Alvimopan (Entereg) is Formulary, Restricted to patients undergoing small or large bowel resection, or radical cystectomy with urinary diversion only. 

Exclusions to alvimopan include any of the following: 
     - patients who have received therapeutic doses of opioids for more than 7 consecutive days prior to alvimopan administration,  
     - patients who did not receive a preoperative dose of alvimopan, or 
     - patients with severe hepatic dysfunction (Child-Pugh class C), end-stage renal disease, or past or present complete gastrointestinal obstruction.  

Note:  Patients who have received more than 3 doses of opioids in the week prior to surgery are likely to experience an increased sensitivity to the effects of alvimopan (e.g., abdominal pain, nausea/vomiting, and diarrhea)

Dosing is limited to no more than 15 doses per patient for administration in the hospital inpatient setting only. See E.A.S.E. REMs program for more information.

• Micromedex
• CareNotes
• UpToDate
• Facts & Comparisons
• MedLinePlus (Patient Information)