Viberzi Case
Viberzi is a new oral agent with an active ingredient eluxadoline mu-opioid receptor agonist. In addition to eluxadoline, Viberzi contains inactive ingredients such as: mannitol, magnesium stearate, microcrystalline cellulose, mannitol, colloidal silica and Opadry II (partially hydrolyzed polyvinyl alcohol, talc, titanium dioxide, polyethylene glycol iron oxide yellow and red).1
Viberzi is indicated in the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults. The drug has been shown to relieve the two main symptoms of IBS-D by making stools less loose and watery and reducing bowel contraction. Eluxadoline mixed mu- and kappa-opioid receptor agonist and delta-opioid receptor antagonist provides continued symptom relief in IBS-D
patients. It reduces diarrhea and abdominal pain by directly working on the enteric neurons in the intestine. 1
Viberzi is a first in its class that works on gastrointestinal tract μ / δ receptors. Eluxadoline is Schedule IV controlled substance because of potential for drug abuse and dependency. Commonly Viberzi is administered 100 mg two times a day with food, however in patient who had cholecystectomy, unable to tolerate the 100 mg dose, on concomitant OATP1B1 inhibitors treatment or in patient with mild-moderate hepatic impairment the dose is lowered to 75 mg twice a day.1 Eluxadoline as compared to loperamide in IBS-D treatment has high quality of evidence and in contrast to alosteron, which is only approved for severe IBS-D in women viberzi is efficacious in both men and women for moderate to severe IBS-D. In addition, Viberzi has no risk of bacterial resistance unlike Xifaxan an antibiotic derived from rifampin.1
Viberzi is indicated in the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults. The drug has been shown to relieve the two main symptoms of IBS-D by making stools less loose and watery and reducing bowel contraction. Eluxadoline mixed mu- and kappa-opioid receptor agonist and delta-opioid receptor antagonist provides continued symptom relief in IBS-D
patients. It reduces diarrhea and abdominal pain by directly working on the enteric neurons in the intestine. 1
Viberzi is a first in its class that works on gastrointestinal tract μ / δ receptors. Eluxadoline is Schedule IV controlled substance because of potential for drug abuse and dependency. Commonly Viberzi is administered 100 mg two times a day with food, however in patient who had cholecystectomy, unable to tolerate the 100 mg dose, on concomitant OATP1B1 inhibitors treatment or in patient with mild-moderate hepatic impairment the dose is lowered to 75 mg twice a day.1 Eluxadoline as compared to loperamide in IBS-D treatment has high quality of evidence and in contrast to alosteron, which is only approved for severe IBS-D in women viberzi is efficacious in both men and women for moderate to severe IBS-D. In addition, Viberzi has no risk of bacterial resistance unlike Xifaxan an antibiotic derived from rifampin.1