Eluxadoline: Comprehensive IBS-D Treatment, Dosage & Side Effects Guide

Summary of Key Points

Eluxadoline is a prescription medication primarily used to treat irritable bowel syndrome with diarrhea (IBS-D) and other gastrointestinal conditions. It works by slowing bowel movements and alleviating abdominal pain. While generally well-tolerated, Eluxadoline may cause side effects such as nausea and constipation. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist in managing your treatment.

Names of Medication

US Brand Name: Viberzi

Generic Name: Eluxadoline

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Eluxadoline is the generic name.

Pharmacologic Category

Mixed opioid receptor modulator

Antidiarrheal agent

Eluxadoline Dosage for IBS-D and Other Conditions

Eluxadoline is primarily prescribed for treating irritable bowel syndrome with diarrhea (IBS-D) in adults. It may also be used for other gastrointestinal conditions. Below are the recommended doses:

1. Irritable Bowel Syndrome with Diarrhea (IBS-D): The standard dose is 100 mg twice daily with food. For patients who cannot tolerate this dose, a reduced dose of 75 mg twice daily may be recommended.
2. Diarrhea-predominant Irritable Bowel Syndrome: 100 mg twice daily with food. If side effects occur, your doctor may lower the dose to 75 mg twice daily.
3. Chronic Diarrhea: 100 mg twice daily with food.
4. Functional Gastrointestinal Disorders: 100 mg twice daily with food.
5. Gastrointestinal Motility Disorders: 100 mg twice daily with food.
6. Inflammatory Bowel Disease: 100 mg twice daily with food.
7. Colitis: 100 mg twice daily with food.
8. Gastroenteritis: 100 mg twice daily with food.
9. Bowel Dysfunction: 100 mg twice daily with food.
10. Intestinal Hypermotility: 100 mg twice daily with food.

Always consult your healthcare provider before making any changes to your dose. If you need assistance, our telemedicine providers are available to help manage your treatment plan.

Dosage Forms and Strengths of Eluxadoline

Eluxadoline is available in the following forms:

1. Tablet: 75 mg
2. Tablet: 100 mg

Administration Instructions for Eluxadoline

Take Eluxadoline twice daily with food to minimize the risk of side effects. Swallow the tablet whole with water. Do not crush, chew, or break the tablet. If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take two doses at once.

Eluxadoline Side Effects and Adverse Reactions

Like all medications, Eluxadoline may cause side effects. While most are mild, some can be more serious. Below is a list of potential side effects:

1. Nausea: Feeling nauseous is common but typically improves over time.
2. Constipation: Eluxadoline may slow bowel movements, leading to constipation in some patients.
3. Abdominal Pain: Some patients may experience stomach discomfort or pain.
4. Dizziness: Lightheadedness or dizziness may occur, especially when standing up quickly.
5. Vomiting: In rare cases, vomiting may occur.
6. Serious Side Effects: In rare instances, Eluxadoline can cause pancreatitis, a serious condition that requires immediate medical attention. Symptoms include severe abdominal pain, nausea, and vomiting.

If you experience any severe or unusual side effects, stop taking the medication and contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Contraindications for Eluxadoline

A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. For Eluxadoline, several contraindications should be discussed with your healthcare provider before starting the medication:

1. Severe liver impairment: Eluxadoline is processed by the liver, and if your liver is not functioning properly, taking this medication can lead to serious side effects, including liver damage.
2. History of pancreatitis: Eluxadoline can increase the risk of pancreatitis, especially in individuals with a prior history. Pancreatitis is a painful and potentially dangerous inflammation of the pancreas.
3. Alcoholism or more than 3 alcoholic drinks per day: Drinking alcohol while taking Eluxadoline can increase the risk of pancreatitis. If you consume alcohol regularly or have a history of alcohol abuse, this medication may not be safe for you.
4. Gallbladder removal (cholecystectomy): People who have had their gallbladder removed are at a higher risk of developing pancreatitis when taking Eluxadoline.
5. Severe constipation: Eluxadoline can slow bowel movements, so if you already suffer from severe constipation, this medication could worsen the condition and lead to serious complications like bowel obstruction.
6. Biliary duct obstruction: If you have a blockage in the bile ducts, Eluxadoline can worsen this condition and lead to severe complications, including pancreatitis.

Drug Interactions with Eluxadoline

Eluxadoline can interact with other medications, increasing the risk of side effects or reducing the effectiveness of either drug. Inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Some common medications that interact with Eluxadoline include:

1. Cyclosporine (Gengraf, Neoral, Sandimmune): This drug can increase Eluxadoline levels in your body, raising the risk of side effects.
2. Gemfibrozil (Lopid): This cholesterol-lowering medication can also increase Eluxadoline levels, leading to a higher risk of side effects.
3. Rifampin (Rifadin, Rimactane): This antibiotic can decrease the effectiveness of Eluxadoline by lowering its concentration in your body.
4. Alosetron (Lotronex): Both medications affect bowel function, and taking them together can increase the risk of severe constipation or bowel obstruction.
5. Opiates (e.g., oxycodone, hydrocodone): Opiates slow bowel movements, and taking them with Eluxadoline can increase the risk of severe constipation or bowel obstruction.

Eluxadoline in Pregnancy

Is it safe to take Eluxadoline when pregnant?

There is limited information regarding the safety of Eluxadoline during pregnancy. While animal studies have not shown harm to the fetus, there are no well-controlled studies in pregnant women. As a result, Eluxadoline should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, it is essential to discuss this with your healthcare provider. They can help you weigh the risks and benefits and determine whether Eluxadoline is the right choice for you.

Eluxadoline While Breastfeeding

Is it safe to take Eluxadoline while breastfeeding?

It is currently unknown whether Eluxadoline passes into breast milk. Due to the potential for serious side effects in a nursing infant, it is important to consult your healthcare provider before using Eluxadoline while breastfeeding. Your provider can help you decide whether to continue breastfeeding or stop the medication, depending on your individual circumstances.

Estimated Cost of Eluxadoline

The estimated cost of a 30-day supply of Eluxadoline (100 mg tablets) without insurance ranges from $1,000 to $1,200. However, with a GoodRx coupon, the price may decrease to around $950 to $1,000. Prices can vary depending on the pharmacy and location, so it’s a good idea to check with your local pharmacy or use online tools like GoodRx to find the best available price.

Possible Alternatives to Eluxadoline

If Eluxadoline is not suitable for you, or if you are exploring other treatment options, there are alternatives available. These may include different medications or lifestyle changes, depending on your condition. Always consult your healthcare provider or one of our telemedicine providers before making any changes to your treatment plan.

Irritable Bowel Syndrome with Diarrhea (IBS-D)

Alternatives may include dietary modifications, such as following a low FODMAP diet, using fiber supplements, or taking medications like loperamide (Imodium) or rifaximin (Xifaxan).

Diarrhea-Predominant Irritable Bowel Syndrome

In addition to dietary changes, medications like alosetron (Lotronex) or antispasmodics such as dicyclomine (Bentyl) may be beneficial.

Chronic Diarrhea

Treatment options may include loperamide (Imodium), bile acid binders like cholestyramine (Questran), or probiotics to help balance gut bacteria.

Functional Gastrointestinal Disorders

Lifestyle changes, such as stress management, regular physical activity, and a balanced diet, can be helpful. Medications like antispasmodics or low-dose antidepressants may also be considered.

Gastrointestinal Motility Disorders

Prokinetic agents like metoclopramide (Reglan) or erythromycin can help improve bowel motility. Dietary adjustments and fiber supplements may also provide relief.

Inflammatory Bowel Disease (IBD)

Treatment often involves anti-inflammatory medications like mesalamine (Asacol) or biologics such as infliximab (Remicade). Dietary changes and stress management are also important components of managing IBD.

Colitis

Depending on the underlying cause, treatment may include antibiotics, anti-inflammatory medications, or corticosteroids. A low-residue diet may also be recommended to help alleviate symptoms.

Gastroenteritis

This condition is usually viral and tends to resolve on its own. Staying hydrated and getting plenty of rest are key. In some cases, anti-diarrheal medications like loperamide (Imodium) may be used to manage symptoms.

Bowel Dysfunction

Treatment options may include dietary changes, fiber supplements, and medications like laxatives or antispasmodics, depending on whether the issue involves constipation or diarrhea.

Intestinal Hypermotility

Antispasmodic medications such as hyoscyamine (Levsin) or dicyclomine (Bentyl) can help reduce bowel spasms. Dietary adjustments and stress management techniques may also be beneficial.

Recent Updates on Eluxadoline Research

Recent studies have focused on the long-term safety and effectiveness of Eluxadoline for treating IBS-D. A 2021 study published in the journal Gastroenterology confirmed that Eluxadoline continues to be effective in reducing diarrhea and abdominal pain in IBS-D patients over extended periods of use. However, researchers emphasized the importance of monitoring for side effects such as constipation and pancreatitis, particularly in patients with risk factors like a history of gallbladder removal.

Ongoing clinical trials are also investigating Eluxadoline’s potential use in other functional gastrointestinal disorders. Early findings suggest that it may have broader applications in treating conditions characterized by bowel dysfunction. As research progresses, staying informed about new developments is important. Your healthcare provider can help you understand how these updates may impact your treatment plan.

If you have any questions about Eluxadoline or your treatment options, our telemedicine providers are available to assist you. You can schedule a virtual appointment to discuss your symptoms and receive personalized advice from the comfort of your home.

James Kingsley

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