Medical Editor: John P. Cunha, DO, FACOEP Last updated on RxList: 11/29/2021
Viberzi Side Effects Center

What Is Viberzi?

Viberzi (eluxadoline) is a mu-opioid receptor agonist used in adults to treat irritable bowel syndrome with diarrhea (IBS-D).

What Are Side Effects of Viberzi?

Common side effects of Viberzi include:

  • constipation,
  • nausea,
  • abdominal pain,
  • upper respiratory tract infection,
  • vomiting,
  • runny or stuffy nose,
  • bloating,
  • bronchitis,
  • dizziness,
  • gas,
  • rash, and
  • fatigue.

Dosage for Viberzi

The recommended dosage of Viberzi in adults is 100 mg twice daily, taken with food.

What Drugs, Substances, or Supplements Interact with Viberzi?

Viberzi may interact with cyclosporine, gemfibrozil, antiretrovirals, rifampin, eltrombopag, ciprofloxacin, gemfibrozil, fluconazole, clarithromycin, paroxetine, bupropion, alosetron, anticholinergics, opioids, rosuvastatin, alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, or tacrolimus. Tell your doctor all medications and supplements you use.

Viberzi During Pregnancy or Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant before taking this drug. It is unknown if Viberzi passes into breast milk. Consult your doctor before breastfeeding.

Additional Information

Our Viberzi (eluxadoline) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Digestive Disorders: Common Misconceptions See Slideshow
Viberzi Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop taking eluxadoline and call your doctor at once if you have:

  • new or worsening stomach pain (may be severe);
  • nausea and vomiting;
  • severe constipation;
  • constipation lasting longer than 4 days; or
  • severe pain in your upper stomach spreading to your back.

Side effects may be more likely in older adults.

Common side effects may include:

  • constipation;
  • nausea; or
  • stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Viberzi (Eluxadoline Tablets)


What is irritable bowel syndrome or IBS? See Answer
Viberzi Professional Information


The following adverse reactions described below and elsewhere in the labeling include:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Over 1700 patients with IBS-D have been treated with 75 or 100 mg of VIBERZI twice daily in controlled trials. Exposures from placebo-controlled clinical trials in adult patients with IBS-D included 1391 exposed for 3 months, 1001 exposed for 6 months and 488 exposed for one year.

Demographic characteristics were comparable between the treatment groups [see Clinical Studies]. Data described below represent pooled data compared to placebo across the randomized trials.


Cases of pancreatitis, not associated with sphincter of Oddi spasm, were reported in 2/807 (0.2%) of patients receiving 75 mg and 3/1032 (0.3%) of patients receiving 100 mg VIBERZI twice daily in clinical trials. Of these 5 cases, 3 were associated with excessive alcohol intake, one was associated with biliary sludge, and in one case the patient discontinued VIBERZI 2 weeks prior to the onset of symptoms. All pancreatic events resolved with lipase normalization upon discontinuation of VIBERZI, with 80% (4/5) resolving within 1 week of treatment discontinuation. The case of sphincter of Oddi spasm-induced pancreatitis resolved within 24 hours of discontinuation.

Sphincter Of Oddi Spasm

In clinical trials, sphincter of Oddi spasm occurred in 0.2% (2/807) of patients receiving 75 mg and 0.8% (8/1032) of patients receiving 100 mg VIBERZI twice daily.

  • Among patients receiving 75 mg, 1/807 (0.1%) patient experienced a sphincter of Oddi spasm presenting with abdominal pain but with lipase elevation less than 3 times the upper limit of normal (ULN) and 1/ 807 (0.1%) patient experienced a sphincter of Oddi spasm manifested as elevated hepatic enzymes associated with abdominal pain
  • Among patients receiving 100 mg, 1/1032 (0.1%) patient experienced a sphincter of Oddi spasm manifested as pancreatitis and 7/1032 (0.7%) patients experienced sphincter of Oddi spasm manifested as elevated hepatic enzymes associated with abdominal pain

Of those patients who experienced a sphincter of Oddi spasm, 80% (8/10) reported their first onset of symptoms within the first week of treatment. The case of sphincter of Oddi spasminduced pancreatitis occurred within minutes of taking the first dose of VIBERZI. No cases of sphincter of Oddi spasm occurred greater than 1 month after treatment onset. All events resolved upon discontinuation of VIBERZI, with symptoms typically improved by the following day.

Common Adverse Reactions

Table 1 provides the incidence of common adverse reactions reported in > 2% of IBS-D patients in either VIBERZI treatment group and at an incidence greater than in the placebo group.

Table 1: Common* Adverse Reactions in the Placebo-Controlled Studies in IBS-D Patients

Adverse Reactions VIBERZI
100 mg twice daily
(N= 1032)
75 mg twice daily
Constipation 8 7 2
Nausea 7 8 5
Abdominal Pain** 7 6 4
Upper Respiratory Tract Infection 5 3 4
Vomiting 4 4 1
Nasopharyngitis 3 4 3
Abdominal Distention 3 3 2
Bronchitis 3 3 2
Dizziness 3 3 2
Flatulence 3 3 2
Rash*** 3 3 2
Increased ALT 3 2 1
Fatigue 2 3 2
Viral gastroenteritis 1 3 2
* Reported in > 2% of VIBERZI-treated patients at either dose and at an incidence greater than in placebo-treated patients
**"Abdominal Pain" term includes: abdominal pain, abdominal pain lower, and abdominal pain upper
*** "Rash" term includes: dermatitis, dermatitis allergic, rash, rash erythematous, rash generalized, rash maculopapular, rash papular, rash pruritic, urticaria, and idiopathic urticaria

Constipation was the most commonly reported adverse reaction in VIBERZI-treated patients in these trials. Approximately 50% of constipation events occurred within the first 2 weeks of treatment while the majority occurred within the first 3 months of therapy. Rates of severe constipation were less than 1% in patients receiving 75 mg and 100 mg VIBERZI. Similar rates of constipation occurred between the active and placebo arms beyond 3 months of treatment.

Adverse Reactions Leading To Discontinuation

Eight percent of patients treated with 75 mg, 8% of patients treated with 100 mg VIBERZI and 4% of patients treated with placebo discontinued prematurely due to adverse reactions. In the VIBERZI treatment groups, the most common reasons for discontinuation due to adverse reactions were constipation (1% for 75 mg and 2% for 100 mg) and abdominal pain (1% for both 75 mg and 100 mg). In comparison, less than 1% of patients in the placebo group withdrew due to constipation or abdominal pain.

Less Common Adverse Reactions

Adverse reactions that were reported in ≤ 2% of VIBERZI-treated patients are listed below by body system.

Gastrointestinal: gastroesophageal reflux disease
General Disorders and administration site conditions: feeling drunk
Investigations: increased AST
Nervous system: sedation, somnolence
Psychiatric disorders: euphoric mood
Respiratory: asthma, bronchospasm, respiratory failure, wheezing

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of VIBERZI. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Hypersensitivity: anaphylaxis, angioedema (e.g. swollen face and throat), dyspnea, throat tightness, and chest pain/tightness [see WARNINGS AND PRECAUTIONS].

Read the entire FDA prescribing information for Viberzi (Eluxadoline Tablets)

© Viberzi Patient Information is supplied by Cerner Multum, Inc. and Viberzi Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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