Opioids
Diphenoxylate (Lomotil)
Street names: Lomotil, Diphenoxylate-atropine
Overdose? Act now. Call emergency services — say "unresponsive, not breathing". Give naloxone for opioid-like signs. Hotlines
⚡What it does
- Opioid antidiarrheal — the poor cousin of loperamide, with the same mega-dose abuse pattern
⚠Key risks
- THE ATROPINE TRAP: high doses mean high atropine — anticholinergic delirium ON TOP of opioid effects; users chasing the opioid get the toxidrome
- Respiratory depression
- Cheap and OTC-ish (Rx but loosely held)
✚Overdose signs
- Delirium + sedation (both toxidromes at once)
- Slow breathing
- Racing heart, dry skin
📋Quick facts
Also known asLomotil, Diphenoxylate-atropine
CategoryOpioids
Schedule / classSchedule V (US — sub-2mg/atropine formulation)
Appearance2.5 mg tablets combined with atropine (0.025 mg) — the atropine is the abuse-deterrent
Street price~$0.20–$0.50 per tablet
Legal statusSchedule V US; Rx elsewhere; loose controls in some countries
Last updated2026-09-18
Sources: FDA, poison-control
Category comparison — Opioids
| Substance | Class | Top risks | Street price |
|---|---|---|---|
| Diphenoxylate (Lomotil) | Schedule V | THE ATROPINE TRAP: high doses mean high atropine — anticholinergic delirium ON TOP of opioid effects; users chasing the opioid get the toxidrome; Respiratory depression | ~$0.20–$0.50 per tablet |
| Loperamide (Imodium) Abuse | OTC — unrestricted; bulk purchases monitored in some US states | CARDIAC DEATH — the signature: mega-doses block cardiac sodium/potassium channels → arrhythmia, QT prolongation, sudden death. Multiple documented fatalities; Not a safe withdrawal tool — the dose that stops withdrawal approaches the dose that stops the heart | ~$5–$12 per pack of 18–42 tablets — the accessibility is the danger |
| Codeine 30/500 mg (co-codamol) | Schedule V / Rx | Paracetamol component destroys the liver at high doses; Lean + alcohol risks fatal respiratory depression | ~$2–$10 per tablet |
Street prices are regional estimates. Potency and cuts vary constantly.
?Frequently asked questions
What does Diphenoxylate (Lomotil) look like?
2.5 mg tablets combined with atropine (0.025 mg) — the atropine is the abuse-deterrent
What are the signs of a Diphenoxylate (Lomotil) overdose?
Delirium + sedation (both toxidromes at once); Slow breathing; Racing heart, dry skin Call emergency services immediately and give naloxone if available — it reverses opioid overdoses.
How addictive is it?
THE ATROPINE TRAP: high doses mean high atropine — anticholinergic delirium ON TOP of opioid effects; users chasing the opioid get the toxidrome Dependence can develop with regular use.
🔗Sources & further reading
Facts on this page are compiled from these primary sources. External links open in a new tab.