Alvimopan

Alvimopan Brand Name– Entereg

What is Alvimopan

Alvimopan is the first oral, gastrointestinal-specific mu-opioid receptor antagonist and is indicated to accelerate the time to upper and lower gastrointestinal recovery following partial large or small bowel resection surgery with primary anastomosis (i.e., prevention of postoperative ileus).

The efficacy of alvimopan in the management of postoperative ileus was evaluated in 6 multicenter, randomized, double-blind, parallel-group, placebo-controlled studies.

Primary approval was supported by trials in patients undergoing bowel resection for benign or malignant colorectal or small bowel disease; expanded approval was supported by a Phase IV controlled trail in patients undergoing radical cystectomy, an extensive surgical procedure that includes resecting a segment of the bowel to reconstruct the lower urinary tract.

Indications

  • ileus prophylaxis
  • opiate agonist-induced constipation

For the acceleration of time to upper and lower gastrointestinal recovery following partial large or small bowel resection surgery with primary anastomosis (i.e., postoperative ileus prophylaxis)

Side Effects

  1. abdominal pain
  2. anemia
  3. back pain
  4. constipation
  5. diarrhea
  6. dyspepsia
  7. flatulence
  8. hypokalemia
  9. myocardial infarction
  10. urinary retention

Monitoring Parameters

  • hemoglobin/hematocrit
  • serum potassium

Contraindications

  • breast-feeding
  • children
  • GI obstruction
  • hepatic disease
  • infants
  • myocardial infarction
  • pregnancy
  • renal disease
  • requires a specialized care setting

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Alfentanil
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Belladonna; Opium
  • Bepridil
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Buprenorphine; Naloxone
  • Bupropion; Naltrexone
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Cyclosporine
  • Dextromethorphan; Quinidine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Fentanyl
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Itraconazole
  • Levorphanol
  • Meperidine
  • Meperidine; Promethazine
  • Methadone
  • Methylnaltrexone
  • Morphine
  • Morphine; Naltrexone
  • Naldemedine
  • Nalmefene
  • Naloxegol
  • Naloxone
  • Naltrexone
  • Opiate Agonists
  • Opiate Antagonists
  • Oxycodone
  • Oxymorphone
  • Pentazocine; Naloxone
  • Propoxyphene
  • Quinidine
  • Quinine
  • Remifentanil
  • Spironolactone
  • Sufentanil
  • Trandolapril; Verapamil
  • Verapamil
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