Eluxadoline
Drugs for irritable bowel syndrome
Drugs for irritable bowel syndrome
A gut-acting opioid-receptor drug for IBS with diarrhoea in adults. It can cause pancreatitis, mainly in people without a gallbladder.
Quick facts
- Group
- Drugs for irritable bowel syndrome
- Target
- Mu and kappa opioid receptors (agonist), delta opioid receptor (antagonist) in the gut
- Used for
- Irritable bowel syndrome
- Key effects
- Constipation · Nausea · Abdominal pain
- Monitor
- Upper abdominal pain · Bowel habit and constipation
- ATC
- A07DA06
No doses: the clinician sets them by the current guideline.
Mechanism of action
Eluxadoline is a mixed opioid-receptor drug: a mu and kappa agonist and a delta antagonist. Acting locally in the gut it reduces motility, abdominal pain and diarrhoea in IBS-D, with less constipation than a pure mu agonist. Mu stimulation can also contract the sphincter of Oddi, which explains spasm and pancreatitis.
- Eluxadoline stimulates gut mu and kappa receptors, blocks delta
- Bowel activity and visceral pain fall
- Fewer loose stools; risk of sphincter of Oddi spasm
Indications
- Irritable bowel syndrome with diarrhoea in adults Irritable bowel syndrome →
Adverse effects
Common
- Constipation
- Nausea
- Abdominal pain
- Drowsiness, more with liver disease
Contraindications
- No gallbladder (higher risk of sphincter of Oddi spasm and pancreatitis)
- Known or suspected biliary duct obstruction or sphincter of Oddi disease
- History of pancreatitis or structural pancreatic disease
- Heavy alcohol use
- Intestinal obstruction, severe constipation, severe liver disease
Key interactions
- Alcohol
- Raises the risk of pancreatitis
- Loperamide and other constipating drugs (opioids, anticholinergics)
- More constipation; loperamide only occasionally and stopped if constipation appears
- Sedatives
- More drowsiness
What is monitored
- Upper abdominal pain (pancreatitis)
- Bowel habit and constipation
- Alcohol intake
Administration and safety
- Oral tablet, taken with food.
- It can be habit-forming: it is taken only as prescribed, never in larger amounts or for longer.
- Stopped at once for severe constipation or symptoms of pancreatitis.
Pregnancy and breastfeeding
Human data are limited; use in pregnancy is discussed with the prescriber and needs a clear benefit.
Nursing care
- Ask about gallbladder removal, gallstones, pancreatitis, liver disease and alcohol use before starting.
- Teach to stop and seek care for upper abdominal pain spreading to the back, or severe constipation.
- Warn about drowsiness before driving.
- Advise avoiding heavy or binge drinking.
Pharmacokinetics
- Absorption
- Taken by mouth; acts mainly in the gut
- Elimination
- Drug and metabolites are excreted in faeces
Test yourself
Think of the answer, then tap the question to see it.
What is eluxadoline's receptor profile?
Mu and kappa opioid agonist, delta opioid antagonist.
Why is it avoided after cholecystectomy?
Patients without a gallbladder have a higher risk of sphincter of Oddi spasm and pancreatitis.
Which habit raises its pancreatitis risk?
Heavy alcohol use.
Connections
← Back to the class: Drugs for irritable bowel syndrome
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Eluxadoline: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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