Alosetron Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Alosetron Tablet (alosetron hydrochloride) is a prescription serotoninergic neuroenteric modulator used to treat severe, chronic diarrhea-predominant irritable bowel syndrome (IBS) in women. It is given only after other treatments have not worked and is not approved for use by men or anyone younger than 18 years old. The medicine can reduce abdominal pain, urgency, and diarrhea, but it carries serious risks related to constipation and reduced blood flow to the bowel.

What is Alosetron Tablet

Alosetron Tablet is a prescription medicine used to treat severe chronic irritable bowel syndrome (IBS) in women whose main symptom is diarrhea. It is given only after other treatments have not worked.

Alosetron Tablet uses

• Treats severe diarrhea-predominant irritable bowel syndrome (IBS) in women who have had symptoms for 6 months or longer and have not responded well to other treatments.
• Not approved for use by men or by anyone younger than 18 years old.

Benefits of Alosetron Tablet

• Can reduce stomach pain and discomfort caused by IBS.
• Can reduce the sudden urgent need to have a bowel movement.
• Can reduce diarrhea.
• May lead to less difficulty sleeping, less tiredness, and less interference with daily activities and work in people with severe symptoms.

How Alosetron Tablet works

Alosetron blocks the action of a body chemical called serotonin in the gut. In IBS, the gut may overreact to serotonin, and this overreaction can make the intestines overactive, causing pain, urgency, and diarrhea. By blocking serotonin's effect on receptors in the gut, alosetron reduces these symptoms.

Alosetron Tablet dosage

Alosetron can be taken with or without food, twice a day, exactly as your doctor prescribes. Do not start taking this medicine if you are currently constipated. If you miss a dose, skip it and take your next dose at the regular time; do not take two doses at once.

Your doctor will usually check your progress about every 4 weeks to see if the dose needs to change. Stop taking the medicine right away and contact your doctor if you develop constipation, new or worsening stomach pain, or blood in your stool. If you stop taking it because of constipation, do not start again unless your doctor tells you to.

If symptoms have not improved after 4 weeks, contact your doctor; stopping suddenly may cause symptoms to return within 1 to 2 weeks.

Available forms and strengths

• Tablets (0.5 mg and 1 mg)

Side effects of Alosetron Tablet

Common

• Constipation
• Nausea
• Stomach or intestinal pain and discomfort
• Abdominal distention
• Gas and reflux
• Hemorrhoids

Serious

• New or worsening constipation that can lead to serious bowel blockage
• Signs of reduced blood flow to the bowel (ischemic colitis): new or worsening stomach pain, blood in stools, or bloody diarrhea
• Allergic reaction: hives, difficulty breathing, swelling of face, lips, tongue, or throat

Warnings and precautions

• This medicine can cause rare but serious bowel problems, including severe constipation complications and reduced blood flow to the bowel (ischemic colitis), which can lead to hospital stay and, rarely, blood transfusion, surgery, or death.
• Do not start this medicine if you are constipated.
• This medicine should not be restarted if you develop ischemic colitis.
• This medicine must not be combined with fluvoxamine, since it can greatly increase the levels of this drug in your blood.
• People who are elderly, debilitated, or taking other medicines that slow the bowel may have a greater chance of serious constipation complications.
• This medicine should not be used by people with a history of severe constipation, bowel blockage, poor blood flow to the intestines, Crohn's disease, ulcerative colitis, diverticulitis, or severe liver disease.
• Animal studies did not show harm to the fetus, but there are no well-controlled studies in pregnant women, so this medicine should only be used during pregnancy if clearly needed.
• It is not known if this medicine passes into human breast milk. Caution should be used if taking it while breastfeeding, and you should tell your doctor if the nursing baby develops constipation or bloody stools.
• No dose adjustment is needed for people with reduced kidney function, since the kidneys play only a small role in removing this drug from the body.
• This medicine is processed by the liver, so people with liver problems may have higher levels of the drug in their body. It should not be used in people with severe liver disease and should be used carefully in people with mild to moderate liver problems.
• No specific direct alcohol interaction is highlighted in the prescribing information, but alcohol may aggravate gastrointestinal symptoms in some people with IBS.
• Alosetron is not generally considered strongly sedating, but patients should avoid driving if they experience dizziness or other symptoms that affect alertness.

Storage

• Store at 25°C (77°F); brief exposure to temperatures between 15-30°C (59-86°F) is permitted.
• Protect from light and moisture.
• Keep out of the reach of children.

When to see a doctor

• Stop taking this medicine and call your doctor right away if you become constipated.
• Get medical help immediately if you have rectal bleeding, bloody diarrhea, or new or worsening abdominal pain, as these can be signs of a serious bowel blood flow problem.
• If constipation does not go away after stopping the medicine, contact your doctor again.
• Get emergency help for signs of a serious allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• If you think you have taken too much of this medicine, seek emergency medical help or contact your local poison control center.

Alternatives

• Rifaximin
• Eluxadoline
• Loperamide