From the FDA Drug Label
Alvimopan capsules are contraindicated in patients who have taken therapeutic doses of opioids for more than 7 consecutive days immediately prior to taking alvimopan capsules [see Warnings and Precautions ( 5.3)] . The contraindications of Entereg (alvimopan) are:
- Patients who have taken therapeutic doses of opioids for more than 7 consecutive days immediately prior to taking alvimopan capsules 1 1
From the Research
Entereg (alvimopan) is contraindicated in patients with severe hepatic impairment, end-stage renal disease, those who have used therapeutic doses of opioids for more than 7 consecutive days immediately before starting Entereg, and patients with known hypersensitivity to the drug or any of its components. The medication should not be used in patients who have had a complete gastrointestinal obstruction or patients who have had surgery for correction of complete bowel obstruction, as well as those who have had recent gastric, small, or large bowel resection 2. The contraindications of Entereg are due to its mechanism of action as a peripherally acting mu-opioid receptor antagonist, which can precipitate withdrawal in opioid-dependent patients and may interfere with healing after certain gastrointestinal surgeries 3. Some key points to consider when prescribing Entereg include:
- Severe hepatic impairment: Entereg is contraindicated in patients with severe hepatic impairment due to the potential for increased risk of adverse effects 4.
- End-stage renal disease: Patients with end-stage renal disease should not receive Entereg due to the potential for increased risk of adverse effects 5.
- Recent opioid use: Patients who have used therapeutic doses of opioids for more than 7 consecutive days immediately before starting Entereg should not receive this medication due to the risk of precipitating withdrawal 6.
- Gastrointestinal obstruction or surgery: Entereg should not be used in patients who have had a complete gastrointestinal obstruction or patients who have had surgery for correction of complete bowel obstruction, as well as those who have had recent gastric, small, or large bowel resection 2.
- Hypersensitivity: Entereg is contraindicated in patients with known hypersensitivity to the drug or any of its components 3. It is essential to carefully evaluate the patient's medical history and current condition before prescribing Entereg to ensure safe and effective use of the medication.