Published Online, 2 August 2005, www.theannals.com, DOI 10.1345/aph.1E615.
The Annals of Pharmacotherapy: Vol. 39, No. 9, pp. 1502-1510. DOI 10.1345/aph.1E615
© 2005 Harvey Whitney Books Company.
NEW DRUG DEVELOPMENTS
Alvimopan for the Management of Postoperative Ileus
John B Leslie, MD MBA
Professor of Anesthesiology, Department of Anesthesiology, Mayo Clinic
Hospital, 13400 E. Shea Blvd., Scottsdale, AZ 85259-5404, fax 480/342-2319,
Leslie.john{at}mayo.edu
Reprints: Dr. Leslie
OBJECTIVE: To review the pharmacology, pharmacokinetics, clinical
efficacy, safety, dosage, and administration of alvimopan, a peripherally
acting µ-opioid receptor antagonist, in the management of postoperative
ileus (POI).
DATA SOURCES: A literature search (1980October 2004) applying
the terms alvimopan, ADL 8-2698, and LY246736 was conducted using MEDLINE.
Information was also obtained from scientific congress abstracts and data on
file with the manufacturer.
STUDY SELECTION AND DATA EXTRACTION: Studies and abstracts
investigating alvimopan and POI were considered for inclusion; however, they
were restricted to English-language articles.
DATA SYNTHESIS: Alvimopan is a novel, peripherally acting
µ-opioid receptor antagonist that is currently under evaluation for the
management of POI. POI presents significant clinical challenges that can delay
patient recovery and contribute to increased morbidity and prolonged
hospitalization after surgery. Clinical trials have demonstrated that
alvimopan, at oral doses of 6 and 12 mg, can accelerate time to recovery of
gastrointestinal (GI) function and time to hospital discharge following
abdominal surgery. The incidence of adverse events with alvimopan therapy was
shown to be similar to that of placebo.
CONCLUSIONS: Alvimopan is well tolerated and effective at
accelerating GI recovery and time to discharge in patients who have undergone
bowel resection or hysterectomy when administered prior to surgery and twice
daily thereafter until discharge or for up to 7 days. Alvimopan potentially
offers significant benefits for patients with POI over currently available
treatments.
Key Words: alvimopan: µ-opioid receptor antagonist, opioid-induced bowel dysfunction, postoperative ileus
Published Online, August 2, 2005. www.theannals.com, DOI 10.1345/aph.1E615
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Copyright © 2005 by Harvey Whitney Books Company.