Alvimopan (Oral)

Alvimopan works by thwarting the effects of some substances (such as opioids, and hormones) on bowel secretion and movement, therefore helping prevent a medical condition known as post-operative ileus.


Alvimopan eases some side effects caused by narcotic medications that are often taken to prevent pain brought on by surgery. Narcotic medication can cause bloating, stomach pain, nausea, constipation, and vomiting. These side effects may slow down the recovery in people undergoing gastrointestinal surgery.

Alvimopan helps prevent the above side effects without weakening the pain-relieving properties of the narcotic.

Alvimopan helps to restore regular digestive function after surgery to do away with a part of your intestine.

Alvimopan is only available under a special plan for short-term use (not more than fifteen doses). You must sign up for the program and know the benefits and risks of using Alvimopan.

Alvimopan can also be taken for uses not listed in this article.

You shouldn't use this medication if you have serious kidney or liver disease, or if you've taken a narcotic medication for over seven consecutive days shortly before your gut surgery. A narcotic medication is sometimes known as an opioid and can include:

  • Codeine (Tylenol 3)
  • Dihydrocodeine (in several prescription cough medication combinations)
  • Fentanyl (Onsolis, Lazanda, Duragesic, Actiq, Fentora)
  • Hydrocodone (Vicodin, Lortab, Vicoprofen)
  • Meperidine (Demerol)
  • Hydromorphone (Exalgo, Dilaudid)
  • Methadone (Dolophine, Methadose)
  • Morphine (Oramorph, MS Contin, Kadian)
  • Oxycodone (Oxycontin, Percocet, Roxicodone, Combunox)
  • Tramadol (Ultracet, Ultram)
  • Oxymorphone (Opana)

Some people suffered heart attacks while using Alvimopan long-term in clinical studies. What's not clear is whether the medication was the real cause of the heart attacks. This medication shouldn't be used longer than seven days post-surgery.

If you're allergic to this medicine, don't use it.

To ensure that this medication is safe, let your healthcare giver know if you have:

  • Kidney or liver disease
  • Heart disease or previous heart attack
  • Blockage in your stomach or intestines (digestive tract)
  • Ileostomy or colostomy
  • A pancreas disorder
  • If you've recently taken any kind of narcotic medication

Alvimopan is usually harmless to an unborn child. Inform your healthcare provider if you're pregnant.

It's uncertain whether Alvimopan could harm a breastfeeding baby or if it gets into human milk. If you're nursing a baby, tell your doctor.

Conditions treated

  • Blocked bowels

Type of medicine

  • Opioid antagonist

Side effects

In addition to its necessary effects, a drug can bring on some undesirable effects. Even though not all of the following effects can occur, they may require medical attention if they do happen.

Check with your healthcare provider right away if you suffer any of these effects:

More common:

  • Belching
  • Bloating
  • Sour or acid stomach
  • Convulsions
  • Dry mouth
  • Decreased urine
  • Trouble having bowel movements (stool)
  • Excess gas/air in the stomach or intestines
  • Full feeling
  • Increased thirst
  • Heartburn
  • Indigestion
  • Loss of appetite
  • Irregular heartbeat
  • Mood changes
  • Cramps or muscle pain
  • Vomiting or nausea
  • Tingling or numbness in feet, hands, or lips
  • Passing gas
  • Pale skin
  • Shortness of breath
  • Stomach upset, pain, or discomfort
  • Difficulty breathing
  • Unusual bruising or bleeding
  • Unusual weakness or tiredness

Less common:

  • Decrease in urination frequency
  • Decrease in volume of urine
  • Painful urination
  • Trouble with passing urine (dribbling)

Some side effects can occur that normally don't require treatment. These side effects can disappear during treatment while your body adjusts to Alvimopan. In addition, your healthcare provider may suggest ways to reduce or prevent some of the side effects. Consult your doctor if these side effects persist or are troublesome or you have a few questions about them.

Less common:

Other Alvimopan side effects not mentioned can occur in some patients as well. If you suffer other side different side effects, consult your healthcare provider.

Seek medical advice concerning side effects from your doctor. You can also report to the FDA any side effects you notice at 1-800-FDA-1088.


Use this medication exactly as your healthcare provider prescribed. Check the prescription label for directions and follow them carefully.

The Alvimopan dose that your doctor recommends will depend on these factors (use whatever applies to you):

  • The disorder being treated
  • Other drugs you're taking
  • Other medical disorders you have
  • Your height
  • Your weight
  • How you react to this medicine
  • Your gender

Alvimopan comes in a 12 mg capsule that's taken orally. Take Alvimopan orally with a cup of water. The medication is given by a doctor when you're in the hospital.

The effectiveness and safety of Alvimopan has not been determined in pediatric patients. All the same, please consult your pediatrician about the use of Alvimopan in kids. Special care possibly will be needed.

Alvimopan is only given in hospital for short-term use.

Take Alvimopan with or without meals. Take with food if the drug causes a stomach upset.

You'll get your first Alvimopan dose up to five hours prior to your surgery. Then you'll receive extra doses twice daily for up to a week. The maximum number of doses you can take is 15.

Don't use Alvimopan for longer than a week after your surgery.

Since Alvimopan is issued by a healthcare provider in a health facility environment, it's unlikely that an overdose will occur.

Since you'll be given Alvimopan in a clinic environment, it's unlikely that you'll miss a dose.

It's important that you don't miss your dose. If you do miss a dose, talk to your healthcare provider.

Your condition will carefully be monitored while you receive Alvimopan.

Follow all your healthcare provider's directions about any checks on food, drink, or activity as you receive Alvimopan.

For elderly use, no adjustment of dose is needed.

Not adjustment of dose is needed in patients with mild or moderate hepatic impairment. Alvimopan isn't recommended for use by patients with serious hepatic impairment.

No dose alteration is needed for people with mild to serious renal impairment. However, they should be assessed for adverse effects. Alvimopan isn't recommended for people with terminal renal disease.

No adjustment of dosage is necessary for Japanese, Hispanic, and Black patients. However, since healthy Japanese male subjects were found to have two times more Alvimopan plasma concentrations, patients of Japanese origin should be assessed for potential adverse effects such as diarrhea, cramping, or gastrointestinal pain.


Inform your healthcare provider about all other drugs you're taking. It's especially vital to let your doctor know if you've taken any narcotic drug in the past week. It's highly likely that you may have bad effects in your stomach if you've recently used a narcotic drug.

Alvimopan may interact with other drugs. Inform your doctor about all prescription and non-prescription drugs you're taking, as well as herbal products, minerals, vitamins, and medicines prescribed by other healthcare providers. Don't start using a new medicine without your doctor's knowledge.

You should not take Alvimopan with the following medications, but in some cases, you may need to. If both medications are prescribed jointly, your healthcare giver may alter your dose or how frequently you take one or both medications.

  • Oxycodone
  • Naloxegol
  • Morphine
  • Morphine Sulfate Liposome
  • Oxymorphone
  • Naldemedine

The presence of some medical conditions may also affect the function of Alvimopan. Be sure to tell your healthcare giver if you've got any of these medical conditions, especially:

  • Blocked bowels
  • Severe kidney disease
  • Severe liver disease

Alvimopan should not be used by people with the above conditions.


It's vitally important that your healthcare provider regularly monitors your condition to find out any unwanted effects or problems that may be brought on by this medicine.

Taking over 15 doses of Alvimopan may increase your chances of suffering a heart attack. You should not take over 15 doses of the medicine.

Inform your healthcare giver if you've been taking narcotic pain relief drugs (such as Morphine, Codeine, or Dolophine) in the past week before you begin using Alvimopan. Taking this medication alongside narcotic pain relievers can increase the risk of undesirable effects.

Alvimopan is only used in a hospital environment on a short-term basis.

Long-term use can increase the risk of myocardial infarction.

Patients with severe hepatic impairment, complete GI obstruction, ESRD, gastric or pancreatic anastomosis should not use this medication.

Patients with mild to moderate hepatic impairment or minor to serious renal impairment should be monitored closely. The medicine should be discontinued if adverse reactions happen.

Patients undergoing surgery for correcting complete bowel obstruction should not use Alvimopan.


Since Alvimopan is given in a doctor's office or hospital, you don't have to store it at your home.


For further information about Alvimopan, talk to your pharmacist or doctor.

Alvimopan is not known to be potentially addictive.

Tell your healthcare provider as soon as possible if you experience these symptoms while using Alvimopan:

  • Pale skin
  • Easy bleeding or bruising
  • Difficult or painful urination
  • Confusion with irregular heart rate
  • Leg discomfort
  • Limp feeling/muscle weakness
  • Increased urination.
Last Reviewed:
December 10, 2017
Last Updated:
April 04, 2018