Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg; .025 mg Tablet, 30-count — NDC 43353-0083-30 package photo

Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg; .025 mg Tablet, 30-count

by Aphena Pharma Solutions - Tennessee, LLC · 30 TABLET in 1 BOTTLE (43353-083-30)
NDC 43353-0083-30
🏷️ FDA NDC (as labeled) 43353-083-30 billing pads the product segment with a zero
This package
Contains30-count Pack sizes6 compare ↓
Also priced by: Part D plans $0.2597/unit — full pricing hub ↓
Rx only Brand On market CV
🗂️ Data synced Aug 27, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 43353-083-30
Product NDC 43353-083
11-digit billing NDC 43353008330
NCPDP billing unit EA — each (per item)
RxCUI 1190572
UNII W24OD7YW48, 03J5ZE7KA5
Application # NDA012462
SPL Set ID 59934cee-4e1f-4958-9e97-6de53b39daf3
Established class (EPC) Anticholinergic; Antidiarrheal; Cholinergic Muscarinic Antagonist
Mechanism of action Cholinergic Antagonists; Cholinergic Muscarinic Antagonists
DEA schedule CV
Marketing category NDA AUTHORIZED GENERIC
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2013-02-27
Route ORAL
Dosage form TABLET
Substance DIPHENOXYLATE HYDROCHLORIDE; ATROPINE SULFATE
GPI-14 47100010100310
GPI class Diphenoxylate-Atropine
GCN Seq No 002841
GCN 65030
HICL code 001235
Ingredient (HICL) Diphenoxylate Hcl/Atropine
HIC1 code D
Therapeutic class — broad (HIC1) Biliary System/Gastro-Intestinal System
HIC2 code D6
Therapeutic class — intermediate (HIC2) Drugs Acting Principally On The Colon
HIC3 code D6D
Therapeutic class — specific (HIC3) Antidiarrheals
AHFS code 12:08.08.00
AHFS class Antimuscarinics/Antispasmodics
FDB label name DIPHENOXYLATE-ATROP 2.5-0.025
FDB brand name Diphenoxylate-Atropine
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AA · RLD · RS
Why two NDCs? The FDA registers this code as 43353-083-30 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 43353-0083-30. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Anticholinergic class.

Pharmacologic class Anticholinergic, Cholinergic Muscarinic Antagonist
Drug family (ATC) Belladonna alkaloids, tertiary amines, Anticholinergics, Antidotes
How it works Cholinergic Muscarinic Antagonists, Cholinergic Antagonists
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerAphena Pharma Solutions - Tennessee, LLC
Application holderPFIZER INC
FDA applicationNDA012462 (NDA AUTHORIZED GENERIC)
Labeler code43353
First marketedFeb 2013
DEA scheduleCV
Product typeHuman Prescription Drug
Portfolio790 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name DIPHENOXYLATE-ATROP 2.5-0.025 Ingredient Diphenoxylate Hcl/Atropine
📖 What it is MedlinePlus · NLM

Diphenoxylate is used along with other treatments such as fluid and electrolyte replacement for the treatment of diarrhea. Diphenoxylate should not be given to children younger than 2 years of age. Diphenoxylate is in a class of medications called antidiarrheal agents. It works by decreasing activity of the bowel.

Read the full MedlinePlus article ↗
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color White
ShapeRound
ImprintSEARLE;61
Size6 mm
ScoringNot scored
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 5C5403N26O
    Acacia is a natural gum derived from acacia tree sap. It serves as a binder, thickener, and emulsifier to help hold ingredients together, improve texture, and stabilize the medicine.
  • UNII 70097M6I30
    Magnesium stearate is a salt made from magnesium and stearic acid, a fatty substance. It's used in tablets and capsules as a lubricant and glidant to help ingredients flow smoothly during manufacturing and prevent sticking.
  • UNII 506T60A25R
    Sorbitol is a natural sugar alcohol derived from glucose. It serves as a sweetener, humectant, and bulking agent in medications to improve taste and help maintain moisture in the product.
  • UNII O8232NY3SJ
    A plant-based carbohydrate derived from corn kernels. It acts as a filler to add bulk, a binder to hold ingredients together, and a disintegrant to help the tablet break apart in your stomach for absorption.
  • UNII C151H8M554
    A natural sugar derived from sugar cane or sugar beets. It's used as a sweetener, filler, and binder to improve taste, add bulk, and help hold tablet or capsule ingredients together.
  • UNII 7SEV7J4R1U
    A powder made from a naturally occurring mineral. In medicines, talc works as a glidant and anti-caking agent, helping tablets and capsules flow smoothly during manufacturing and preventing clumping.

6 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eachPer package
Retail pharmacies payNADAC · weekly Not in the retail survey — common for institutional, discontinued, or low-volume packs.
Medicaid paysCMS SDUD · 12 mo No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data.
Medicare drug plans payPart D · Q2 2026 $0.2597 $7.79 / 30 tablets
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 00406-1236-01 SpecGx 100 tablets $0.139 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 59762-1061-01 Mylan 100 tablets $0.139 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 60687-0890-01 American 100 tablets $0.139 AA Availability likely
Diphenoxylate hydrochloride and atropine sulfate 2.5 mg/1; .025 mg 62135-0618-12 Chartwell 120 tablets $0.139 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 62559-0490-01 ANI 100 tablets $0.139 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 69315-0910-01 Leading 100 tablets $0.139 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 75826-0107-00 Winder 1000 tablets $0.139 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 76385-0107-01 Unichem 100 tablets $0.139 AA Availability likely
Lomotil 2.5 mg/1; .025 mg 00025-0061-31 Pfizer 100 tablets $3.003 AA Availability likely
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mgthis 43353-0083-30 Aphena 30 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 43353-0594-30 Aphena 30 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 50090-5589-00 A-S 15 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 50090-5592-00 A-S 20 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 63187-0939-10 Proficient 10 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate .025 mg/1; 2.5 mg 63629-1933-01 Bryant 100 tablets AA Discontinued
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 67296-1485-09 Redpharm 100 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 67296-2240-05 Redpharm 15 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 68071-4063-01 NuCare 10 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 68788-8090-02 Preferred 20 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 70518-3915-00 REMEDYREPACK 30 tablets AA Discontinued
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 71205-0909-00 Proficient 100 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 71335-0311-01 Bryant 20 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 71335-1693-01 Bryant 20 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 71610-0714-30 Aphena 30 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 71610-0809-53 Aphena 60 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate .025 mg/1; 2.5 mg 72162-1765-00 Bryant 1000 tablets AA Discontinued
Diphenoxylate Hydrochloride And Atropine Sulfate 2.5 mg/1; .025 mg 72189-0336-10 Direct 10 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 72789-0375-25 PD-Rx 25 tablets AA FDA listed
Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg/1; .025 mg 50090-3456-00 A-S 15 tablets AA Discontinued
About this product: this is an authorized generic — the brand-name product marketed without its brand name. Other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2013
On the market since
Feb 2013
📍
2026
Currently FDA-listed
13 years listed
🔓
·
Generic versions listed
see equivalents
Generic appears available

FDA-approved generic versions are listed, and recent pricing/market data suggests they may be available — see Therapeutic equivalents.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Diphenoxylate Hydrochloride and Atropine Sulfate — the ingredient across all brands.

Top reported reactions

Diarrhoea2,729
Nausea1,617
Fatigue1,477
Vomiting914
Weight Decreased884
Pain784
Dehydration766

Reporter sex

0 reports
Male · 36%
Female · 64%
Unknown · 0%

Serious outcomes

Hospitalization5,217
Death1,339
Life-threatening372
Disabling241
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 919 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
43353-0083-30 You're viewing this 30 TABLET in 1 BOTTLE (43353-083-30) 2015-07-13 Active
43353-0083-53 60 TABLET in 1 BOTTLE (43353-083-53) 2015-07-14 Active
43353-0083-60 90 TABLET in 1 BOTTLE (43353-083-60) 2015-07-13 Active
43353-0083-70 120 TABLET in 1 BOTTLE (43353-083-70) 2015-07-13 Active
43353-0083-80 180 TABLET in 1 BOTTLE (43353-083-80) 2015-08-15 Active
43353-0083-90 240 TABLET in 1 BOTTLE (43353-083-90) 2015-07-27 Active

You're viewing the smallest of 6 pack sizes for this product.

Pack size FAQ

What quantity is in NDC 43353-0083-30?
NDC 43353-0083-30 is a 30-count package — 30 tablet in 1 bottle.
What is the difference between NDC 43353-0083-30 and NDC 43353-0083-53?
Both are Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg; .025 mg Tablet — the drug itself is identical. NDC 43353-0083-30 is the 30-count package, while NDC 43353-0083-53 is the 60 tablets package.
What NDC number is used to bill for this package of Diphenoxylate Hydrochloride and Atropine Sulfate 2.5 mg; .025 mg Tablet?
Bill NDC 43353-0083-30 — the 11-digit billing format is 43353008330. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

🧭 About this NDC listing & data coverage

Finished prescription product
What data is (and isn’t) available for this NDC — tap to expand
NDC identity (package / product / labeler codes) ✓ Available
Labeler ✓ Available
Product & package description ✓ Available
Marketing category & status ✓ Available
Active ingredient / dosage form / route ✓ Available
FDA label (SPL via DailyMed) ✓ Available
Package photos ✓ Available
Inactive ingredients (structured) ✓ Available
NADAC pharmacy acquisition price (CMS) — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey.
Orange Book / therapeutic-equivalence data ✓ Available
HCPCS J-code billing crosswalk — Not published for this NDC Most self-administered / retail products have no J-code — that is normal.
Medicaid utilization (CMS SDUD) — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold.
“Not published” reflects what the public FDA / CMS / NLM sources provide for this exact package code — it is a property of the data feeds, not a judgment about the product.

Questions about this listing

Why is there no price listed?
The pricing shown on our NDC pages comes from CMS NADAC, a voluntary survey of retail community pharmacy invoices. CMS does not publish a NADAC for every NDC — packages outside the retail survey (institutional and hospital products, bulk packages, discontinued items, and many OTC items) may never receive one. A missing price reflects the survey's scope, not this product's actual cost, and does not mean the product is free or unavailable.
Is the NDC printed on the package the same as the 11-digit billing NDC?
Yes, they identify this exact package in different formats. The FDA registers it as 43353-083-30, which is what is printed on the packaging and shown on DailyMed. Insurance claims use a fixed 11-digit 5-4-2 format, so the short segment is padded with a leading zero: 43353-0083-30, written without dashes as 43353008330. The Identity section at the top of this page lists every form of this code.
What do the three segments of this NDC mean?
In 43353-0083-30, the first segment (43353) is the labeler code FDA assigned to Aphena Pharma Solutions - Tennessee, LLC; the middle segment (0083) identifies this specific product — its ingredient, strength, and dosage form; and the last segment (30) identifies this exact package size and type. Together they name one specific package of one specific product.
Is this package still being marketed?
Yes, per the latest FDA NDC Directory data on this page: this package is listed as actively marketed, with no marketing end date reported by Aphena Pharma Solutions - Tennessee, LLC. Listing status can change — the directory data on this page refreshes weekly.
Does this product come in other package sizes?
Yes — the FDA directory lists 5 other package presentations of this same product, including 60 tablets (43353-0083-53), 90 tablets (43353-0083-60), 120 tablets (43353-0083-70). Each has its own NDC and its own page — see the package list near the top of this page.
Who lists this product with the FDA?
Aphena Pharma Solutions - Tennessee, LLC is the labeler of record for this NDC — the company under whose FDA-assigned code the package is listed. The labeler may be the manufacturer itself or a distributor marketing the product under its own code.
Do I need a prescription for this product?
This NDC is listed with FDA as a prescription product, so it is dispensed under a prescriber's order. Your pharmacist can tell you whether any over-the-counter forms of the same medication exist.
This page identifies an FDA-listed package (the NDC) and reports public regulatory and pricing data about the listing. It is reference information, not a medical recommendation — talk to your pharmacist or prescriber about your own medication.
Where does this data come from?
Listing facts (marketing category, packager status, marketing dates) from the FDA openFDA NDC Directory; label availability from DailyMed; pricing coverage from CMS NADAC; equivalence scope from the FDA Orange Book.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 15 words

INDICATIONS AND USAGE Diphenoxylate hydrochloride is effective as adjunctive therapy in the management of diarrhea.

⏱️ Dosage and Administration 167 words

DOSAGE AND ADMINISTRATION DO NOT EXCEED RECOMMENDED DOSAGE. Adults The recommended initial dosage is two diphenoxylate hydrochloride tablets four times daily . Most patients will require this dosage until initial control has been achieved, after which the dosage may be reduced to meet individual requirements.

Control may often be maintained with as little as 5 mg (two tablets) daily. Clinical improvement of acute diarrhea is usually observed within 48 hours. If clinical improvement of chronic diarrhea after treatment with a maximum daily dose of 20 mg of diphenoxylate hydrochloride is not observed within 10 days, symptoms are unlikely to be controlled by further administration.

Children Diphenoxylate hydrochloride is not recommended in children under 2 years of age and should be used with special caution in young children (see Warnings and Precautions ). The nutritional status and degree of dehydration must be considered. Do not use diphenoxylate hydrochloride tablets for children under 13 years of age .

KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN.

Contraindications 24 words

CONTRAINDICATIONS Diphenoxylate hydrochloride is contraindicated in patients with: Known hypersensitivity to diphenoxylate or atropine. Obstructive jaundice. Diarrhea associated with pseudomembranous enterocolitis or enterotoxin-producing bacteria.

⚠️ Warnings ~1 min read

WARNINGS DIPHENOXYLATE HYDROCHLORIDE IS NOT AN INNOCUOUS DRUG AND DOSAGE RECOMMENDATIONS SHOULD BE STRICTLY ADHERED TO, ESPECIALLY IN CHILDREN. DIPHENOXYLATE HYDROCHLORIDE IS NOT RECOMMENDED FOR CHILDREN UNDER 2 YEARS OF AGE. OVERDOSAGE MAY RESULT IN SEVERE RESPIRATORY DEPRESSION AND COMA, POSSIBLY LEADING TO PERMANENT BRAIN DAMAGE OR DEATH (SEE OVERDOSAGE ).

THEREFORE, KEEP THIS MEDICATION OUT OF THE REACH OF CHILDREN. THE USE OF DIPHENOXYLATE HYDROCHLORIDE SHOULD BE ACCOMPANIED BY APPROPRIATE FLUID AND ELECTROLYTE THERAPY, WHEN INDICATED. IF SEVERE DEHYDRATION OR ELECTROLYTE IMBALANCE IS PRESENT, DIPHENOXYLATE HYDROCHLORIDE SHOULD BE WITHHELD UNTIL APPROPRIATE CORRECTIVE THERAPY HAS BEEN INITIATED.

DRUG-INDUCED INHIBITION OF PERISTALSIS MAY RESULT IN FLUID RETENTION IN THE INTESTINE, WHICH MAY FURTHER AGGRAVATE DEHYDRATION AND ELECTROLYTE IMBALANCE. DIPHENOXYLATE HYDROCHLORIDE SHOULD BE USED WITH SPECIAL CAUTION IN YOUNG CHILDREN BECAUSE THIS AGE GROUP MAY BE PREDISPOSED TO DELAYED DIPHENOXYLATE TOXICITY AND BECAUSE OF THE GREATER VARIABILITY OF RESPONSE IN THIS AGE GROUP. Antiperistaltic agents may prolong and/or worsen diarrhea associated with organisms that penetrate the intestinal mucosa (toxigenic E. coli, Salmonella, Shigella), and pseudomembranous enterocolitis associated with broad-spectrum antibiotics.

Antiperistaltic agents should not be used in these conditions. In some patients with acute ulcerative colitis, agents that inhibit intestinal motility or prolong intestinal transit time have been reported to induce toxic megacolon. Consequently, patients with acute ulcerative colitis should be carefully observed and diphenoxylate hydrochloride therapy should be discontinued promptly if abdominal distention occurs or if other untoward symptoms develop.

Since the chemical structure of diphenoxylate hydrochloride is similar to that of meperidine hydrochloride, the concurrent use of diphenoxylate hydrochloride with monoamine oxidase (MAO) inhibitors may, in theory, precipitate hypertensive crisis. Diphenoxylate hydrochloride should be used with extreme caution in patients with advanced hepatorenal disease and in all patients with abnormal liver function since hepatic coma may be precipitated. Diphenoxylate hydrochloride may potentiate the action of barbiturates, tranquilizers, and alcohol.

Therefore, the patient should be closely observed when any of these are used concomitantly.

🤒 Adverse Reactions 127 words

ADVERSE REACTIONS At therapeutic doses, the following have been reported; they are listed in decreasing order of severity, but not of frequency: Nervous system: numbness of extremities, euphoria, depression, malaise/lethargy, confusion, sedation/drowsiness, dizziness, restlessness, headache. Allergic: anaphylaxis, angioneurotic edema, urticaria, swelling of the gums, pruritus. Gastrointestinal system: toxic megacolon, paralytic ileus, pancreatitis, vomiting, nausea, anorexia, abdominal discomfort.

The following atropine sulfate effects are listed in decreasing order of severity, but not of frequency: hyperthermia, tachycardia, urinary retention, flushing, dryness of the skin and mucous membranes. These effects may occur, especially in children. THIS MEDICATION SHOULD BE KEPT IN A CHILD-RESISTANT CONTAINER AND OUT OF THE REACH OF CHILDREN SINCE AN OVERDOSAGE MAY RESULT IN SEVERE RESPIRATORY DEPRESSION AND COMA, POSSIBLY LEADING TO PERMANENT BRAIN DAMAGE OR DEATH.

🔄 Drug Interactions 69 words

Drug interactions Known drug interactions include barbiturates, tranquilizers, and alcohol. Diphenoxylate hydrochloride may interact with MAO inhibitors (see Warnings ). In studies with male rats, diphenoxylate hydrochloride was found to inhibit the hepatic microsomal enzyme system at a dose of 2 mg/kg/day.

Therefore, diphenoxylate has the potential to prolong the biological half-lives of drugs for which the rate of elimination is dependent on the microsomal drug metabolizing enzyme system.

🤰 Pregnancy 147 words

Pregnancy Pregnancy Category C Diphenoxylate hydrochloride has been shown to have an effect on fertility in rats when given in doses 50 times the human dose (see above discussion ). Other findings in this study include a decrease in maternal weight gain of 30% at 20 mg/kg/day and of 10% at 4 mg/kg/day. At 10 times the human dose (4 mg/kg/day), average litter size was slightly reduced.

Teratology studies were conducted in rats, rabbits, and mice with diphenoxylate hydrochloride at oral doses of 0.4 to 20 mg/kg/day. Due to experimental design and small numbers of litters, embryotoxic, fetotoxic, or teratogenic effects cannot be adequately assessed. However, examination of the available fetuses did not reveal any indication of teratogenicity.

There are no adequate and well-controlled studies in pregnant women. Diphenoxylate hydrochloride should be used during pregnancy only if the anticipated benefit justifies the potential risk to the fetus.

🧒 Pediatric Use 80 words

Pediatric use Diphenoxylate hydrochloride may be used as an adjunct to the treatment of diarrhea but should be accompanied by appropriate fluid and electrolyte therapy, if needed. DIPHENOXYLATE HYDROCHLORIDE IS NOT RECOMMENDED FOR CHILDREN UNDER 2 YEARS OF AGE. Diphenoxylate hydrochloride should be used with special caution in young children because of the greater variability of response in this age group.

See Warnings and Dosage and Administration . In case of accidental ingestion by children, see Overdosage for recommended treatment.

🆘 Overdosage ~2 min read

OVERDOSAGE RECOMMENDED DOSAGE SCHEDULES SHOULD BE STRICTLY FOLLOWED. THIS MEDICATION SHOULD BE KEPT IN A CHILD-RESISTANT CONTAINER AND OUT OF THE REACH OF CHILDREN, SINCE AN OVERDOSAGE MAY RESULT IN SEVERE, EVEN FATAL, RESPIRATORY DEPRESSION. Diagnosis Initial signs of overdosage may include dryness of the skin and mucous membranes, mydriasis, restlessness, flushing, hyperthermia, and tachycardia followed by lethargy or coma, hypotonic reflexes, nystagmus, pinpoint pupils, and respiratory depression.

Respiratory depression may be evidenced as late as 30 hours after ingestion and may recur despite an initial response to narcotic antagonists. TREAT ALL POSSIBLE DIPHENOXYLATE HYDROCHLORIDE OVERDOSAGES AS SERIOUS AND MAINTAIN MEDICAL OBSERVATION FOR AT LEAST 48 HOURS, PREFERABLY UNDER CONTINUOUS HOSPITAL CARE. Treatment In the event of overdose, induction of vomiting, gastric lavage, establishment of a patent airway, and possibly mechanically assisted respiration are advised.

In vitro and animal studies indicate that activated charcoal may significantly decrease the bioavailability of diphenoxylate. In noncomatose patients, a slurry of 100 g of activated charcoal can be administered immediately after the induction of vomiting or gastric lavage. A pure narcotic antagonist (e.g., naloxone) should be used in the treatment of respiratory depression caused by diphenoxylate hydrochloride.

When a narcotic antagonist is administered intravenously, the onset of action is generally apparent within two minutes. It may also be administered subcutaneously or intramuscularly, providing a slightly less rapid onset of action but a more prolonged effect. To counteract respiratory depression caused by diphenoxylate hydrochloride overdosage, the following dosage schedule for the narcotic antagonist naloxone hydrochloride should be followed: Adult dosage An initial dose of 0.4 mg to 2 mg of naloxone hydrochloride may be administered intravenously.

If the desired degree of counteraction and improvement in respiratory functions is not obtained, it may be repeated at 2- to 3-minute intervals. If no response is observed after 10 mg of naloxone hydrochloride has been administered, the diagnosis of narcotic-induced or partial narcotic-induced toxicity should be questioned. Intramuscular or subcutaneous administration may be necessary if the intravenous route is not available.

Children The usual initial dose in children is 0.01 mg/kg body weight given I.V. If this dose does not result in the desired degree of clinical improvement, a subsequent dose of 0.1 mg/kg body weight may be administered. If an I.V. route of administration is not available, naloxone hydrochloride may be administered I.M. or S.C. in divided doses.

If necessary, naloxone hydrochloride can be diluted with sterile water for injection. Following initial improvement of respiratory function, repeated doses of naloxone hydrochloride may be required to counteract recurrent respiratory depression. Supplemental intramuscular doses of naloxone hydrochloride may be utilized to produce a longer-lasting effect.

Since the duration of action of diphenoxylate hydrochloride is longer than that of naloxone hydrochloride, improvement of respiration following administration may be followed by recurrent respiratory depression. Consequently, continuous observation is necessary until the effect of diphenoxylate hydrochloride on respiration has passed. This effect may persist for many hours.

The period of observation should extend over at least 48 hours, preferably under continuous hospital care. Although signs of overdosage and respiratory depression may not be evident soon after ingestion of diphenoxylate hydrochloride, respiratory depression may occur from 12 to 30 hours later.

🧬 Clinical Pharmacology ~1 min read

CLINICAL PHARMACOLOGY Diphenoxylate is rapidly and extensively metabolized in man by ester hydrolysis to diphenoxylic acid (difenoxine), which is biologically active and the major metabolite in the blood. After a 5-mg oral dose of carbon-14 labeled diphenoxylate hydrochloride in ethanolic solution was given to three healthy volunteers, an average of 14% of the drug plus its metabolites was excreted in the urine and 49% in the feces over a four-day period. Urinary excretion of the unmetabolized drug constituted less than 1% of the dose, and diphenoxylic acid plus its glucuronide conjugate constituted about 6% of the dose.

In a 16-subject crossover bioavailability study, a linear relationship in the dose range of 2.5 to 10 mg was found between the dose of diphenoxylate hydrochloride (given as diphenoxylate hydrochloride liquid) and the peak plasma concentration, the area under the plasma concentration-time curve, and the amount of diphenoxylic acid excreted in the urine. In the same study the bioavailability of the tablet compared with an equal dose of the liquid was approximately 90%. The average peak plasma concentration of diphenoxylic acid following ingestion of four 2.5-mg tablets was 163 ng/ml at about 2 hours, and the elimination half-life of diphenoxylic acid was approximately 12 to 14 hours.

In dogs, diphenoxylate hydrochloride has a direct effect on circular smooth muscle of the bowel that conceivably results in segmentation and prolongation of gastrointestinal transit time. The clinical antidiarrheal action of diphenoxylate hydrochloride may thus be a consequence of enhanced segmentation that allows increased contact of the intraluminal contents with the intestinal mucosa.

📦 How Supplied / Storage and Handling 44 words

HOW SUPPLIED Tablets — round, white, with SEARLE debossed on one side and 61 on the other side and containing 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate, supplied as: NDC Number Size 59762-1061-1 bottle of 100 59762-1061-2 bottle of 1000

📋 Description 84 words

DESCRIPTION Each diphenoxylate hydrochloride and atropine sulfate tablet contains: diphenoxylate hydrochloride 2.5 mg atropine sulfate 0.025 mg Diphenoxylate hydrochloride, an antidiarrheal, is ethyl 1-(3-cyano-3,3-diphenylpropyl)-4-phenylisonipecotate monohydrochloride and has the following structural formula: Atropine sulfate, an anticholinergic, is endo-(±)-α-(hydroxymethyl) benzeneacetic acid 8-methyl-8-azabicyclo[3.2.1] oct-3-yl ester sulfate (2:1) (salt) monohydrate and has the following structural formula: A subtherapeutic amount of atropine sulfate is present to discourage deliberate overdosage.

Inactive ingredients of diphenoxylate hydrochloride tablets include acacia, corn starch, magnesium stearate, sorbitol, sucrose, and talc. Chemical Structure Chemical Structure

💬 Information for Patients 113 words

Information for patients INFORM THE PATIENT (PARENT OR GUARDIAN) NOT TO EXCEED THE RECOMMENDED DOSAGE AND TO KEEP DIPHENOXYLATE HYDROCHLORIDE OUT OF THE REACH OF CHILDREN AND IN A CHILD-RESISTANT CONTAINER. INFORM THE PATIENT OF THE CONSEQUENCES OF OVERDOSAGE, INCLUDING SEVERE RESPIRATORY DEPRESSION AND COMA, POSSIBLY LEADING TO PERMANENT BRAIN DAMAGE OR DEATH. Diphenoxylate hydrochloride may produce drowsiness or dizziness.

The patient should be cautioned regarding activities requiring mental alertness, such as driving or operating dangerous machinery. Potentiation of the action of alcohol, barbiturates, and tranquilizers with concomitant use of diphenoxylate hydrochloride should be explained to the patient. The physician should also provide the patient with other information in this labeling, as appropriate.

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.