Motofen
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.
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 Brands | Motofen |
|---|---|
| Drug Class | Opioid / Anticholinergic |
| Controlled Substance Classification | Schedule IV |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
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.
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
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:
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
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
Pharmacist tips for Motofen (difenoxin / atropine)
- 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.
Motofen (difenoxin / atropine) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1mg/0.025mg | 30 tablets | $222.14 | $7.40 |
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.
Interactions between Motofen (difenoxin / atropine) and other drugs
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.
- Ambenonium
- Nalmefene
- Naltrexone
- Potassium
- Safinamide
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.
- Alfentanil
- Alprazolam
- Amifampridine
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Bromazepam
- Bromopride
- Buprenorphine
- Bupropion
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Carbinoxamine
- Cetirizine
- Clobazam
- Clopidogrel
- Clozapine
- Codeine
- Desmopressin
- Desvenlafaxine
- Dextroamphetamine
- Dihydrocodeine
- Donepezil
- Doxylamine
- Duloxetine
- Escitalopram
- Esketamine
- Fenfluramine
- Fentanyl
- Flibanserin
- Furazolidone
- Gabapentin
- Gabapentin Enacarbil
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Granisetron
- Hydrocodone
- Hydromorphone
- Iproniazid
- Isocarboxazid
- Ketamine
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofexidine
- Lorazepam
- Loxapine
- Macimorelin
- Magnesium Oxybate
- Meclizine
- Meperidine
- Metaxalone
- Methacholine
- Methadone
- Methamphetamine
- Methylene Blue
- Metoclopramide
- Midazolam
- Mirtazapine
- Moclobemide
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Ondansetron
- Oxycodone
- Oxymorphone
- Ozanimod
- Pentazocine
- Periciazine
- Phenelzine
- Potassium Oxybate
- Pregabalin
- Procarbazine
- Rasagiline
- Remifentanil
- Remimazolam
- Revefenacin
- Scopolamine
- Secretin Human
- Selegiline
- Sertraline
- Sodium Oxybate
- Sufentanil
- Tapentadol
- Tiotropium
- Tramadol
- Tranylcypromine
- Trazodone
- Vortioxetine
- Zolpidem
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
How much does Motofen (difenoxin / atropine) cost?
$222.14
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
