Entereg (alvimopan) reduces certain side effects of narcotic medicines that are often used to prevent pain caused by surgery. Narcotic medicine can cause stomach pain, bloating, nausea, vomiting, and constipation. These side effects can delay recovery in patients undergoing gastrointestinal surgery.
Entereg helps prevent these side effects without reducing the pain-relieving effects of the narcotic.
Entereg is used to help restore normal digestive functioning after surgery to remove a portion of your intestine. This medicine is available only under a special program for short-term use (no more than 15 doses). You must be registered in the program and understand the risks and benefits of taking this medicine.
Important information
You should not use Entereg if you have severe liver or kidney disease, or if you have used a narcotic medicine for more than 7 days in a row just before your surgery.
Entereg is available only under a special program for short-term use.
Some people had heart attacks while taking Entereg long-term during clinical studies. It is not clear whether alvimopan is the actual cause of heart attack. This medicine should not be used for longer than 7 days after your surgery.
Tell your caregivers right away if you have pale skin, easy bruising or bleeding, painful or difficult urination, or confusion with uneven heart rate, leg discomfort, muscle weakness or limp feeling, and increased urination.
Before receiving this medicine
You should not use Entereg if you are allergic to alvimopan, if you have severe liver or kidney disease.
Do not take Entereg if you have used an opioid medicine for more than 7 days in a row just before your intestinal surgery. An opioid is sometimes called a narcotic, and may include:
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codeine (Tylenol #3);
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dihydrocodeine (in many prescription cough medicine combinations);
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fentanyl (Actiq, Fentora, Duragesic, Lazanda, Onsolis);
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hydrocodone (Lortab, Vicodin, Vicoprofen);
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hydromorphone (Dilaudid, Exalgo);
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levorphanol (Levo-Dromoran);
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meperidine (Demerol);
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methadone (Methadose, Dolophine)
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morphine (Kadian, MS Contin, Oramorph);
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oxycodone (OxyContin, Combunox, Roxicodone, Percocet);
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oxymorphone (Opana);
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tramadol (Ultram, Ultracet);
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and many others.
To make sure this medicine is safe for you, tell your doctor if you have:
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liver or kidney disease;
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heart disease or prior heart attack;
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blockage in your digestive tract (stomach or intestines);
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colostomy or ileostomy;
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a pancreas disorder; or
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if you have recently used any type of narcotic medicine.
FDA pregnancy category B. Entereg is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant.
See also: Pregnancy and breastfeeding warnings (in more detail)
It is not known whether alvimopan passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How is Entereg given?
Entereg is given only in a hospital for a short period of time.
You will receive your first dose up to 5 hours before your surgery. You will then be given additional doses 2 times per day for up to 7 days.
This medicine should not be used for longer than 7 days after your surgery.
Entereg dosing information
Usual Adult Dose for Gastrointestinal Surgery:
Accelerate the time to upper and lower gastrointestinal recovery following partial large or small resection surgery with primary anastomosis:
Initial dose: 12 mg orally once, administered 30 minutes to 5 hours prior to surgery
Maintenance dose: 12 mg orally twice daily beginning the day after surgery for a maximum of 7 days or until discharge
Maximum dose: Not to exceed 15 doses
What happens if I miss a dose?
Because you will receive Entereg in a clinical setting, you are not likely to miss a dose.
What happens if I overdose?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while receiving Entereg?
Follow your doctor"s instructions about any restrictions on food, beverages, or activity.
Entereg side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Entereg: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Some people had heart attacks while taking Entereg long-term during clinical studies. It is not clear whether alvimopan is the actual cause of heart attack. Call your doctor at once if you have heart attack symptoms, such as:
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chest pain or pressure;
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pain spreading to your jaw or shoulder;
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anxiety, nausea, sweating.
Common Entereg side effects may include:
You may be more likely to have unpleasant effects on your stomach if you have recently used any type of narcotic (opioid) medicine.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Entereg?
Other drugs may interact with alvimopan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
It is especially important to tell your doctor if you have taken a narcotic medicine within the past 7 days. Narcotic medications are usually given to treat moderate to severe pain. Some prescription cough medications also contain narcotics.
