Risks and side effects of eluxadoline for IBS

What is eluxadoline and how does it work?

Eluxadoline (Viberzi) is a medication used for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults. It acts by binding to specific opioid receptors. Opioid receptors are found in the brain, spinal cord, and gastrointestinal tract. Opioid receptors in the gut help regulate gastrointestinal motility, secretions, and sensations. This is the reason why one of the most common side effects of opioid pain medications like codeine and morphine is constipation.

Unlike the traditional opioids, eluxadoline is specific to opioid receptors in the gut rather than the central or peripheral nervous system. Because of this, symptoms like fatigue, euphoria, or drowsiness are uncommon.

Eluxadoline is a schedule IV drug, which means that it has a low potential for abuse and low risk of dependence.

What are important safety concerns for eluxadoline? 

The most common side effects of eluxadoline are mild constipation, nausea, and abdominal pain. It's important to note the following rare but potentially serious side effects:

• Severe constipation requiring hospitalization has been reported. Stop taking eluxadoline and inform your doctor if you experience severe constipation.

• Risk for pancreatitis and spasm of the sphincter of Oddi: In March 2017, The US Food and Drug Administration issued a warning, stating that eluxadoline should not be used in patients who do not have gallbladders due to the risk for potentially life-threatening pancreatitis. To date, two deaths have occurred in patients who developed pancreatitis shortly after starting eluxadoline; both patients did not have gallbladders. There is also an increased risk of spasm of the sphincter of Oddi, the valve that regulates the movement of bile and digestive juices from the pancreas into the small intestine. This can result in pancreatitis. Stop taking eluxadoline and inform your doctor right away if you develop new or worsening abdominal pain or right upper abdominal pain (that can sometimes radiate to back or shoulder) with or without nausea and vomiting.

• Use with alcohol: Eluxadoline should not be taken by those with alcohol abuse, alcoholism, or alcohol addiction or by patients who drink more than 3 alcoholic beverages per day. This is due to an increased risk for pancreatitis.

• Drug-drug interactions: There is potential for drug-drug interactions between eluxadoline and certain classes of medications that share the same metabolic pathways. It's important to notify your doctor and pharmacist of any medications or supplements you're taking before you start eluxadoline. Similarly, if you're already taking eluxadoline ask your doctor and pharmacist to check for potential drug-drug interactions before you start any new medication or supplement.

• Use in children: Eluxadoline has not been studied in children. Therefore, its safety profile in children is not known. Children might be more susceptible to more serious central nervous system effects.

If you are concerned about an exposure to eluxadoline, use the webPOISONCONTROL^® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.