Drug interactions
Belladonna and opium + Diphenoxylate-atropine
Severity: Major
Belladonna and opium and Diphenoxylate-atropine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both preparations contain an opioid and an antimuscarinic, so their effects are duplicated. Combination raises the risk of excess sedation, respiratory depression, severe constipation, urinary retention and paralytic ileus.
What this interaction means in plain words
Belladonna and opium and Diphenoxylate-atropine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive opioid-mediated CNS and gut-motility depression plus additive muscarinic blockade.
What to do
Avoid using these together. If unavoidable, use the lowest doses for the shortest time and monitor for respiratory depression, abdominal distension and urinary retention.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine Major
Frequently asked questions
Can I take Belladonna and opium with Diphenoxylate-atropine?
MediHelp rates the interaction as major. Belladonna and opium and Diphenoxylate-atropine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both preparations contain an opioid and an antimuscarinic, so their effects are duplicated. Combination raises the risk of excess sedation, respiratory depression, severe constipation, urinary retention and paralytic ileus.
How serious is the interaction between Belladonna and opium and Diphenoxylate-atropine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using these together. If unavoidable, use the lowest doses for the shortest time and monitor for respiratory depression, abdominal distension and urinary retention.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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