

By severity: 3 major · 32 moderate · 12 minor.

From our pharmacist’s overview on the Atropine, Diphenoxylate page

“People reach for Lomotil (atropine with diphenoxylate) during a bout of diarrhea, and the supplement most likely to sit in the same cabinet, activated charcoal, is also one of its three major-rated interactions, since charcoal can soak up the drug in the gut and blunt its effect. This is a list to treat with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Atropine, Diphenoxylate interaction page

One more smart check

Taking Choline as Part of a Dietary Supplement Product? Check It for Interactions

We hold 11,172 real supplement products containing Choline, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Choline. Your product may carry other ingredients that interact with Atropine, Diphenoxylate too, on top of Choline — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Choline and Atropine, Diphenoxylate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Choline
Top 5%

#21 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Atropine, Diphenoxylate
Top 25%

#456 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Choline

What is Choline?

Choline
  • Liver health and fatty liver
  • Brain and memory support
  • Prenatal nutrition and fetal development
  • General nutritional supplementation
  • Sports performance

Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help people who are deficient or who have higher needs (such as during pregnancy), but they are not proven cure-alls and very high doses can cause side effects. Check with your pharmacist or doctor before starting a supplement.

Read the full Choline monograph & all interactions
Keep checking

Other Drugs & Choline

Browse every other medication we’ve checked against Choline — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
15Minor
2,814No known interaction
Minor

15 interactions

No interaction 2,814 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Choline and Atropine, Diphenoxylate Together: Common Questions

Can you take Choline with Atropine, Diphenoxylate?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Choline and Atropine, Diphenoxylate interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Atropine, Diphenoxylate and Choline?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.