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Motofen

difenoxin / atropine
Used for Diarrhea

Motofen (difenoxin / atropine) is a combination medication used to treat diarrhea. It's typically used in addition to other medications to treat sudden (acute) or long-lasting (chronic) diarrhea. This medication has a risk of serious breathing problems and dizziness, and can be habit-forming.

Reviewed by:Last reviewed on February 17, 2022
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What is Motofen (difenoxin / atropine)?

What is Motofen (difenoxin / atropine) used for?

  • Diarrhea

How Motofen (difenoxin / atropine) works

Motofen (difenoxin / atropine) is a combination of two different medications.

  • Difenoxin is an opioid. It works directly on the walls of your gut and slows down movement in your intestines and colon to relieve diarrhea.
  • Atropine is an anticholinergic. It blocks a chemical in your brain called acetylcholine. If acetylcholine builds up in your body, it can cause diarrhea. Atropine also helps prevent misuse and overdose by causing unpleasant side effects if too much is taken.

Drug facts

Common BrandsMotofen
Drug ClassOpioid / Anticholinergic
Controlled Substance ClassificationSchedule IV
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Risks and warnings for Motofen (difenoxin / atropine)

Motofen (difenoxin / atropine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Overdose and atropine poisoning

  • Risk factors: Taking high doses of Motofen (difenoxin / atropine) | Children | History of Down's syndrome

Taking high doses of Motofen (difenoxin / atropine) or using it more often than prescribed can cause you to overdose on this medication. Overdose can lead to serious breathing problems, brain damage, coma, and even death. The chances of overdose are higher in children, especially those under the age of 2. If you've been told to avoid anticholinergic medications, don't take Motofen (difenoxin / atropine) because it can lead to atropine poisoning, especially if you have Down's syndrome. Atropine poisoning can occur in children even at recommended doses.

Motofen (difenoxin / atropine) overdose is a medical emergency that requires treatment and observation at a hospital for at least 2 days. If you or your child accidentally overdoses on Motofen (difenoxin / atropine), call for emergency medical help right away. Symptoms of an overdose include dry or flushed skin, tiredness, muscle weakness, difficulty breathing, slowed breathing, small pupils, uncontrolled eye movements, or fast heart rate.

Dehydration and electrolyte imbalance

  • Risk factors: Not hydrating after having diarrhea | Taking medications that affect movement of your stomach and intestines | Children

When you have diarrhea, your body loses large amounts of fluid, water, and electrolytes. This can lead to dehydration, which can be serious and life-threatening if left untreated. In addition to taking Motofen (difenoxin / atropine), you should hydrate your body by drinking plenty of fluids. Dehydration in children can be especially dangerous and can lead to serious harmful effects of Motofen (difenoxin / atropine). If you take any medications that affect movement of the muscles in your stomach or intestines, let your healthcare provider know, as this can lead to further dehydration.

Serious inflammation of your colon and intestines

  • Risk factors: History of ulcerative colitis (UC)

Use Motofen (difenoxin / atropine) with caution if you have ulcerative colitis (UC), a condition that causes inflammation in your colon and intestines. If you have severe ulcerative colitis, using Motofen (difenoxin / atropine) can possibly lead to a rare, but life-threatening condition called toxic megacolon. If you suddenly develop stomach pain, stomach swelling, bloody diarrhea, fever, fast heart rate, or confusion, let your healthcare provider know right away.

Liver and kidney damage

  • Risk factors: History of liver and kidney disease

If you have liver and kidney disease (hepatorenal disease) or abnormal liver function, let your healthcare provider know before using Motofen (difenoxin / atropine). This medication can worsen liver damage, which can lead to brain damage. If you're confused or having trouble thinking or concentrating, let your provider know right away.

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Side effects of Motofen (difenoxin / atropine)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea (7%)
  • Dizziness or lightheadedness (5%)
  • Sleepiness (4%)
  • Headache (3%)
  • Dry mouth (3%)
  • Vomiting (3%)
  • Stomach upset (1%)

Less Common Side Effects

  • Constipation
  • Tiredness
  • Nervousness
  • Trouble falling asleep or staying asleep (insomnia)
  • Confusion
  • Eyes burning
  • Blurry vision

Motofen (difenoxin / atropine) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Overdose: dry or flushed skin, tiredness, muscle weakness, difficulty breathing, slowed breathing, small pupils, uncontrolled eye movements, fast heart rate

Source: DailyMed

The following Motofen (difenoxin / atropine) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Bloating

constipation

loss of appetite

stomach pain (severe) with nausea and vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Blurred vision (continuing) or changes in near vision

drowsiness (severe)

dryness of mouth, nose, and throat (severe)

fast heartbeat

shortness of breath or troubled breathing (severe)

unusual excitement, nervousness, restlessness, or irritability

unusual warmth, dryness, and flushing of skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common or rare

Blurred vision

confusion

difficult urination

dizziness or lightheadedness

drowsiness

dryness of skin and mouth

fever

headache

trouble in sleeping

unusual tiredness or weakness

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Increased sweating

muscle cramps

nausea or vomiting

shivering or trembling

stomach cramps

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Motofen (difenoxin / atropine)

Pros

  • Conveniently combines two different medications into one tablet
  • Works within 4 hours to treat sudden diarrhea
  • Contains atropine, which helps prevent misuse and intentional opioid overdose
  • Safe to use in children 12 years or older

Cons

  • No lower-cost generic available so can be more expensive
  • Can cause unpleasant side effects, such as nausea, vomiting, dizziness, and dry mouth
  • Risk of abuse, misuse, and addiction
  • Risk of serious breathing problems, coma, or brain damage when used at high doses
  • Can't be used to treat diarrhea caused by antibiotics or bacteria, such as Clostridioides difficile (C. diff), Escherichia coli (E. coli), or Salmonella
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Pharmacist tips for Motofen (difenoxin / atropine)

pharmacist
  • Motofen (difenoxin / atropine) can cause severe sleepiness, dizziness, or lightheadedness. The risk is greater if you drink alcohol, use medications to help you sleep or treat seizures (e.g., barbiturates), or use other opioid medications. For your safety, discuss with your healthcare provider before taking Motofen (difenoxin / atropine) with other medications.
  • Motofen (difenoxin / atropine) can sometimes cause dry mouth. Sipping water, chewing gum, or using over-the-counter (OTC) saliva sprays or rinses can help with dry mouth. Ask your pharmacist if you need help selecting OTC products that are safe for you.
  • Motofen (difenoxin / atropine) interacts with many medications. If you take monoamine oxidase inhibitor (MAOIs) for depression or Parkinson's disease, such as phenelzine (Nardil), tranylcypromine (Parnate), or selegiline, let your healthcare provider know before taking Motofen (difenoxin / atropine). Combining these medications can lead to dangerously high blood pressure.
  • Don't take Motofen (difenoxin / atropine) if you have diarrhea right after or while using an antibiotic. If you feel like an antibiotic might've caused your diarrhea, let your healthcare provider know before using any medications to treat your diarrhea. Taking Motofen (difenoxin / atropine) in this situation can sometimes worsen your diarrhea or cause you to have diarrhea for a longer period of time.
  • Store Motofen (difenoxin / atropine) at room temperature in a place out of reach from children, pets, and visitors at all times to prevent accidental overdose. In the event of an accidental overdose, get emergency medical help or call your local poison control center at 1-800-222-1222 right away. Symptoms of an overdose include dry or flushed skin, tiredness, muscle weakness, difficulty or slowed breathing, small pupils, uncontrolled eye movements, or fast heart rate.
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Common questions about Motofen (difenoxin / atropine)

Motofen (difenoxin / atropine) works quickly to relieve diarrhea. It typically starts working within 4 hours. You'll most likely have more normal and less frequent stools within 1 day of using the medication. If you feel like Motofen (difenoxin / atropine) isn't working well or if your diarrhea doesn't go away within 2 days, let your healthcare provider know.

Based on studies looking at how well Motofen (difenoxin / atropine) works, effects of the medication can last up to 4 days. If you have chronic or long-lasting diarrhea, Motofen (difenoxin / atropine) can continue to relieve your diarrhea for 4 days.

Motofen (difenoxin / atropine) rarely causes constipation. Constipation isn't as common as some of the other side effects, such as nausea, vomiting, or dry mouth. In studies looking at side effects of this medication, constipation occurred in fewer than 1% of people who took the medication. If you're constipated or concerned about constipation, talk to your pharmacist or healthcare provider.

There aren't any studies looking at the safety of using Motofen (difenoxin / atropine) during pregnancy in humans. But studies with pregnant animals showed a risk of harm to the mother and baby. If you're pregnant or plan on becoming pregnant, discuss with your healthcare provider and only use this medication if the benefits outweigh the risks.

Motofen (difenoxin / atropine) works well and is safe to use in children 12 years and older. There aren't any studies looking at the safety of this medication in children under the age of 12, so it should be avoided in this age group. Motofen (difenoxin / atropine) should never be used in children under the age of 2. If your child is under 12 years old but has diarrhea, discuss other options with your child's healthcare provider.

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Motofen (difenoxin / atropine) dosage

The average cost for 30 tablets of 1mg/0.025mg of Motofen (difenoxin / atropine) is $217.12 with a free GoodRx coupon. This is 18.38% off the average retail price of $266.01.
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DosageQuantityPrice as low asPrice per unit
1mg/0.025mg30 tablets$217.12$7.24

Typical dosage for Motofen (difenoxin / atropine)

The typical starting dose is 2 tablets by mouth, followed by 1 tablet after each loose stool OR 1 tablet by mouth every 3 to 4 hours on an as-needed basis for diarrhea.

Each tablet contains 1 mg of difenoxin and 0.025 mg of atropine. Don't take more than 8 tablets per day.

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Interactions between Motofen (difenoxin / atropine) and other drugs

Motofen (difenoxin / atropine) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Motofen (difenoxin / atropine). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Arbutamine
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Motofen (difenoxin / atropine) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Motofen (difenoxin / atropine) will not be safe for you to take.

  • Diarrhea caused by antibiotics or bacteria, such as Clostridioides difficile (C. diff), Escherichia coli (E. coli), Salmonella, or Shigella
  • History of jaundice (yellowing of your skin or eyes)
  • Children under the age of 2
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What are alternatives to Motofen (difenoxin / atropine)?

There are a number of medications that your doctor can prescribe in place of Motofen (difenoxin / atropine). Compare a few possible alternatives below.
Motofen (difenoxin / atropine)
Used for:
  • Diarrhea
$217.12Lowest GoodRx priceView prices
Used for:
  • Add-on therapy for diarrhea for people 13 years and older
$9.22Lowest GoodRx priceView prices
Used for:
  • Controlling symptoms of diarrhea - OTC and prescription
  • Controlling diarrhea related to chronic gut-related conditions - prescription only
  • Lowering the amount of discharge from an ileostomy - prescription only
$5.71Lowest GoodRx priceView prices

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