II. Indications
III. Contraindications
- History of Ischemic Colitis (including from Alosetron)
- Fluvoxamine concurrent use (CYP1A2 Inhibitor)
- Constipation
- Crohns Disease
- Intestinal Obstruction
- Severe liver disease
IV. Precautions
- FDA Black box warning
- Deaths have occurred due to Ischemic Colitis
- Requires signed Informed Consent before prescribing
V. Mechanism
- Potent, selective 5-HT3 Receptor Antagonist
- Blocks Serotonin at 5-HT3 receptors throughout Peripheral Nervous System including the Gastrointestinal System
- Effects (similar to Ondansetron)
- Decreases gastrointestinal motility (decreases rapid transit and stool urgency)
- Decreases gastrointestinal secretions
VI. Dosing
- Start 0.5 mg orally twice daily for 4 weeks
- Next: Increase to 1 mg orally twice daily if tolerated
VII. Adverse Effects
- Common
- Serious
- Ischemic Colitis (deaths have occurred)
VIII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
IX. Drug Interactions
-
CYP1A2 Inhibitors
- Fluvoxamine (contraindicated)
- Fluoroquinolone
- Cimetidine
- CYP3A4 Inhibitors
X. Resources
XI. References
- (2021) Irritable Bowel Syndrome Drug Comparison, Presc Lett, #370305
- (2020) Med Lett Drugs Ther 62(1594): 41-58
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| alosetron (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ALOSETRON HCL 0.5 MG TABLET | Generic | $4.67 each |
| ALOSETRON HCL 1 MG TABLET | Generic | $6.20 each |