Names and pronunciation
(el-ux-ad′oh-leen) Viberzi
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Drug reference
(el-ux-ad′oh-leen) Viberzi
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Func. class.: GI agent
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ACTION: Acts locally, reducing abdominal pain of IBS, works on the μ-opioid receptor
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USES: Irritable bowel syndrome with diarrhea
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CONTRAINDICATIONS: Hyper- sensitivity, alcoholism, GI/biliary obstruc- tion, constipation, pancreatitis
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INTERACTIONS Increase: CYP3A4 substrate (narrow therapeutic index) effect Increase: constipation risk—anticholinergics Increase: eluxadoline effect—OATP1B1 inhibitors, CYP3A4 inhibitors
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DOSAGE AND ROUTES • Adult: PO 100 mg bid with food. Decrease to 75 mg bid with food in those who are receiving an OATP1B1 inhibitor; do not use in those without a gallbladder Renal dose Adult: PO CCr <60 mL/min: reduce to 75 mg bid with food Hepatic dose Adult: PO Child-Pugh Class A or B: reduce to 75 mg bid with food; Child-Pugh Class C: Do not use
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Available forms: Tablets 75, 100 mg Administer • Give with food • Give as prescribed, do not double, if a dose is missed, give at next regular sched- uled dose • Store at room temperature SIDE EFFECT CNS: Headache, dizziness, insomnia, drowsiness, drunk feeling GI: Constipation, nausea, vomiting, dis- tention, increased LFTs EENT: Nasopharyngitis INTEG: Rash RESP: URI, asthma
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Assess: • IBS symptoms: assess for constipa- tion/diarrhea or both, abdominal pain, bloating, gas. Identify if product is lessen- ing symptoms; monitor AST/ALT, serum lipase, BUN/creatinine • CNS changes: assess for dizziness, drowsiness; caution against driving or other hazardous activities until response is known, usually with hepatic impairment • Spasm: epigastric pain, may radiate to back, may have increased LFTs • Pregnancy/breastfeeding: unknown as to fetal risk, use cautiously in breast- feeding
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Evaluate: • Therapeutic response • Decreasing abdominal pain, bloating, gas, diarrhea/constipation
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • Severe constipation: avoid using with other products that cause consti- pation; if severe constipation occurs, stop drug, notify prescriber, avoid using • Pancreatitis: usually with increased alcohol use, severe abdominal pain, nau- sea, vomiting, discontinue immediately • Not to drive or perform other hazard- ous activities until response is known • Pregnancy/breastfeeding: identify if pregnancy is planned or suspected • Spasm: to notify provider of in- creasing epigastric pain that radiates to back • To take missed dose at prescribed time, do not double or skip doses
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PHARMACOKINETICS: Onset unknown, peak 1½ hr, duration un- known, half-life 3.7-6 hr
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• Adult: PO 100 mg bid with food. Decrease to 75 mg bid with food in those who are receiving an OATP1B1 inhibitor; do not use in those without a gallbladder Renal dose Adult: PO CCr <60 mL/min: reduce to 75 mg bid with food Hepatic dose Adult: PO Child-Pugh Class A or B: reduce to 75 mg bid with food; Child-Pugh Class C: Do not use
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