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Can you tell me something about lomotil dependence? My 21 year old son is finally diagnosed with Crohn’s disease and among some other medicines he’s advised to take lomotil during Crohn’s flare-ups. Lomotil would successfully fight his abdominal pain and diarrhea but I’ve read somewhere lomotil is a strong drug actually I’m pretty much concerned could my son become lomotil dependant?

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Lomotil is a drug that might help your son in reducing bowel movements and relax his intestinal muscles and also helps in solving diarrhea problems so common in Crohn’s disease. Lomotil dependence is possible but if lomotil is taken as prescribed by the doc than you shouldn’t worry that much. Normally you should control how it’s being taken meaning that while on lomotil your son is not allowed to drink no alcohol for the serious side effects also known as sedative effects. Make him drink lomotil with a plenty of water I know this is very important though I’ve forgat for what reason, but anyway let him drink with much much water. Lomotil dependence usually occurs when the way of usage is not strongly respected so it is extremely important that your son takes lomotil as much as it is prescribed. Possible lomotil side effects are headache, dizziness, drowsiness, fast heart beating, nausea and vomiting.
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Lomotil is a synthetic opiate-like drug (opioid), it ataches to the same receptors in the brain as other opiates like morphine, heroin, etc. Chemically, it is called diphenoxylate and it is a member of a group of compounds called phenylpiperidines, that is derivatives (think, closely related compounds with minor differences in molecular structure). This is the same group that a number of other opioids (narcotics) that are used medically belong to including meperidine (Demerol), fentanyl (Sublimaze, Duragesic). At low doses such as found in Lomotil tablets (2.5mg/tab), this drug causes constipation (like all other opioids do) by increasing the time the digested material takes to travel through the large intestine where water is absorbed thus producing a drier consistency stool (anti-diarrhea effect). In larger single doses such as 40-60 mg (16-24 Lomotil tabs), this drug produces typical strong opioid effects (in addition to constipation) such as sedation, pain relief, euphoria and respiratory depression which can progress to coma and respiratory arrest with very large doses just like with overdose of other opioids. And, just like with other opioids, if used regulary over time it produces tolerance, opioid withdrawal symptoms if suddenly stopped and will take the place of other opioids to prevent the opioid withdrawal syndrome in cases where a person has become dependent on any other opioid (i.e, morphine, herion, methadone, etc.) that has suddenly been stopped.
Because it behaves like a typical opioid drug, it therefore can be readily abused at high doses while at low doses, it primarily effects the bowel (anti-diarrhea). To limit the extent to which this drug can be abused (and to reduce the restrictions placed on prescribing it), a small amount of a drug called atropine is added to each tablet which at low doses can produce some dry mouth and may also help the anti-diarrhea effect of the diphenoxylate but at high doses (such as when many tablets are taken at once), will produce unpleasant effects such as racing heart, blurred vision, very dry mouth and throat. The addition of small doses of atropine to each tablet is primarily intended to reduce deliberate overdose of Lomotil to exploit the strong opioid effect that comes with it. Unfortunately, tolerance will also develop to atropine if taken repeatedly (as many opioid abusers have discovered) and so, over time, addicts may take 50-100 or more tablets of Lomotil/day to obtain a narcotic effect or prevent withdrawal. That said, this drug should be prescribed with caution, especially to persons recovering from chemical dependency of any sort and probably not at all to persons recovering from opioid dependency due to its potential to re-activate the addictive process (and so make diarrhea the least of one's problems). In this case, another synthetic opioid that is not absorbed into the bloodstream in any relevant amount when taken orally called loperimide (Imodium) can be taken for diarrhea. (interestingly, this drug is related to the phenylpiperidine series as well as having some chemical similarity to another series of drugs called butryphenones to which the antipsychotic drug Haldol belongs)
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I've been taking one lomotil tablet a day for about 12 years for IBS. What happens if I stop?
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One tablet a day is not a large amount. I don't think you would have any problems at all if you stopped. Well other than having to run to the bathroom because of your IBS. I currently take 8 Lomotil pills a day for Crohn's disease. I also take 240 Percocet 10/325 for chronic pain due to Crohn's. It's not a fun world to live in when you have IBS, IBD, Crohn's or other bowel diseases. :(
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I was on a larger dose and I stop completely cold turkey and nothing happened to me, just a couple of mild headaches and that's it. I would worry more about the percocet and slowly come off that drug. But I done it and it's possible, you just go through some chills and a bit of depression for a few weeks once your completely off them. I guess I was lucky I heard. But I also didn't make a big deal of it because the pain from the crohn's was worst then coming of the meds for me. Good luck
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Ive used Lomotil for 12 years and take between 4 - 10 .25mg tabs per day.  Without it I would not have any hope whatsoever of controlling my Chrons Disease.  I did run out of pills once, for two days had none, and found I was jittery, felt like I was coming down with a cold and had terrible insomnia.  Once I took my pills I was fine, so definitely have some level of addiction.  However the benefits far outweigh the downside so I shall keep taking it.

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