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ALIMENTARY TRACT AND METABOLISM › DRUGS FOR CONSTIPATION › DRUGS FOR CONSTIPATION › Peripheral opioid receptor antagonists
alvimopan
A06AH02
Adult Dosing
- Postoperative ileus acceleration (short-term use only): 12 mg administered 30 minutes to 5 hours prior to partial bowel resection surgery, then 12 mg twice daily for up to 7 consecutive doses or until discharge
Pediatric Dosing
- Safety and efficacy not established in pediatric patients (< 18 years)
Indications
- Accelerate time to recovery of bowel function after partial small or large bowel resection surgery with primary anastomosis
Mechanism of Action
- Peripherally acting mu-opioid receptor antagonist (PAMORA) that selectively blocks mu-opioid receptors in the gastrointestinal tract, reducing opioid-induced delay in bowel motility without centrally reversing analgesia
Contraindications
- Patients receiving therapeutic doses of opioids for more than consecutive immediate-release doses (or equivalent) for more than 7 consecutive days prior to surgery
- Known hypersensitivity to alvimopan or its excipients
Adverse Reactions
- Dyspepsia
- Hypokalemia
- Anemia
- Back pain
- Urinary retention
- Potential increased risk of myocardial infarction with long-term use (though not approved for chronic use)
Drug Interactions
- Strong inhibitors of CYP3A4 (potential for increased systemic exposure, though primarily cleared via gut/biliary mechanisms)
- Opioid analgesics (concurrent use with chronic opioids is contraindicated due to increased risk of opioid withdrawal and exacerbated GI sensitivity)
Curated Content: Needs Vetting Before Put to Clinical Use