Treatment of opioid-induced constipation (OIC) in patients with chronic non-cancer pain, including those with chronic pain related to prior cancer or its treatment who do not require frequent (e.g. weekly) opioid dose escalation.
Acts peripherally as a mu receptor antagonist, blocking opioid receptors in the GI tract.
Blocks constipating effects of opioids on the GI tract without loss of analgesia.
Discontinue all maintenance laxative therapy before starting naloxegol. If a suboptimal response occurs with naloxegol, laxatives may be used after 3 days.
PO: Administer on an empty stomach at least 1 hr before first meal in morning or 2 hrs after meal. Tablet may be crushed to a powder, mixed with 4 ounces of water (120 mL) for patients with difficulty swallowing. Drink mixture immediately; refill glass with 120 mL water, stir and drink contents.
May be administered by NG tube. Flush the NG tube with 1 ounce (30 mL) of water using a 60 mL syringe. Crush tablet to a powder and mix with 2 ounces (60 mL) of water. Draw up mixture using the 60 mL syringe and administer through the NG tube. Add 2 ounces (60 mL) of water to rinse container and administer to flush NG tube and any remaining medicine from NG tube into stomach.
Avoid grapefruit and grapefruit juice during therapy.
Instruct patient to take naloxegol on an empty stomach as directed. Laxatives should be stopped before starting naloxegol, but may be restarted after 3 days if needed. Advise patient to read Medication Guide prior to starting therapy and with each refill in case of changes.
Caution patient to avoid grapefruit and grapefruit juice during therapy.
Advise patient to notify health care professional immediately if stomach pain that does not go away occurs.
Advise patient to notify health care professional if signs and symptoms of opioid withdrawal (sweating, chills, diarrhea, stomach pain, anxiety, irritability, yawning) occur. Patients taking methadone for pain are at increased risk for stomach pain and diarrhea.
Instruct patient to stop taking naloxegol if they stop taking opioid medications.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Advise female patients to notify health care professional if pregnancy is planned or suspected and avoid breast feeding during therapy.
Relief of OIC, especially if opioid therapy has been for 4 wks or more.
naloxegol is a sample topic from the Davis's Drug Guide.
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