ALVIMOPAN CAP,ORAL
Clinical Criteria Summary
Exclusion Criteria
- Complete bowel obstruction or having surgery for correction of complete bowel obstruction
- Patients scheduled for total colectomy, ileostomy, colostomy, pancreatic anastomosis or gastric anastomosis
- Inflammatory bowel disease
- Therapeutic doses of opioids for more than 7 consecutive days immediately prior to taking alvimopan
- Intrathecal or epidural opioids or anesthetics are scheduled to be used during surgery
- Recent treatment with alvimopan in current episode of care (No studies evaluated safety and efficacy of more than one treatment course)
- Situations where pre-operative dose cannot be administered
- Severe hepatic impairment (Child-Pugh C)
- End-stage renal disease
- Any non-FDA approved indication (Alvimopan Shared System REMS applies)
Inclusion Criteria
- Undergoing surgery that includes partial bowel resection with primary anastomosis (including resection of intra-abdominal organs with large or small bowel resection / anastomoses, e.g. radical cystectomy)
- Intravenous postoperative opioid pain management is planned
- Particular consideration for patients at risk for prolonged post operative ileus (PPOI):
- Prior occurrence of PPOI after any surgical procedure
- Anticipation of extensive (over 2 hours) adhesiolysis associated with a small or large bowel resection
- Significant en bloc resection of intraabdominal organs including large or small bowel