Naloxegol in opioid-induced constipation: a new paradigm in the treatment of a common problem

Abstract

Stephanie C Yoon,1 Heather C Bruner2 1Scripps Health and University of California San Diego, Joint Hospice and Palliative Medicine Fellowship, San Diego, 2Department of Medicine, University of California San Diego, Doris A. Howell Palliative Care Service, La Jolla, CA, USA Abstract: Opioid-induced constipation (OIC) imposes a significant burden for patients taking pain medications, often resulting in decreased quality of life. Treatment of OIC with traditional medications for functional constipation can be incompletely effective, leading to nonadherence with opioid treatment and undertreated pain. An emerging class of medications that counteract the adverse effects of opioids in the gastrointestinal tract while preserving central nervous system-based pain relief may represent a paradigm shift in the prevention and treatment of OIC. One of these medications, naloxegol, is a once-daily, oral opioid antagonist that is effective, well-tolerated, and approved for treatment of OIC in patients with noncancer pain. More studies are needed to demonstrate this same utility in patients with cancer-related pain. Keywords: opioid-induced constipation, chronic pain, bowel care, peripherally acting mu-opioid-receptor antagonist, OIBD

Keywords

• Opioid-induced constipation
• chronic pain
• bowel care
• peripherally-acting mu-opioid receptor antagonist
• PAMORA
• OIC
• OIBD