Alvimopan
ENTEREG
What it isPeripherally restricted mu antagonist; postoperative ileus after bowel resection.
Why this oneIt speeds return of bowel function without reversing systemic analgesia.
What limits itMyocardial infarction signal restricts it to inpatient use for a maximum of fifteen doses.
FDA-approved for
- postoperative ileus (2008)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Accelerate GI recovery after partial bowel resection with primary anastomosis | Adult (hospital) | 12 mg 30 min–5 h before surgery | 12 mg BID | 15 doses / ≤7 days |
Renal No adjustment for mild–severe impairment (monitor for GI reactions); not recommended in ESRD.
Hepatic No adjustment for mild–moderate impairment (monitor); not recommended in severe impairment.
Single 12 mg dose 30 min–5 h preop, then 12 mg BID until discharge; max 15 doses over ≤7 days.
Instructions
- Hospital use only; do not exceed 15 doses.
- Take with or without food.
Contraindications
- Patients who have taken therapeutic doses of opioids for >7 consecutive days immediately prior
Cautions
- MI risk with long-term use
- GI reactions in opioid-tolerant patients
- Not recommended in severe hepatic impairment, ESRD, complete GI obstruction, or pancreatic/gastric anastomoses
Adverse reactions
- Dyspepsia
Pregnancy Limited human data; no fetal harm in animal reproduction studies.
Lactation No human data; alvimopan and metabolite detected in rat milk.
⚠ BOXED WARNING
- Myocardial infarction with long-term use; short-term hospital use only
Principal riskMyocardial infarction signal; hospital use only, limited to 15 doses
Classes and tags
Clinical profile
Mechanism of action: Alvimopan ballicule
