Antimotility Agents

Diphenoxylate and loperamide are antimotility agents used in the treatment of diarrhea and work by stimulating presynaptic opioid receptors in the enteric nervous system, which results in reduced acetylcholine release and, thus, decreased gut contractility and secretions. The overall effect slows gut transit.  Caution with use of these medications in cases of severe colitis.  Additionally, use can contribute to the development of toxic megacolon.

Class Drugs

• Diphenoxylate

• Loperamide

Class Mechanism of Action

Activation of presynaptic opioid receptors decreases release of acetylcholine in the enteric nervous system, which results in slowed transit time.

Class Applications

Diarrhea

Class Adverse Effects

Do not use in severe colitis

Do not use in young children  (increased risk of ileus, lethargy, or death)

May contribute to development of toxic megacolon

Drug Table

Drug Name	Application	Comments	Image
Diphenoxylate			"Dice" "Fence" "Ox" "Latte"
Loperamide			"Low" "Pear"