Viberzi (eluxadoline) is a prescription medication used to treat irritable bowel syndrome with diarrhea (IBS-D) in adults. It works on the opioid receptor to help ease symptoms such as stomach pain and diarrhea. You typically take a dose by mouth twice a day with food. Because of its potential for misuse and dependence, it’s considered a controlled substance. Common side effects include constipation, nausea, and stomach pain.
Viberzi (eluxadoline) is an opioid receptor agonist/antagonist, which means it attaches to different types of opioid receptors in your body. While experts aren’t exactly sure how it works, it's thought to reduce gut sensitivity and slow down how food moves through your intestines. This can help relieve stomach pain and diarrhea in people with IBS-D.
Viberzi (eluxadoline) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Not having a gallbladder | Drinking excessive alcohol
Viberzi (eluxadoline) can cause pancreatitis, which is inflammation of the pancreas. This side effect is more likely in people without a gallbladder, and in some cases, it has been severe or even deadly. Because of this, you shouldn't use Viberzi (eluxadoline) if you don’t have a gallbladder. Most cases of pancreatitis happened within the first week of starting this medication, sometimes after only one or two doses.
If you do have a gallbladder, your prescriber will review your alcohol use before starting Viberzi (eluxadoline). Avoid drinking too much alcohol while taking this medication since doing so can raise your risk of pancreatitis. Watch for symptoms like severe stomach pain that spreads to your back or shoulder, with or without nausea or vomiting. If you notice any of these symptoms, stop taking this medication right away and get medical help.
Risk factors: Not having a gallbladder
Viberzi (eluxadoline) can cause a muscle spasm in the bile duct area (called sphincter of Oddi spasm), which can lead to pancreatitis or liver problems. This is more likely in people without a gallbladder. This spasm can cause sudden stomach pain, especially in the upper right side, and the pain can spread to your back or shoulder. You might also feel nausea or vomiting. Most cases happen within the first week of starting this medication, even after just one or two doses.
Viberzi (eluxadoline) can cause allergic reactions, including some that were life-threatening, sometimes after just the first or second dose. If you have a rash, itching, swelling, trouble breathing, or dizziness, stop taking Viberzi (eluxadoline) and contact your prescriber right away.
Risk factors: Also taking other medications that cause constipation
Constipation has been reported in people taking Viberzi (eluxadoline), and in some cases, it has been severe enough to require hospitalization. Rarely, it has led to serious problems like intestinal blockage, a tear in the intestine, or stool buildup that needed medical treatment. Stop taking Viberzi (eluxadoline) and contact your prescriber right away if you experience severe constipation. Avoid taking Viberzi (eluxadoline) with other medications that can cause constipation.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Tablet that's taken by mouth
Typically works within a week
Approved for males and females with IBS-D
Must be taken twice a day with food
Is a controlled substance
Risk of pancreatitis, inflammation of the pancreas
Take Viberzi (eluxadoline) by mouth twice a day with food. You need to take it every day, not just when you have diarrhea or stomach pain.
If you have diarrhea while taking Viberzi (eluxadoline), you can use loperamide occasionally. But try not to take both medications long term since this could make you constipated.
If you miss a dose of Viberzi (eluxadoline), skip it and take your next dose at your regular time. Never take two doses at once.
If you get severe constipation while taking Viberzi (eluxadoline), stop taking it and contact your prescriber. Severe constipation can be dangerous and lead to blocked intestines or stool buildup.
Viberzi (eluxadoline) can cause pancreatitis, which is inflammation of the pancreas. Stop taking it and get medical help right away if you have severe stomach pain that might spread to your back or shoulder, with or without nausea and vomiting.
Avoid drinking more than 3 alcoholic drinks a day while taking Viberzi (eluxadoline) since this can raise your risk of pancreatitis.
The typical starting dose is 100 mg by mouth twice a day with food.
Your dose might be lower if you can't tolerate the 100 mg dose, are taking medications that interact with Viberzi (eluxadoline), or have kidney or liver problems.
People without a gallbladder
Biliary duct problems
Alcohol use disorder or people who drink more than 3 alcoholic drinks per day
Pancreas problems
Serious liver problems
History of long-term constipation or severe constipation
Severe irritable bowel syndrome with diarrhea (IBS-D) in females (when other treatment options haven't worked well)
Treatment of travelers' diarrhea caused by E. coli in people ages 12 years and older
Treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults
Prevention of hepatic encephalopathy (HE) in adults
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Allergan, Inc. (2024). Viberzi- eluxadoline tablet, film coated [package insert]. DailyMed.
Crittenden, J. P., et al. (2023). Sphincter of Oddy dysfunction. StatPearls.
Dhaliwal, A., et al. (2023). Physiology, opioid receptor. StatPearls.
Lembo, A. J., et al. (2016). Eluxadoline for irritable bowel syndrome with diarrhea. The New England Journal of Medicine.
Maltz, F., et al. (2017). Eluxadoline (Viberzi): A mu-opioid receptor agonist for the treatment of irritable bowel syndrome with diarrhea. Pharmacy and Therapeutics.
Wade, P. R., et al. (2012). Modulation of gastrointestinal function by MuDelta, a mixed µ opioid receptor agonist/ µ opioid receptor antagonist. British Journal of Pharmacology.
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