Drug reference

alvimopan

Peripherally restricted mu-opioid receptor antagonist · Postoperative ileus treatment

Peripherally restricted mu-opioid receptor antagonistPostoperative ileus treatmentATC A06AH04

CDSCO approvedATC A06AH04

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

BenzhydrocodoneSevereDatabaseDDInter
BuprenorphineSevereDatabaseDDInter
ButorphanolSevereDatabaseDDInter
CodeineSevereDatabaseDDInter

Mechanism

Alvimopan is a mu-opioid receptor antagonist with distribution restricted to the periphery, penetrating poorly into the CNS. It reverses peripheral opioid effects without affecting centrally mediated analgesia.

Indications

postoperative ileus (in patients with less than 7 days of opioid exposure immediately prior to beginning alvimopan)Accelerate time to upper and lower GI recovery following partial large- or small-bowel resection surgery with primary anastomosis

Dosing

Adult: Short-term use (15 doses) only

Pharmacokinetics

Peak effect

About 36 h (active metabolite)

Half-life

10–18 h (parent drug and metabolite)

Metabolism

Oral administration leads to deamidated metabolite, attributed to intestinal microbiome activity

Excretion

Urine and feces

Contraindications

prolonged use (more than 15 doses, due to increased incidence of myocardial infarction)
Risk of myocardial infarctions
Neoplasia (available only through a restricted-access program in the U.S. due to these risks)

Side effects

Common

DyspepsiaAnemiaBack painUrinary retention

Serious

increased incidence of myocardial infarction (with prolonged use)
Hypokalemia
Myocardial infarctions
Neoplasia