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Effect of alvimopan and codeine on gastrointestinal transit: a randomized controlled study.
Jonathan Gonenne1, Michael Camilleri, Irene Ferber
1Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Summary
Alvimopan reversed codeine
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Opiate bowel dysfunction is a common clinical issue.
- Codeine is known to cause gastrointestinal transit delays.
Purpose of the Study:
- To assess if alvimopan, a peripheral mu-opioid antagonist, can counteract codeine's effects on gastrointestinal transit.
- To investigate alvimopan's impact on gastric, small-bowel, and colonic transit.
Main Methods:
- A double-blind, placebo-controlled study involving 74 healthy volunteers.
- Participants were randomized into four groups: alvimopan and codeine, alvimopan alone, codeine alone, or placebo.
- Gastric emptying, small-bowel, and colonic transit were measured using scintigraphy.
Main Results:
- Codeine significantly delayed gastric, small-bowel, and colonic transit.
- Alvimopan successfully reversed codeine's delaying effects on small-bowel and colonic transit.
- Alvimopan alone accelerated colonic transit compared to placebo.
Conclusions:
- Alvimopan effectively reverses codeine-induced gastrointestinal transit delays in the small bowel and colon.
- Alvimopan shows potential for treating opiate bowel dysfunction.
- The findings suggest mu-opioid pathways play a role in regulating colonic transit.