Elobixibat
Also known as: A3309, AZD7806, Goofice
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Summary
Elobixibat is an orally administered prescription drug that inhibits the ileal bile acid transporter (IBAT). By blocking bile‑acid reabsorption, it increases colonic bile‑acid concentrations, which promotes fluid secretion and intestinal motility. It is approved for chronic constipation and is being investigated for constipation associated with Parkinson's disease.
Mechanism of Action
Elobixibat binds to and blocks the apical ileal bile acid transporter (ASBT/IBAT) on enterocytes of the distal ileum. This inhibition reduces active reabsorption of bile acids, leading to a higher load of bile acids entering the colon. In the colon, bile acids stimulate secretion of water and electrolytes and activate receptors that enhance colonic motility, thereby facilitating bowel movements.
What the Research Shows
A 2024 systematic review and meta‑analysis of randomized trials found elobixibat’s efficacy in increasing spontaneous bowel movements to be comparable to lubiprostone and linaclotide, with a similar number needed to treat. Its safety profile differed, showing a higher incidence of abdominal pain than the other agents. A double‑blind, placebo‑controlled Parkinson’s disease study (CONST‑PD) reported a modest increase in weekly spontaneous bowel movements and improved stool form and satisfaction, although the primary endpoint was not statistically significant after adjustment. Elderly‑patient reviews list elobixibat among newer agents with efficacy similar to other laxatives, and a 2019 network meta‑analysis placed it among drugs superior to placebo for chronic idiopathic constipation.
Reported Benefits
Clinical data indicate that elobixibat can increase the frequency of spontaneous bowel movements and improve stool consistency, offering relief comparable to other secretagogues and pro‑kinetic agents. Patient‑reported outcomes such as treatment satisfaction and quality‑of‑life scores have shown improvement in short‑term studies, including in Parkinson’s disease cohorts.
Limitations of the Evidence
Evidence is limited to short‑term (4–12 week) trials; long‑term efficacy and safety remain unclear. The Parkinson’s disease trial did not meet its adjusted primary endpoint, and abdominal pain appears more common than with some alternatives. Direct head‑to‑head comparisons with all laxatives are lacking, and data in specific subpopulations (e.g., severe constipation, children) are absent.
Safety Considerations
The most frequently reported adverse event for elobixibat is abdominal pain. Nausea and diarrhea are less common compared with lubiprostone and linaclotide, respectively. In the Parkinson’s disease study, adverse events were consistent with the known safety profile and were generally mild. No serious safety signals have emerged, but clinicians should monitor for gastrointestinal discomfort.
How It Is Administered
Elobixibat is administered orally as a tablet. It is marketed as a prescription medication and is taken once daily, typically with or without food, according to the approved labeling.
Routes of Administration
Goals & Uses
- Relief of chronic idiopathic constipationGastroenterologyHigh
- Treatment of constipation-predominant IBS (IBS-C)GastroenterologyModerate
- Improvement of stool consistencyGastroenterologyHigh
- Reduction of LDL cholesterolCardiovascular/MetabolicLow
Contraindications
- Bowel obstructionGastrointestinalHigh
- PregnancyPopulationModeratePotential fetal risk or insufficient safety data
- Hypersensitivity to elobixibatAllergyHigh
- Severe inflammatory bowel disease (acute phase)GastrointestinalHigh
Adverse Effects
- NauseaGastrointestinalUncommonFeeling of sickness or urge to vomit
- Elevated liver enzymes (transaminases)HepaticRare
- FlatulenceGastrointestinalCommonExcess gas in the digestive tract
- Abdominal pain/crampingGastrointestinalCommon
- DiarrheaGastrointestinalCommonLoose or frequent stools
Drug Interactions
- Lipid-lowering agents (statins)Low
- Bile acid sequestrants (e.g., cholestyramine)Moderate
- Oral medications with narrow therapeutic indexModerate
Population Constraints
- Nursing mothersReproductiveRelative
- Pediatric patientsAgeRelative
- Elderly patients (≥75 years)AgeRelative
- Patients with severe hepatic impairmentHepaticRelative
- Pregnant womenReproductiveRelative
Regulatory Status
- European UnionUnapprovedNot approved by EMA; development in Europe did not progress to approval.
- United StatesUnapprovedPhase II/III trials were conducted; not submitted for or received FDA approval as of knowledge cutoff.
- United KingdomUnapprovedNot approved by MHRA.
Approved in Japan (2018) by PMDA under the brand name Goofice for chronic idiopathic constipation. Not approved by the FDA or EMA as of the knowledge cutoff; clinical trials in Western markets were conducted but regulatory approval was not pursued in those jurisdictions.
Evidence & Sources
- Journal ArticleHighRao SS, et al.2024-01-01T00:00:00.000000Z
- Journal ArticleModerateHatano T, et al.2024-01-01T00:00:00.000000Z
- Journal ArticleModerateCorsetti M, Landes S, Lange R2021-01-01T00:00:00.000000Z
- Journal ArticleModerateHojo M, Shibuya T, Nagahara A2025-01-01T00:00:00.000000Z
- Journal ArticleModerateKang SJ, et al.2021-01-01T00:00:00.000000Z
- Journal ArticleHighLuthra P, et al.2019-01-01T00:00:00.000000Z
Frequently Asked Questions
How does elobixibat differ from other constipation drugs?
Elobixibat works by inhibiting the ileal bile acid transporter, increasing bile acids in the colon to stimulate secretion and motility. Other agents, such as lubiprostone or linaclotide, act on chloride channels or guanylate cyclase receptors, respectively.
Is elobixibat effective for constipation in Parkinson’s disease?
A short‑term placebo‑controlled trial showed a modest rise in weekly bowel movements and improved stool form, though the primary endpoint was not statistically significant after adjustment. It suggests possible benefit, but larger studies are needed.
What side effects should patients expect?
The most common side effect reported is abdominal pain. Nausea and diarrhea are less frequent. Most adverse events are mild, but patients should report persistent or severe abdominal discomfort.
Can elobixibat be used long‑term?
Current evidence is limited to trials lasting up to 12 weeks. Long‑term safety and efficacy have not been established, so ongoing monitoring is advisable.
How is elobixibat taken?
It is taken orally, usually once daily, as a prescription tablet. Specific dosing instructions should follow the prescribing information and the clinician’s guidance.
What is Elobixibat?
Elobixibat is an orally administered prescription drug that inhibits the ileal bile acid transporter (IBAT). By blocking bile‑acid reabsorption, it increases colonic bile‑acid concentrations, which promotes fluid secretion and intestinal motility. It is approved for chronic constipation and is being investigated for constipation associated with Parkinson's disease.
What is Elobixibat used for?
Elobixibat is educationally associated with: Relief of chronic idiopathic constipation, Treatment of constipation-predominant IBS (IBS-C), Improvement of stool consistency, Reduction of LDL cholesterol. Educational only — not medical advice.
How is Elobixibat administered?
Recorded routes of administration: Oral.
What are the potential side effects of Elobixibat?
Reported adverse effects include: Nausea, Elevated liver enzymes (transaminases), Flatulence, Abdominal pain/cramping, Diarrhea. This list is not exhaustive — consult a qualified clinician.
Who should avoid Elobixibat?
Recorded contraindications: Bowel obstruction, Pregnancy, Hypersensitivity to elobixibat, Severe inflammatory bowel disease (acute phase). Consult a qualified clinician before use.