Eluxadoline: A New FDA-Approved Treatment for Irritable Bowel Syndrome with Diarrhea

ABSTRACT: Irritable bowel syndrome (IBS) is characterized by chronic, recurrent abdominal pain with altered bowel habits, in the absence of organic disease, with episodes lasting for at least 3 months. Despite many treatment approaches to control symptoms, including dietary modification, newer agents that affect serotonin receptors, and antibiotics, cases that are refractory to these treatments persist and are associated with many functionally and socially disabling symptoms that can have a negative impact on the patient’s quality of life. This article provides an update on a new medication, eluxadoline, for IBS with diarrhea, recently approved by the US Food and Drug Administration. As a µ- and κ-opioid receptor agonist and a δ-opioid receptor antagonist, eluxadoline showed efficacy in animal studies in controlling abdominal pain with fewer side effects of constipation and analgesic tolerance. Its efficacy and safety have been determined in phase 3 trials. Sphincter of Oddi spasm and pancreatitis are serious observed side effects in patients with no gallbladder, and avoidance of this medication in this patient population is advised.

Keywords: diarrhea, irritable bowel syndrome, Receptors, Opioid, delta