Eluxan 75

Indications

Eluxadoline is used in adults to treat irritable bowel syndrome with diarrhoea (IBS-D), a long-term bowel condition with stomach pain, bloating and frequent loose stools.

How It Works

Eluxadoline acts on opioid receptors in the gut wall. It activates mu and kappa receptors, which slows bowel movement and reduces pain signals, and blocks delta receptors, which helps prevent constipation. It works mainly in the gut, with very little absorbed into the blood.

Dosage and Administration

The usual adult dose is 100 mg twice daily, taken with food. A lower dose of 75 mg twice daily is used for people who cannot tolerate 100 mg, those with mild to moderate liver problems, and those taking certain interacting medicines, as prescribed. Stop taking it and contact your doctor if you develop constipation lasting more than 4 days.

Interactions

• Ciclosporin, Gemfibrozil, Rifampicin and some HIV medicines (OATP1B1 inhibitors): raise Eluxadoline levels; lower dose needed.
• Strong CYP3A inhibitors such as Clarithromycin or Ketoconazole: may raise levels.
• Opioid painkillers, Loperamide, Alosetron and anticholinergic medicines: higher risk of constipation; avoid or use only occasionally on advice.
• Rosuvastatin: levels may rise, increasing muscle side effects.
• Alcohol: heavy drinking raises the risk of pancreatitis.

Contraindications

• No gallbladder (removed or absent), because of a higher risk of serious pancreatitis.
• Known or suspected blockage of the bile duct or pancreatic duct, or sphincter of Oddi problems.
• History of pancreatitis or structural pancreatic disease.
• Alcohol dependence or drinking more than 3 alcoholic drinks a day.
• Severe liver impairment.
• History of severe constipation or bowel obstruction.

Side Effects

Common side effects include constipation, nausea, stomach pain, vomiting, wind and bloating. Less often, it can cause spasm of the sphincter of Oddi (a muscle controlling bile and pancreatic flow) or pancreatitis, inflammation of the pancreas.

Get urgent medical help if you have new or worsening severe pain in the upper stomach that may spread to the back or shoulder, with or without nausea and vomiting, severe constipation, or signs of a severe allergic reaction such as swelling of the face or throat or difficulty breathing.

Pregnancy and Lactation

There is limited information on use in pregnancy, so it should be used only if your doctor feels the benefit outweighs the risk. Discuss with your doctor before breastfeeding.

Precautions and Warnings

• Avoid alcohol or keep it to a minimum.
• It may cause drowsiness or dizziness; take care when driving.
• Tell your doctor about gallbladder, liver or pancreatic problems and all other medicines you take.
• Not for use in children.

Overdose

An overdose may cause effects similar to opioids, such as drowsiness, slow breathing and severe constipation. Seek emergency medical help.

Therapeutic Class

Gastrointestinal agent for IBS with diarrhoea, mixed opioid receptor agonist and antagonist.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.