Viberzi vs Imodium – Comparison of Uses & Side Effects

Viberzi

It is the brand name of a drug called eluxadoline, which is part of a group of drugs called mu-opioid receptor antagonists.

Mechanism of Action

It works by interacting with the opioid receptors in the gut.

Uses

This prescription medication is used to treat irritable bowel syndrome with diarrhea (IBS-D) in adults. It is not approved for use by anyone younger than 18 years old.

Note – as of February 2017, the US Food and Drug Administration has recommended peoples without a gallbladder not take this medication.

Dosage

For irritable bowel syndrome, the usual recommended dose is 100 mg orally twice a day.

Note – if severe constipation lasts for more than 4 days, this medication should be discontinued.

Side Effects and Precautions

Common side effects may include:

  • stomach pain;
  • nausea;
  • constipation.

Rare side effects may include:

  • severe pain in your upper stomach;
  • constipation lasting longer than 4 days;
  • vomiting;
  • nausea ;
  • worsening stomach pain.

Contraindications

Before taking this mu-opioid receptor antagonist, tell your healthcare provider if you have:

  • severe liver disease;
  • a blockage in your intestines;
  • a habit of drinking more than 3 alcoholic beverages a day;
  • severe constipation;
  • a pancreas disorder;
  • digestive problems caused by the sphincter of Oddi;
  • if your gallbladder has been removed;
  • a history of gallbladder obstruction.

Alcohol

Avoid drinking alcoholic beverages while taking this mu-opioid receptor antagonist since alcohol use can substantially increase the risk of side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • tramadol;
  • amitriptyline;
  • Lomotil (atropine/diphenoxylate);
  • Bentyl (dicyclomine);
  • Imodium (loperamide);
  • cyclobenzaprine;
  • dicyclomine.

Pregnancy & Breastfeeding

It is not known whether this mu-opioid receptor antagonist passes into breast milk or if it could harm a nursing infant. Also, it is not known whether this medicine will harm a developing fetus.

Viberzi – Controlled Substance

Eluxadoline is a Schedule IV controlled substance. In addition, it is a mixed mu-opioid receptor agonist with delta-opioid receptor antagonist activity and kappa-opioid agonist activity.

It targets local opioid receptors in the gut, that reduces the chance of additional central nervous system side effects.

Imodium

It is the brand name of a drug called loperamide, that is part of a group of drugs called antidiarrheals.

Mechanism of Action

This medication works by affecting the nerves in the intestines to reduce stool frequency. Also, it reduces cramping and makes the stools more solid.

It was first approved by the US FDA in 1976.

Contraindications

Before taking this antidiarrheal, tell your healthcare provider if you have:

  • fever;
  • AIDS (acquired immunodeficiency syndrome);
  • mucus in your stools;
  • liver disease.

Also, this medication must not be taken by children under 12 years of age unless it is prescribed by a doctor.

Uses

This medication is used to relieve the symptoms of diarrhea which start suddenly and last for several days.

Causes of diarrhea may include:

  • viral infections;
  • parasitic infections, such as those which cause giardiasis and amoebiasis;
  • irritable bowel syndrome (IBS);
  • food allergies and intolerance;
  • a side effect of some medications;
  • bacterial infections, such as Shigella, C.diff (Clostridium), or cholera (Vibrio cholerae).

In addition, this medication may be used to decrease the amount of discharge in sufferers who have undergone an ileostomy or to treat patients with inflammatory bowel disease.

Note – the effect of this medicine can be observed within 1-3 hours after intake.

Alcohol

Drinking alcoholic beverages while taking this antidiarrheal may substantially increase the drowsy effect of loperamide.

Dosage

For acute diarrhea, the usual recommended dosage is 4 mg, taken straightaway, followed by 2 mg after each time the patient goes to the toilet with diarrhea.

Note – to keep you from getting dehydrated, take the medication with a full glass of water.

Drug Interactions

It may negatively interact with other medications, especially:

  • Viberzi (eluxadoline);
  • azithromycin;
  • Lomotil (atropine/diphenoxylate);
  • Lotemax;
  • Zoloft (sertraline);
  • Pepto Bismol;
  • Zantac (ranitidine);
  • Lexapro (escitalopram);
  • Benadryl (diphenhydramine);
  • Dicyclomine;
  • Zyrtec (cetirizine);
  • Injectafer;
  • Cipro (ciprofloxacin);
  • Fetzima.

Pregnancy & Breastfeeding

Since this medication can pass into breast milk and may negatively affect the breastfed infant, do not breastfeed while taking this antidiarrheal.

There are no conclusive studies to determine the safety of the antidiarrheal during pregnancy.

Abuse

This medication contains a small quantity of opiates, and a growing number of scientific reports have concluded that ingesting large amounts of this drug can result in getting mild narcotic effects.

Side Effects and Precautions

Common side effects may include:

  • constipation;
  • dizziness;
  • stomach cramps;
  • nausea;
  • drowsiness.

Less common side effects may include:

  • sudden dizziness;
  • ongoing or worsening diarrhea;
  • fluttering in your chest;
  • stomach pain or bloating;
  • a feeling like you might pass out;
  • fast or pounding heartbeats;
  • diarrhea which is watery or bloody;
  • shortness of breath. 

Bottom Line – Viberzi vs Imodium

Viberzi (active ingredient – eluxadoline) is a medication that is used to treat irritable bowel syndrome when the main symptom is diarrhea. It works directly in your intestines to slow the movement of food during digestion.

Imodium (active ingredient – loperamide) is a medication that allows the small intestines to have more time to absorb nutrients and fluids from the foods you consume. It also slows the rhythm of digestion.

According to a 2017 study, Viberzi effectively and safely treats IBS-D symptoms of diarrhea and abdominal pain in people who self-report either inadequate or adequate control of their symptoms with prior Imodium treatment, with comparable safety and efficacy irrespective of the use of Imodium as a rescue medication during Viberzi treatment.

References

https://www.nejm.org/doi/full/10.1056/NEJMoa1505180
https://www.sciencedirect.com/science/article/pii/S1542356517301349
https://www.ncbi.nlm.nih.gov/pubmed/23583433
 

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