Alvimopan for postoperative ileus

Purpose. The efficacy, safety, pharmacology, pharmacokinetics, drug–drug interactions, and administration of alvimopan for postoperative ileus are reviewed. Summary. Alvimopan is a selective mopioid receptor antagonist with no central nervous system activity. When orally administered after partial smallor largebowel resection in patients with primary anastomosis, alvimopan shortened the return of bowel function and time to discharge by approximately one day without compromising analgesia. Alvimopan was not shown to be beneficial on these same outcomes after hysterectomy and has not been studied in other surgical populations. Alvimopan is generally well tolerated, with the frequency of adverse events being similar to placebo when used postoperatively for one week or less. Long-term studies of alvimopan in opioid-induced bowel dysfunction have shown an association with adverse cardiovascular outcomes, neoplasms, and fractures. Because of these concerns, the Entereg Access Support and Education program was developed. The recommended dosage of alvimopan is 12