Drug interactions
Diphenoxylate-atropine + Levorphanol
Severity: Major
Diphenoxylate-atropine and Levorphanol: major interaction.
Last updated Sources: US FDA label
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 drugs are opioids, and combining them adds to sedation, respiratory depression and constipation. Atropine may add to the constipating and urinary retention effects, with a risk of ileus.
What this interaction means in plain words
Diphenoxylate-atropine and Levorphanol 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 mu-opioid receptor agonism, causing CNS and respiratory depression and reduced gut motility.
What to do
Avoid combining where possible; if both are needed, use the lowest doses and monitor sedation, respiratory rate and bowel function. Avoid with other sedatives.
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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References
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 Diphenoxylate-atropine with Levorphanol?
MediHelp rates the interaction as major. Diphenoxylate-atropine and Levorphanol 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 drugs are opioids, and combining them adds to sedation, respiratory depression and constipation. Atropine may add to the constipating and urinary retention effects, with a risk of ileus.
How serious is the interaction between Diphenoxylate-atropine and Levorphanol?
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 combining where possible; if both are needed, use the lowest doses and monitor sedation, respiratory rate and bowel function. Avoid with other sedatives.
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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