Digestive Health Irritable Bowel Syndrome Treatment Treating IBS With Viberzi By Barbara Bolen, PhD twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Barbara Bolen, PhD Medically reviewed by Medically reviewed by Priyanka Chugh, MD on January 28, 2020 linkedin Priyanka Chugh, MD, is a board-certified gastroenterologist and Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai. Learn about our Medical Review Board Priyanka Chugh, MD on January 28, 2020 Print Irritable Bowel Syndrome Overview Symptoms Causes Diagnosis Treatment Coping Nutrition Westend61/Getty Images Viberzi (eluxadoline) is a medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of diarrhea-predominant IBS (IBS-D) in adults. Viberzi was designed to act locally on the digestive tract to help control diarrhea and alleviate abdominal pain caused by the disease. While doctors still don't fully understand what causes the recurrent symptoms of IBS (including abdominal pain, bloating, gas, diarrhea, or constipation), Viberzi is able to provide relief to sufferers who don't respond to traditional anti-diarrheal agents. How Viberzi Works Viberzi is available by prescription and is designed to be taken by mouth, twice daily, with food. It comes in both a 75-milligram and 100-milligram film-coated tablet. Viberzi works by activating or impeding various opioid receptors in the digestive tract. These are the receptors involved in gut motility, pain sensation, and the secretion of intestinal fluids. Viberzi is unique in that it stimulates two types of receptors and inhibits another, providing relief without constipation. These receptors each have different and unique functions: Mu receptors are responsible for gut motility (the contraction of gastrointestinal muscles).Kappa receptors inhibit colon contractions.Delta receptors are associated intestinal secretions. The addition of a delta receptor antagonist is key to avoiding constipation seen with other drugs such as Imodium (loperamide) and Lomotil (atropine/diphenoxylate), which only affect the mu and kappa receptors. The FDA approved Viberzi based on two Phase III clinical trials which concluded that the drug offered modest improvement in the frequency and urgency of bowel movements and a modest improvement in abdominal pain and stool consistency. Drug Side Effects The side effects of Viberzi are typically gastrointestinal in nature but may also affect other systems due to the opioid effects. In some cases, the symptoms of the drug may trigger the very same ones experienced with IBS. Among some of the more common side effects: NauseaAbdominal painUpper respiratory tract infectionVomitingRunny or stuffy noseBloatingBronchitisDizzinessGasRashFatigue The opioid effect can, in rare cases, affect the sphincter of Oddi (the valve while regulates the flow of bile and pancreatic fluid into the intestines). If this happens, pancreatitis can develop. As such, Viberzi cannot be prescribed to persons who do not have a gallbladder (the organ that produces bile) or who have pancreatitis, liver impairment, a bile duct obstruction, or severe constipation. Hospitalization and death have been reported in persons without a gallbladder who took as few as two doses of Viberzi. It should also be avoided in persons who drink more than three alcoholic beverages per day. An opioid drug, Viberzi has the potential for abuse and/or dependence. It should only be used under the supervision of a doctor. While the effects are far less profound than Oxycontin (oxycodone), it can cause euphoria if abused and lead to opioid dependence. Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Maltz F, Fidler B. Eluxadoline (Viberzi): A mu-opioid receptor agonist for the treatment of irritable bowel syndrome with diarrhea. P T. 2017;42(7):438-442. Özdener AE, Rivkin A. Eluxadoline in the treatment of diarrhea-predominant irritable bowel syndrome. Drug Des Devel Ther. 2017;11:2827-2840. doi:10.2147/DDDT.S127405 Davenport JM, Covington P, Bonifacio L, Mcintyre G, Venitz J. Effect of uptake transporters OAT3 and OATP1B1 and efflux transporter MRP2 on the pharmacokinetics of eluxadoline. J Clin Pharmacol. 2015;55(5):534-42. doi:10.1002/jcph.442 Lacy BE, Chey WD, Cash BD, Lembo AJ, Dove LS, Covington PS. Eluxadoline efficacy in IBS-D patients who report prior loperamide use. Am J Gastroenterol. 2017;112(7):1210. doi:10.1038/ajg.2017.72 MedlinePlus. Eluxadoline. Updated October 15, 2018. Lacy BE. Review article: an analysis of safety profiles of treatments for diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2018;48(8):817-830. doi:10.1111/apt.14948 Dove LS, Lembo A, Randall CW, et al. Eluxadoline benefits patients with irritable bowel syndrome with diarrhea in a phase 2 study. Gastroenterology. 2013;145(2):329-38.e1. doi: 10.1053/j.gastro.2013.04.006 FDA. FDA warns about an increased risk of serious pancreatitis with irritable bowel drug Viberzi (eluxadoline) in patients without a gallbladder. Updated March 15, 2017.