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Interações medicamentosas

Alvimopan + Diphenoxylate-atropine

Gravidade: Grave

Alvimopan and Diphenoxylate-atropine: major interaction.

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Para profissionais de saúde — apenas referência. Esta página é um resumo breve, não é aconselhamento médico nem substitui a bula oficial ou o julgamento clínico. Verifique sempre antes de prescrever ou dispensar.

O conteúdo clínico desta página está disponível apenas em inglês.

Resumo

Alvimopan is a peripherally acting mu-opioid antagonist, and diphenoxylate is an opioid. Opioid-exposed patients may be more sensitive to alvimopan and can develop abdominal pain, nausea, vomiting and diarrhea, while antidiarrheal efficacy may be reduced.

O que esta interação significa em palavras simples

Alvimopan and Diphenoxylate-atropine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Nível de evidência: Moderate

Por que acontece

Competitive antagonism of peripheral mu-opioid receptors by alvimopan opposes diphenoxylate's gut effects.

O que fazer

Avoid alvimopan in patients who have been taking opioids, including diphenoxylate, for a prolonged period before surgery. Use alternative management for diarrhea and postoperative ileus if appropriate.

O que perguntar ao farmacêutico

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

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Perguntas frequentes

Can I take Alvimopan with Diphenoxylate-atropine?

MediHelp rates the interaction as major. Alvimopan and Diphenoxylate-atropine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Alvimopan is a peripherally acting mu-opioid antagonist, and diphenoxylate is an opioid. Opioid-exposed patients may be more sensitive to alvimopan and can develop abdominal pain, nausea, vomiting and diarrhea, while antidiarrheal efficacy may be reduced.

How serious is the interaction between Alvimopan and Diphenoxylate-atropine?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid alvimopan in patients who have been taking opioids, including diphenoxylate, for a prolonged period before surgery. Use alternative management for diarrhea and postoperative ileus if appropriate.

What other medicines interact with Diphenoxylate-atropine?

MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.

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