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Details

Stereochemistry ABSOLUTE
Molecular Formula C25H32N2O4
Molecular Weight 424.5326
Optical Activity UNSPECIFIED
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ALVIMOPAN ANHYDROUS

SMILES

C[C@H]1CN(C[C@H](CC2=CC=CC=C2)C(=O)NCC(O)=O)CC[C@@]1(C)C3=CC=CC(O)=C3

InChI

InChIKey=UPNUIXSCZBYVBB-JVFUWBCBSA-N
InChI=1S/C25H32N2O4/c1-18-16-27(12-11-25(18,2)21-9-6-10-22(28)14-21)17-20(24(31)26-15-23(29)30)13-19-7-4-3-5-8-19/h3-10,14,18,20,28H,11-13,15-17H2,1-2H3,(H,26,31)(H,29,30)/t18-,20-,25+/m0/s1

HIDE SMILES / InChI
Molecular Formula C25H32N2O4
Molecular Weight 424.5326
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 3 / 3
E/Z Centers 0
Optical Activity UNSPECIFIED

Description
Curator's Comment: Description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/8057274 | http://adisinsight.springer.com/drugs/800003539

Alvimopan (LY246736, ADL 8-2698, trade name Entereg) is a potent, peripherally selective mu-opioid receptor antagonist. Alvimopan was developed by Adolor Corporation (now Cubist Pharmaceuticals) and GlaxoSmithKline for the treatment of postoperative ileus. Postoperative ileus is the impairment of gastrointestinal motility after intra-abdominal surgery or other non-abdominal surgeries. This may potentially delay gastrointestinal recovery and hospital discharge until its resolution. Morphine and other mu-opioid receptor agonists are universally used for the treatment of acute postsurgical pain; however, they are known to have an inhibitory effect on gastrointestinal motility and may prolong the duration of postoperative ileus. Following oral administration, alvimopan antagonizes the peripheral effects of opioids on gastrointestinal motility and secretion by competitively binding to gastrointestinal tract mu-opioid receptors.

CNS Activity

Originator

Eli Lilly
237
Curator's Comment: # Eli Lilly

Approval Year

2008
174
Targets

Targets

Primary TargetPharmacologyConditionPotency
Antagonist
2778
 0.77 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Preventing
Approved
8429
ENTEREG

Approved Use

ENTEREG is a peripherally acting μ-opioid receptor antagonist indicated to accelerate the time to upper and lower gastrointestinal recovery following partial large or small bowel resection surgery with primary anastomosis.

Launch Date

2008
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
10.98 ng/mL
DRUG LABEL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
12 mg 2 times / day multiple, oral
dose: 12 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
ALVIMOPAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
40.2 ng × h/mL
DRUG LABEL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
12 mg 2 times / day multiple, oral
dose: 12 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
ALVIMOPAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
13.5 h
DRUG LABEL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
12 mg 2 times / day multiple, oral
dose: 12 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
ALVIMOPAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
20%
DRUG LABEL
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
12 mg 2 times / day multiple, oral
dose: 12 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
ALVIMOPAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
120 mg single, oral
Highest studied dose
Dose: 120 mg
Route: oral
Route: single
Dose: 120 mg
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
healthy, adult
Health Status: healthy
Age Group: adult
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
48 mg 1 times / day multiple, oral
Highest studied dose
Dose: 48 mg, 1 times / day
Route: oral
Route: multiple
Dose: 48 mg, 1 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
healthy, adult
Health Status: healthy
Age Group: adult
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
12 mg 2 times / day multiple, oral
Recommended
Dose: 12 mg, 2 times / day
Route: oral
Route: multiple
Dose: 12 mg, 2 times / day
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
unhealthy, adult
Health Status: unhealthy
Age Group: adult
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
Sources:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021775lbl.pdf
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Other AEs: Ascites, Ileus...
Other AEs:
Ascites (serious, 1 patient)
Ileus (serious, 1 patient)
Electrolyte imbalance (serious, 1 patient)
Failure to thrive (serious, 1 patient)
Syncope (serious, 1 patient)
Wound infection (serious, 2 patients)
Wound complication (serious, 1 patient)
Mania (serious, 1 patient)
Hypertension (below serious, 3 patients)
Constipation (below serious, 18 patients)
Diarrhea (below serious, 6 patients)
Dyspepsia (below serious, 1 patient)
Nausea (below serious, 20 patients)
Vomiting (below serious, 9 patients)
Anorexia (below serious, 4 patients)
Esophagitis (below serious, 1 patient)
Gastroparesis (below serious, 1 patient)
Weight loss (below serious, 3 patients)
Leukocytosis (below serious, 4 patients)
International normalized ratio increased (below serious, 1 patient)
Electrolyte imbalance (below serious, 8 patients)
Hypomagnesemia (below serious, 2 patients)
Elevated liver enzymes (below serious, 2 patients)
Delirium (below serious, 3 patients)
Insomnia (below serious, 1 patient)
Sensory neuropathy (below serious, 3 patients)
Cystostomy (below serious, 1 patient)
Pelvic abscess (below serious, 1 patient)
Urinary tract obstruction (below serious, 1 patient)
Allergic reaction to chemotherapy (below serious, 1 patient)
Pneumonitis (below serious, 2 patients)
Pneumothorax (below serious, 2 patients)
Wound infection (below serious, 7 patients)
Skin infection (below serious, 2 patients)
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
AEs

AEs

AESignificanceDosePopulation
Allergic reaction to chemotherapy below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Cystostomy below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Dyspepsia below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Esophagitis below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Gastroparesis below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Insomnia below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
International normalized ratio increased below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Pelvic abscess below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Urinary tract obstruction below serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Constipation below serious, 18 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Elevated liver enzymes below serious, 2 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Hypomagnesemia below serious, 2 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Pneumonitis below serious, 2 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Pneumothorax below serious, 2 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Skin infection below serious, 2 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Nausea below serious, 20 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Delirium below serious, 3 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Hypertension below serious, 3 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Sensory neuropathy below serious, 3 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Weight loss below serious, 3 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Anorexia below serious, 4 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Leukocytosis below serious, 4 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Diarrhea below serious, 6 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Wound infection below serious, 7 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Electrolyte imbalance below serious, 8 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Vomiting below serious, 9 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Ascites serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Electrolyte imbalance serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Failure to thrive serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Ileus serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Mania serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Syncope serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Wound complication serious, 1 patient
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Wound infection serious, 2 patients
12 mg 2 times / day steady, oral
Dose: 12 mg, 2 times / day
Route: oral
Route: steady
Dose: 12 mg, 2 times / day
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
unhealthy
n = 66
Health Status: unhealthy
Condition: ovarian cancer
Population Size: 66
Sources:
https://clinicaltrials.gov/ct2/show/NCT01704651
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG
inhibitor
1587
inhibitor
1767

inducer
389
inhibitor
1852
inhibitor
1612

OverviewOther

Other InhibitorOther SubstrateOther Inducer
CYP1A2
1524

CYP2A6
707

CYP2B6
810

CYP2C8
911

CYP2C19
1478

CYP2E1
882

P-gp
1461
CYP
270

P-gp
1537
CYP1A2
701

CYP2B6
547

CYP2C19
293

CYP3A4/5
124
Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
CYP1A2
1692
 no [IC50 >50 uM]
CYP2A6
739
 no [IC50 >50 uM]
CYP2B6
1001
 no [IC50 >50 uM]
CYP2C19
1553
 no [IC50 >50 uM]
CYP2C8
965
 no [IC50 >50 uM]
CYP2C9
1819
 no [IC50 >50 uM]
CYP2D6
1891
 no [IC50 >50 uM]
CYP2E1
970
 no [IC50 >50 uM]
CYP3A4
1925
 no [IC50 >50 uM]
CYP1A2
1692
 no
CYP2B6
1001
 no
CYP2C19
1553
 no
CYP2C9
1819
 no
CYP3A4/5
335
 no
P-gp
1650
 no
no (co-administration study)
Comment: based on study using MDCKII cells, digoxin transport not affected
Page: 66, 67
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
CYP
270
 no
P-gp
1537
 yes
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
hERG
1647
PubMed

PubMed

TitleDatePubMed
ADL 8-2698, a trans-3,4-dimethyl-4-(3-hydroxyphenyl) piperidine, prevents gastrointestinal effects of intravenous morphine without affecting analgesia.
2001 Jan
Opioid-induced bowel dysfunction: pathophysiology and potential new therapies.
2003
Postoperative ileus: etiologies and interventions.
2003 Mar
Methylnaltrexone and alvimopan: economic management of opioid-induced bowel dysfunction.
2004 Apr
Emerging techniques for postoperative analgesia in orthopedic surgery.
2004 May
Opioids and opioid receptors in the enteric nervous system: from a problem in opioid analgesia to a possible new prokinetic therapy in humans.
2004 May 6
Alvimopan, a novel, peripherally acting mu opioid antagonist: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus.
2004 Oct
Alvimopan, a selective peripherally acting mu-opioid antagonist.
2005 Apr
Alvimopan: an oral, peripherally acting, mu-opioid receptor antagonist for the treatment of opioid-induced bowel dysfunction--a 21-day treatment-randomized clinical trial.
2005 Mar
Peripheral opioids for functional GI disease: a reappraisal.
2006
Current choices--good or bad--for the proactive management of postoperative ileus: A surgeon's view.
2006 Apr
Nurses are everywhere: a practical perspective on the surgical team in managing postoperative ileus.
2006 Apr
The surgical team and outcomes management: focus on postoperative ileus.
2006 Apr
Peripherally acting mu-opioid-receptor antagonists and the connection between postoperative ileus and pain management: The anesthesiologist's view and beyond.
2006 Apr
Optimizing perioperative management of patients undergoing colorectal surgery: what is new?
2006 Apr
Use of novel prokinetic agents to facilitate return of gastrointestinal motility in adult critically ill patients.
2006 Aug
Pain management research goes beyond the obvious.
2006 Dec 1
Current gut-directed therapies for irritable bowel syndrome.
2006 Jul
Postoperative upper and lower gastrointestinal recovery and gastrointestinal morbidity in patients undergoing bowel resection: pooled analysis of placebo data from 3 randomized controlled trials.
2006 Mar
Meta-analysis: Alvimopan vs. placebo in the treatment of post-operative ileus.
2007 Jan 1
Novel and alternative therapies for childhood constipation.
2007 Jun
Alvimopan accelerates gastrointestinal recovery after bowel resection regardless of age, gender, race, or concomitant medication use.
2007 Oct
Alvimopan: a peripherally acting mu-opioid receptor antagonist.
2007 Sep
Opioid-induced constipation in intensive care patients: relief in sight?
2008
Mu-opioid antagonists for opioid-induced bowel dysfunction.
2008 Apr 16
Alvimopan (Entereg) for postoperative ileus.
2008 Dec 1
Opioid-induced bowel dysfunction.
2008 Jan
Systemic prokinetic pharmacologic treatment for postoperative adynamic ileus following abdominal surgery in adults.
2008 Jan 23
New therapies in the treatment of postoperative ileus after gastrointestinal surgery.
2008 Jan-Feb
New drug to restore bowel function approved under new FDA rules.
2008 Jul 1
Alvimopan, a peripherally acting mu-opioid receptor (PAM-OR) antagonist for the treatment of opioid-induced bowel dysfunction: results from a randomized, double-blind, placebo-controlled, dose-finding study in subjects taking opioids for chronic non-cancer pain.
2008 Jul 15
Alvimopan and COX-2 inhibition reverse opioid and inflammatory components of postoperative ileus.
2008 Jun
Novel trans-3,4-dimethyl-4-(3-hydroxyphenyl)piperidines as mu opioid receptor antagonists with improved opioid receptor selectivity profiles.
2008 Mar 15
Alvimopan (Entereg), a Peripherally Acting mu-Opioid Receptor Antagonist For Postoperative Ileus.
2008 Oct
Management of postoperative ileus: focus on alvimopan.
2008 Oct
Development of peripheral opioid antagonists' new insights into opioid effects.
2008 Oct
Alvimopan.
2008 Sep
[News from the cochrane library: mu opioid antagonists for opioid-induced bowel dysfunction].
2008 Sep
Methylnaltrexone, a new peripherally acting mu-opioid receptor antagonist being evaluated for the treatment of postoperative ileus.
2008 Sep
Pharmacological management of postoperative ileus.
2009 Apr
Novel opioid antagonists for opioid-induced bowel dysfunction and postoperative ileus.
2009 Apr 4
Alvimopan for postoperative ileus: only one piece of the puzzle.
2009 Jul 15
Alvimopan for postoperative ileus.
2009 Jul 15
Peripherally acting mu-opioid receptor antagonists and postoperative ileus: mechanisms of action and clinical applicability.
2009 Jun
Opioid receptors in the gastrointestinal tract.
2009 Jun 5
An overview of constipation and newer therapies.
2009 Jun-Jul
Alvimopan (entereg) for the management of postoperative ileus in patients undergoing bowel resection.
2010 Jan
The effects of a short course of antibiotics on alvimopan and metabolite pharmacokinetics.
2010 Mar
Gastrointestinal recovery after laparoscopic colectomy: results of a prospective, observational, multicenter study.
2010 Mar
Patents

Patents

JP4343948B2
9
WO2007047935A1
3
WO2011161646A2
3
WO2013080221A2
3

Sample Use Guides

In Vivo Use Guide
12 mg administered 30 minutes to 5 hours prior to surgery followed by 12 mg twice daily for up to 7 days for a maximum of 15 doses
Route of Administration: Oral
In Vitro Use Guide
Curator's Comment: In morphine-naive guinea pig ileum alvimopan increased, the amplitude of electrically evoked contractions and spontaneous mechanical activity.
Unknown
Substance Class Chemical
Created
by admin
on Fri Dec 15 16:19:53 GMT 2023
Edited
by admin
on Fri Dec 15 16:19:53 GMT 2023
Record UNII
Q153V49P3Z
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
ALVIMOPAN ANHYDROUS
Common Name English
Alvimopan [WHO-DD]
Common Name English
ALVIMOPAN [MI]
Common Name English
N-((2S)-2-(((3R,4R)-4-(3-HYDROXYPHENYL)-3,4-DIMETHYL-1-PIPERIDINYL)METHYL)-1-OXO-3-PHENYLPROPYL)GLYCINE
Systematic Name English
ANHYDROUS ALVIMOPAN
MART.  
Common Name English
ALVIMOPAN [MART.]
Common Name English
GLYCINE, N-(2-((4-(3-HYDROXYPHENYL)-3,4-DIMETHYL-1-PIPERIDINYL)METHYL)-1-OXO-3-PHENYLPROPYL)-, (3R-((S*),3.ALPHA.,4.ALPHA.))-
Common Name English
alvimopan [INN]
Common Name English
ANHYDROUS ALVIMOPAN [MART.]
Common Name English
((2(S)-((4(R)-(3-HYDROXYPHENYL)-3(R),4-DIMETHYL-1-PIPERIDINYL)METHYL)-1-OXO-3-PHENYLPROPYL)AMINO)ACETIC ACID
Systematic Name English
(((2S)-2-(((3R,4R)-4-(3-HYDROXYPHENYL)-3,4-DIMETHYLPIPERIDIN-1-YL)METHYL)-3-PHENYLPROPANOYL)AMINO)ACETIC ACID
Systematic Name English
Classification Tree Code System Code
NDF-RT N0000000154
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
WHO-ATC A06AH02
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
NCI_THESAURUS C681
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
NDF-RT N0000175691
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
Code System Code Type Description
MERCK INDEX
m1636
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY Merck Index
CAS
156053-89-3
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
EVMPD
SUB20585
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
INN
8245
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
SMS_ID
100000085983
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
DAILYMED
Q153V49P3Z
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
FDA UNII
Q153V49P3Z
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
NCI_THESAURUS
C77377
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
EPA CompTox
DTXSID60166035
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
HSDB
7704
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
PUBCHEM
5488548
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY
RXCUI
1516803
Created by admin on Fri Dec 15 16:19:53 GMT 2023 , Edited by admin on Fri Dec 15 16:19:53 GMT 2023
PRIMARY RxNorm
Related Record Type Details
Structure of ALVIMOPAN MONOHYDRATE
SOLVATE->ANHYDROUS
Structure of ALVIMOPAN ANHYDROUS
EXCRETED UNCHANGED
AMOUNT EXCRETED
URINE
PLASMA PROTEIN FRACTION (HUMAN)
BINDER->LIGAND
Plasma protein binding of alvimopan was independent of concentration over ranges observed clinically and averaged 80% .
BINDING
Structure of ALVIMOPAN ANHYDROUS
EXCRETED UNCHANGED
AMOUNT EXCRETED
FECAL
MU-TYPE OPIOID RECEPTOR
TARGET -> INHIBITOR
Ki
Structure of ALVIMOPAN
SOLVATE->ANHYDROUS
Structure of ALVIMOPAN MONOHYDRATE
SALT/SOLVATE -> PARENT
Related Record Type Details
Structure of ADL-08-0011
METABOLITE -> PARENT
demonstrated in vitro to be equipotent to alvimopan
MAJOR
URINE
Structure of (2S,3S,4S,5R,6S)-6-(3-((3R,4R)-1-((2S)-2-BENZYL-3-HYDROXY-3-OXO-PROPYL)-3,4-DIMETHYL-4-PIPERIDYL)PHENOXY)-3,4,5-TRIHYDROXY-TETRAHYDROPYRAN-2-CARBOXYLIC ACID
METABOLITE -> PARENT
URINE
Related Record Type Details
Structure of ALVIMOPAN ANHYDROUS
ACTIVE MOIETY
Name Property Type Amount Referenced Substance Defining Parameters References
Volume of Distribution PHARMACOKINETIC
Tmax PHARMACOKINETIC
NIH
NCATS
PRIVACY ACT
ACCESSIBILITY
DISCLAIMER
HHS VULNERABILITY DISCLOSURE
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