Entereg (alvimopan) Pain Relief After Surgery: Side Effects & Dosage

What is Entereg, and how does it work?

Entereg (alvimopan) is an opioid receptor antagonist that works by preventing narcotic side effects without reducing the pain-relieving effects of the drug used to speed recovery of stomach and intestinal functions after a gastrointestinal surgery and to prevent side effects caused by narcotic medications.

What are the side effects of Entereg?

Common side effects of Entereg include:

• stomach pain or upset,
• indigestion,
• nausea,
• vomiting,
• diarrhea,
• constipation,
• gas,
• bloating, or
• back pain

WARNING: FOR SHORT-TERM HOSPITAL USE ONLY

Entereg is available only for short-term (15 doses) use in hospitalized
patients. Only hospitals that have registered in and met all of the requirements
for the Entereg Access Support and Education (E.A.S.E.) program may use Entereg.

What is the dosage for Entereg?

• For hospital use only.
• The recommended adult dosage of Entereg is 12 mg administered 30 minutes to 5 hours prior to surgery followed by 12 mg twice daily beginning the day after surgery until discharge for a maximum of 7 days.
• Patients should not receive more than 15 doses of Entereg.
• Entereg can be taken with or without food.

What drugs interact with Entereg?

Effects Of Alvimopan On Intravenous Morphine

• Coadministration of alvimopan does not appear to alter the pharmacokinetics of morphine and its metabolite, morphine-6-glucuronide, to a clinically significant degree when morphine is administered intravenously.
• Dosage adjustment for intravenously administered morphine is not necessary when it is coadministered with
  Entereg.

Effects Of Concomitant Acid Blockers Or Antibiotics

• A population pharmacokinetic analysis suggests that the pharmacokinetics of alvimopan were not affected by concomitant administration of acid blockers (proton pump inhibitors (PPIs), histamine-2 (H₂) receptor antagonists) or antibiotics.
• No dosage adjustments are necessary in patients taking acid blockers or antibiotics with
  Entereg.

Is Entereg safe to use while pregnant or breastfeeding?

• Available data regarding use of Entereg in pregnant women are limited, and are insufficient to inform a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes.
• There are no data on the presence of alvimopan in human milk, the effects on the breastfed infant, or the effects on milk production.
• Alvimopan and its ‘metabolite’ are detected in the milk of lactating rats following intravenous administration.