Alvimopan is a peripherally acting mu-opioid receptor antagonist (PAMORA) used primarily to accelerate gastrointestinal recovery following bowel resection surgery with primary anastomosis. Chemically, it is a derivative of the opioid antagonist naloxone. Alvimopan works by selectively blocking the mu-opioid receptors in the gastrointestinal tract, thereby reducing the inhibitory effects of opioids on gut motility and secretion. This leads to faster restoration of bowel function, decreased postoperative ileus (delayed bowel function), and shorter hospital stays. Alvimopan is typically administered orally in the immediate preoperative period and continued for a limited duration postoperatively. It is contraindicated in patients who have received therapeutic doses of opioids for more than 7 consecutive days prior to surgery or in those with a known or suspected gastrointestinal obstruction or perforation.
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