Evidence-based recommendations on eluxadoline (Truberzi) for treating irritable bowel syndrome with diarrhoea in adults.
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Eluxadoline is recommended as an option for treating irritable bowel syndrome with diarrhoea (IBS-D) in adults, only if:
It is the combination of abdominal pain, bloating, loose frequent stools often with faecal urgency in the absence of structural, inflammatory, or biochemical abnormalities. It affects about a third of people with IBS.
It is an opioid receptor agonist and delta-opioid receptor antagonist that binds to opioid receptors in the gut thereby slowing movement & decreasing awareness of pain.
The results of large well-conducted trials suggest about 30% of patients with IBS-D responded to the drug compared with about 20% taking placebo. There was a significant improvement in abdominal pain, diarrhoea and faecal urgency.
100 mg taken by mouth twice daily.
Within the first week symptoms should start to improve with peak benefit by 6 weeks.
Stop eluxadoline at 4 weeks if there is inadequate relief of the symptoms of IBS-D. Results from trials confirmed benefit for up to 6 months.
The most common adverse effects are nausea, constipation and abdominal pain. Rarely the drug may case pancreatitis (0.3%) or spasm of the sphincter of Oddi leading to pain and a rise in liver enzymes (0.5%). The latter was more common in patients without a gallbladder.
It is not recommended in pregnancy, in patients planning a pregnancy and should be avoided if breastfeeding