Clinical Medicine Reviews in Therapeutics

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic abdominal pain and constipation (IBS-C), diarrhea (IBS-D), or a mixed pattern of altered bowel habits (IBS-M). It has a prevalence of 12% in North America with approximately one-third of patients having IBS-D in the United States. This subtype is associated with the poorest quality of life. A variety of treatment options exist, making a one-size-fits-all treatment strategy impossible. These treatment options alleviate one or more of the common IBS symptoms including abdominal pain and cramps, diarrhea, constipation, and bloating. These drugs include loperamide, antispasmodics, tricyclic antidepressants, alosetron, probiotics, and rifaximin. Eluxadoline is a µ-opioid receptor agonist and a δ-opioid receptor antagonist approved to treat adult patients with IBS-D. The aim of this study was to review eluxadoline for the treatment of IBS-D, including its pharmacology, clinical efficacy, safety, and current therapy.