The limited use of alvimopan in patients undergoing radical cystectomy and urinary diversion was found to have a positive impact in several areas when compared with placebo, according to a recent Cochrane review of a randomized trial involving 280 individuals.

Participants who were undergoing bladder removal surgery received either 12 mg alvimopan (up to 15 doses over 7 days; n=143) or placebo (n=137). They were treated by experienced surgeons at centers that performed at least 50 such procedures per year. Among the results:

• Alvimopan appeared to reduce the time needed to tolerate solid food, time to hospital discharge, and major adverse event rates.
• Patients receiving it were less likely to have a tube placed back into their stomach.
• There were no differences in hospital readmissions, risk of heart problems, or need for narcotics to treat pain.