Contraindications and Precautions for Lomotil Use

Relative Contraindications and Cautions

The American Gastroenterological Association recommends that Lomotil should not be used in patients with severe dysentery with high fever or blood in stool, as it may worsen outcomes and is no more effective than placebo 1, 2
The American Academy of Pediatrics advises that children under 2 years of age should not be given Lomotil due to the risk of rare adverse central and peripheral side effects, likely due to immature hepatic function and blood-brain barrier 2
The European Society for Medical Oncology suggests that neutropenic patients require careful risk-benefit assessment when considering Lomotil, as overdosage may lead to iatrogenic ileus with increased risk of bacteremia 3, 4, 5

The American College of Gastroenterology notes that Lomotil is generally less effective than loperamide for acute diarrhea 1, 2
The National Comprehensive Cancer Network recommends that in cancer patients with therapy-associated diarrhea, Lomotil may be considered an alternative when loperamide is ineffective, but only after infectious diarrhea has been excluded 3, 4, 5