Alosetron Brand Name– Lotronex
What is Alosetron
Alosetron is an oral selective serotonin 5-HT3 receptor antagonist. It is approved with restrictions for the treatment of women who exhibit severe diarrhea-predominant irritable bowel syndrome (IBS) and have failed conventional therapy.
Severe IBS occurs in < 5% of patients. Efficacy in men has not been established. In clinical studies, women with severe diarrhea-predominant IBS (bowel urgency >= 50% of days) had significant increases (13—16%) in the median percentage of days with urgency control vs. placebo; a retrospective analysis of the data concurred that alosetron had a beneficial effect on control of bowel urgency in these patients.
The diagnosis of IBS has been defined according to the ROME II criteria used to assess IBS subgroups (e.g., diarrhea- or constipation-predominant) as well as by a recent evidence and consensus-based guideline.
The FDA originally approved alosetron for diarrhea-predominant IBS in February 2000.
Indications
- irritable bowel syndrome
For the treatment of severe, chronic, diarrhea-predominant irritable bowel syndrome (IBS) in women for whom conventional therapy has failed
NOTE: Diarrhea-predominant IBS is considered severe if it includes diarrhea and one or more of the following: frequent/severe abdominal pain; frequent bowel urgency or fecal incontinence; restriction of daily activities due to IBS.
Side Effects
- abdominal pain
- alopecia
- anxiety
- atopic dermatitis
- bone pain
- cholecystitis
- colitis
- confusion
- constipation
- cough
- depression
- diuresis
- drowsiness
- dysgeusia
- dyspepsia
- elevated hepatic enzymes
- flatulence
- folliculitis
- gastroesophageal reflux
- GI bleeding
- GI obstruction
- GI perforation
- headache
- hemorrhoids
- hepatitis
- hyperglycemia
- hypertension
- hypoglycemia
- ileus
- increased urinary frequency
- infection
- laryngitis
- menstrual irregularity
- myalgia
- nausea
- photophobia
- polyuria
- rash
- sinus tachycardia
- toxic megacolon
- urticaria
- vomiting
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- anticholinergic medications
- bleeding
- breast-feeding
- children
- constipation
- Crohn’s disease
- diverticulitis
- geriatric
- GI bleeding
- GI disease
- GI obstruction
- GI perforation
- hepatic disease
- infants
- ischemic colitis
- neonates
- pregnancy
- renal failure
- renal impairment
- thrombophlebitis
- toxic megacolon
- ulcerative colitis
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Propoxyphene
- Acrivastine; Pseudoephedrine
- Alfentanil
- Amantadine
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Anticholinergics
- Antidiarrheals
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Bethanechol
- Boceprevir
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Cannabidiol
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pyrilamine
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Ceritinib
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlorcyclizine
- Chlordiazepoxide; Clidinium
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Clarithromycin
- Clemastine
- Clomipramine
- Clozapine
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crofelemer
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Dalfopristin; Quinupristin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desipramine
- Dexamethasone
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dicyclomine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Doxepin
- Doxylamine
- Doxylamine; Pyridoxine
- Eluxadoline
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Erythromycin
- Erythromycin; Sulfisoxazole
- Fentanyl
- Flavoxate
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluvoxamine
- Fosamprenavir
- Givosiran
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydantoins
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Idelalisib
- Imipramine
- Indacaterol; Glycopyrrolate
- Indinavir
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ketoconazole
- Leflunomide
- Letermovir
- Levorphanol
- Lopinavir; Ritonavir
- Lubiprostone
- Maprotiline
- Meclizine
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Mesoridazine
- Methadone
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methscopolamine
- Metoclopramide
- Mexiletine
- Mitotane
- Morphine
- Morphine; Naltrexone
- Nefazodone
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Norfloxacin
- Nortriptyline
- Obeticholic Acid
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Opiate Agonists
- Orphenadrine
- Oxybutynin
- Oxycodone
- Oxymorphone
- Palonosetron
- Peginterferon Alfa-2b
- Perphenazine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phenothiazines
- Phenylephrine; Promethazine
- Posaconazole
- Pramlintide
- Primidone
- Procainamide
- Prochlorperazine
- Promethazine
- Propantheline
- Propoxyphene
- Protriptyline
- Quinine
- Remifentanil
- Ribociclib
- Ribociclib; Letrozole
- Rifamycins
- Ritonavir
- Rucaparib
- Saquinavir
- Scopolamine
- Sedating H1-blockers
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Sufentanil
- Telaprevir
- Telithromycin
- Teriflunomide
- Thiabendazole
- Thiethylperazine
- Thioridazine
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimipramine
- Triprolidine
- Trospium
- Tucatinib
- Vemurafenib
- Voriconazole
- Zafirlukast
- Zileuton
