Peripherally acting μ-opioid receptor antagonists as treatment options for constipation in noncancer pain patients on chronic opioid therapy.
Opioid-induced constipation (OIC), a prevalent and distressing side effect of opioid therapy, does not reliably respond to treatment with conventional laxatives. OIC can be a treatment-limiting adverse event. Recent advances in medications with peripherally acting μ-opioid receptor antagonists, such as methylnaltrexone, naloxegol, and alvimopan, hold promise for treating OIC and thus extending the benefits of opioid analgesia to more chronic pain patients. Peripherally acting μ-opioid receptor antagonists have been clinically tested to improve bowel symptoms without compromise to pain relief, although there are associated side effects, including abdominal pain. Other treatment options include fixed-dose combination products of oxycodone analgesic together with naloxone.
NEMA Research, Inc., Naples, FL.
Joseph V
JV
Pergolizzi
University of Arizona College of Pharmacy, University of Arizona, Tucson, AZ; Temple University School of Pharmacy, Temple University, Philadelphia, PA.
Robert B
RB
Raffa
Department of Medicine, Albert Einstein College of Medicine, New York, NY.
Marco
M
Pappagallo
NEMA Research, Inc., Naples, FL.
Charles
C
Fleischer
NEMA Research, Inc., Naples, FL.
Joseph
J
Pergolizzi
Department of Medicine, St. Luke's Hospital, Cleveland, OH, USA.
Gianpietro
G
Zampogna
NEMA Research, Inc., Naples, FL.
Elizabeth
E
Duval
NEMA Research, Inc., Naples, FL.
Janan
J
Hishmeh
NEMA Research, Inc., Naples, FL.
Jo Ann
JA
LeQuang
NEMA Research, Inc., Naples, FL.
Robert
R
Taylor
PAMORA; noncancer pain patients; opioid bowel disorder; opioid-associated side effects; opioid-induced constipation; peripherally acting mu-opioid receptor antagonist