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(al-vi-mo-pan) ,


(trade name)


Therapeutic: gastric stimulant
Pharmacologic: opioid antagonists
Pregnancy Category: B


Speed time to upper/lower GI recovery following partial bowel resection surgery with primary anastamosis.


Acts peripherally as μ-opioid receptor antagonist which speeds recovery of bowel function after to partial large or small bowel resection surgery with anastomosis surgery.

Therapeutic effects

Accelerated time to bowel recovery following primary anastamotic surgery.


Absorption: 6% absorbed following oral administration.
Distribution: Does not cross the blood-brain barrier.
Protein Binding: alvimopan—80% bound to albumin; metabolite—94% bound to albumin.
Metabolism and Excretion: Converted by bacterial flora in the GI tract to an active metabolite; elimination is mostly via biliary secretion, followed by conversion by bacterial flora. Elimination of unabsorbed drug and metabolites is via feces and urine.
Half-life: alvimopan—10–17 hr; metabolite—10–18 hr.

Time/action profile (blood leves)

POunknown2 hr12 hr


Contraindicated in: Therapeutic doses of opioid analgesics for more than 7 consecutive days before initiation of alvimopan; Severe hepatic impairment or end-stage renal disease.
Use Cautiously in: More than 3 doses of opioids within the wk prior to surgery (↑ sensitivity to effects and adverse reactions including abdominal pain, nausea, vomiting and diarrhea); Mild to moderate hepatic or renal impairment (↑ risk of adverse reactions); genetic implication Japanese patients (may have ↑ risk of adverse reactions); Geriatric: May have ↑ sensitivity to effects; Obstetric / Lactation: Use in pregnancy only if clearly needed; use cautiously during lactation; Pediatric: Safety not established.

Adverse Reactions/Side Effects


  • MI (life-threatening)


  • constipation (most frequent)
  • dyspepsia (most frequent)
  • flatulence (most frequent)

Fluid and Electrolyte

  • hypokalemia


  • urinary retention


  • anemia


  • back pain


Drug-Drug interaction

Previous (within 1 wk) opioid use ↑ risk of adverse reactions (avoid if therapeutic opioid doses used during prior wk, use cautiously if more than 3 doses have been used).


Oral (Adults) 12 mg for 30 min–5 hr prior to surgery, then 12 mg twice daily for up to 15 doses.


Capsules: 12 mg

Nursing implications

Nursing assessment

  • Assess bowel sounds and frequency, quantity, and consistency of stools periodically during therapy.
  • Lab Test Considerations: May cause anemia and hypokalemia.

Potential Nursing Diagnoses

Constipation (Indications)


  • Must be administered only during hospitalization. Only available in hospitals enrolled in the Entereg Access Support and Education (E.A.S.E.) program.
  • Oral: Administer twice daily without regard to food for no more than 7 days.

Patient/Family Teaching

  • Explain purpose of alvimopan to patient.
  • Advise patient to notify health care professional if they have taken long term or intermittent opioid pain therapy, including any use of opioids in the wk prior to receiving alvimopan.

Evaluation/Desired Outcomes

  • Resolution of postoperative ileus following bowel resection.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
"In addition, Cubist's Entereg helps to improve recovery times in patients who undergo bowel surgery.
Alvimopan is available only for inpatient use at facilities registered under the ENTEREG Access Support and Education (E.A.S.E.) program because of its known potential to precipitate a cardiac event in patients with long-term use (Cubist Pharmaceuticals, 2014; Kraft et al., 2010).
Adolor is marketing an FDA-approved therapy called Entereg, which aims at accelerating the time to upper and lower gastrointestinal recovery following partial large or small bowel resection surgery with primary anastomosis.
M2 EQUITYBITES-June 15, 2011-Adolor Corporation to acquire full ownership of ENTEREG held by GSK(C)2011 M2 COMMUNICATIONS
The increase in net sales was driven primarily by an increase in the number of hospitals ordering ENTEREG and increased penetration within existing hospital customers, as well as the impact of pricing changes since the first quarter of 2010.
The brokerage has a bullish view of the company's Entereg, which is approved for gastrointestinal problems that could result from bowel surgery and is in late stage development for chronic opioid bowel dysfunction.
Adolor and GlaxoSmithKline are collaborating in the worldwide development and commercialization of Entereg in multiple indications.
GlaxoSmithKline revealed that it had gained backing from Food and Drug Administration (FDA) for Entereg.
Another peripherally acting mureceptor opioid antagonist under development is alvimopan (Entereg).
Adolor, the company that makes alvimopan (Entereg), sponsored these studies and submitted an application to the Food and Drug Administration last year to approve the drug for managing postoperative ileus.