The role of oxycodone/naloxone in the management of patients with pain and opioid-induced constipation.

The role of oxycodone/naloxone in the management of patients with pain and opioid-induced constipation.

Publication date: Apr 01, 2019

Common opioid adverse effects (AE) of the gastrointestinal tract include opioid-induced constipation (OIC) and opioid-induced bowel dysfunction (OIBD) with traditional laxatives being of limited efficacy, having AEs and not addressing the pathophysiology of OIC or OIBD. Targeted treatment comprises of PAMORA (peripherally acting mu-opioid receptor antagonists) and a combination of an opioid receptor agonist with its antagonist, namely prolonged-release oxycodone with prolonged-release naloxone (OXN) tablets at a fixed ratio of 2:1. Oxycodone provides analgesia, whereas naloxone prevents binding or displaces it from opioid receptors located in the gut wall. Areas covered: The authors review the role of OXN in the management of patients with pain and OIC. A literature search was performed using the search terms ‘oxycodone/naloxone’ and ‘opioid-induced constipation’ using the PubMed database up to October 2018. Expert opinion: OXN delivers analgesia comparable (or superior versus placebo and in observational studies) to oxycodone alone and other opioids with a limited or decreased disturbing effect on bowel function. OXN in daily doses of up to 160 mg/80 mg provides effective analgesia with little negative impact on bowel function. OXN may be successfully used in patients with chronic pain, to prevent or treat symptoms of OIC and OIBD.

Leppert, W., Zajaczkowska, R., and Wordliczek, J. The role of oxycodone/naloxone in the management of patients with pain and opioid-induced constipation. 03314. 2019 Expert Opin Pharmacother (20):5.

Concepts Keywords
Analgesia Μ-opioid receptor
Antagonist Oxycodone
Bowel Naloxone
Chronic Pain Euphoriants
Common Ketones
Constipation Opioid antagonists
Gastrointestinal Tract RTT
Gut Wall Morphinans
Laxatives Chemical compounds
Mu Opioid Receptor Drugs
Naloxone Opioids
Observational Studies
OIC
Opioid
Opioid Receptor Agonist
Opioid Receptor Antagonists
Opioids
Oxycodone
Pain
Pathophysiology
Placebo
PubMed
Receptors
Tablets

Semantics

Type Source Name
disease MESH Narcotic
disease MESH Gastrointestinal Diseases
disease MESH chronic pain
gene UNIPROT IMPACT
disease DOID analgesia
pathway BSID Release
gene UNIPROT AES
disease DOID bowel dysfunction
disease DOID constipation
drug DRUGBANK Naloxone
drug DRUGBANK Oxycodone

Original Article

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