Evaluation of efficacy and safety of diphenoxylate hydrochloride and atropine sulphate in patient with acute radiation or chemotherapy induced diarrhea

Shrikant Khare; Dilip Nikam; Abhishek Singh; Laxman Pandey

doi:10.18203/2320-6012.ijrms20242219

Authors

Shrikant Khare Department of Radiation Oncology, Signus Hospital, Nashik, Maharashtra, India
Dilip Nikam Department of Radiation Oncology, Bombay Hospital and Medical Research Center, Mumbai, Maharashtra, India
Abhishek Singh Department of Radiation Oncology, Gangashill Cancer Institute, Bareilly, Uttar Pradesh, India
Laxman Pandey Department of Radiation Oncology, Rohilkhand Cancer Institute, Bareilly, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20242219

Keywords:

Improvement, Quality of life, Mucus, Stool frequency

Abstract

Background: Chemoradiotherapy (CRT)-induced diarrhea poses significant challenges for cancer patients, impacting both quality of life and treatment efficacy. Current management strategies often involve symptomatic relief with medications such as lomotil and loperamide, but limited data exist on the efficacy of lomotil for management of CRT-induced diarrhea. This study aimed to evaluate the efficacy and safety of lomotil in managing acute CRT-induced diarrhea.

Methods: A cross-sectional observational trial was conducted at 25 Indian healthcare centers having medical records of adult patients with cancer who had received lomotil for the treatment of CRT-induced diarrhea. Adult patients (aged ≥18 years) with confirmed diagnosis of cancer, who were experiencing CRT-induced diarrhea of grade II or grade III severity were included in this study. Demographic information and treatment history were collected. Moreover, data related to stool frequency, stool consistency, abdominal cramp, and occurrence of blood or mucus were collected at baseline, day 1, day 2, day 3, 2^nd week, 3^rd week, and 4^th week.

Results: A total of 177 patients were included in this study. Of these 30.51% underwent radiotherapy, while 26.55% received both chemotherapy and radiotherapy in combination. Post-lomotil treatment, diarrhea incidence declined significantly by week 4 [pre-treatment to week 4: 3.58 to 0.42; P<0.001]. The presence of blood or mucus decreased significantly from baseline to week 4 (0.25 to 0.05; p<0.01). The overall global assessment for improvement showed that a majority of the patients (80.79%) experienced improvement.

Conclusions: Lomotil demonstrated efficacy in reducing CRT-induced diarrhea incidence and symptoms, with minimal adverse effects.

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