QuickView for Alvimopan (compound)

Summary
General Info

PubChem

PubChem Compound 10137178

Name:	alvimopan
PubChem Compound ID:	10137178
Molecular formula:	C₂₅H₃₂N₂O₄
Molecular weight:	424.533 g/mol

DrugBank

Identification

Name:	alvimopan
Name (isomeric):	DB06274
Drug Type:	small molecule
Synonyms:	ADL 8-2698
Brand:	Entereg
Category:	Opiate Antagonists
CAS number:	156053-89-3

Pharmacology

Indication:	Used to accelerate the time to upper and lower gastrointestinal recovery following partial large or small bowel resection surgery with primary anastomosis. Also investigated for use in the treatment of pain (acute or chronic).
Mechanism of Action:	Alvimopan competitively binds to mu-opioid receptor in the gastrointestinal tract. Unlike methylnaltrexone (another peripherally acting mu-receptor antagonist) that bears a quaternary amine, alvimopan owes its selectivity for peripheral receptors to its kinetics. Alvimopan binds to peripheral mu-receptors with a Ki of 0.2 ng/mL and dissociates slow... show more » Alvimopan competitively binds to mu-opioid receptor in the gastrointestinal tract. Unlike methylnaltrexone (another peripherally acting mu-receptor antagonist) that bears a quaternary amine, alvimopan owes its selectivity for peripheral receptors to its kinetics. Alvimopan binds to peripheral mu-receptors with a Ki of 0.2 ng/mL and dissociates slower than most other ligands. show less «
Absorption:	Alvimopan's high affinity for the peripheral mu-receptor results in an absolute oral bioavailability of less than 7%.
Protein binding:	80% to 90% of systemically available alvimopan is bound to plasma protein.
Biotransformation:	Alvimopan undergoes no significant hepatic metabolism, but is metabolized by intestinal flora. Gut metabolism produces an active metabolite with no clinically significant contribution to drug effect.
Route of elimination:	Biliary secretion was considered the primary pathway for alvimopan elimination. Unabsorbed drug and unchanged alvimopan resulting from biliary excretion were then hydrolyzed to its ‘metabolite’ by gut microflora.
Half Life:	10 to 17 hours (gut metabolite: 10 to 18 hours)
Clearance:	402 +/- 89 mL/min
Affected organisms:	Humans and other mammals

Interactions

Drug interaction:

Butorphanol

Opioid analgesics such as butorphanol may enhance the adverse/toxic effect of alvimopan. This is most notable for patients receiving long-term (i.e., more than 7 days) opiates prior to alvimopan initiation. According to alvimopan prescribing information, alvimopan is contraindicated in patients receiving therapeutic doses of opioids for more than 7 consecutive days immediately prior to alvimopan initiation. Monitor for increased alvimopan adverse effects in patients using opioids prior to alvimopan.

Buprenorphine

Opioids like buprenorphine may enhance the adverse/toxic effect of Alvimopan. This is most notable for patients receiving long-term (i.e., more than 7 days) opiates prior to alvimopan initiation. Consider therapy modification.

Targets

Mu-type opioid receptor

Kappa-type opioid receptor

Delta-type opioid receptor