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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Related Studies
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 |
Ontology: alosetron (C0291772)
Definition (NCI) | A potent and selective 5-HT3 receptor antagonist. Alosetron blocks the actions of serotonin at 5-HT3 sites in the peripheral nervous system, particularly on enteric and nociceptive sensory neurons, thereby affecting the regulation of visceral pain, decreasing gastrointestinal contraction and motility, and decreasing gastrointestinal secretions. This agent is used to treat diarrhea-predominant irritable bowel syndrome in women. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C090840 |
SnomedCT | 116509006, 409148009 |
English | alosetron, alosetron [Chemical/Ingredient], Alosetron (substance), Alosetron, Alosetron (product), ALOSETRON |
Spanish | alosetrona, alosetrón, alosetrón (sustancia), alosetrona (sustancia), alosetrón (producto), alosetrona (producto) |