Naldemedine Brand Name– SYMPROIC
What is Naldemedine
Naldemedine is an opioid antagonist indicated for the treatment of opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain.
Naldemedine has been shown to be efficacious in patients who have taken opioids for at least 4 weeks.
At recommended doses, naldemedine functions peripherally in GI tissues with limited CNS penetration.
Naldemedine was approved by the FDA in March 2017.
Indications
- opiate agonist-induced constipation
For the treatment of opiate agonist-induced constipation in patients with chronic non-cancer pain, including patients with chronic pain related to prior cancer or its treatment who do not require frequent (e.g., weekly) opioid dosage escalation
Side Effects
- abdominal pain
- agitation
- anxiety
- bronchospasm
- chills
- diarrhea
- fever
- flushing
- GI perforation
- hyperhidrosis
- irritability
- lacrimation
- nausea
- rash
- rhinorrhea
- sinus tachycardia
- sneezing
- tremor
- vomiting
- yawning
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abdominal pain
- acute opioid withdrawal
- breast-feeding
- cholelithiasis
- Crohn’s disease
- diarrhea
- diverticulitis
- fecal impaction
- gastric cancer
- GI disease
- GI obstruction
- GI perforation
- hepatic disease
- inflammatory bowel disease
- peptic ulcer disease
- pregnancy
Interactions
- Alvimopan
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Aprepitant, Fosaprepitant
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Brigatinib
- Buprenorphine; Naloxone
- Bupropion; Naltrexone
- Cabozantinib
- Capmatinib
- Carbamazepine
- Ceritinib
- Chloramphenicol
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Crizotinib
- Cyclosporine
- Daclatasvir
- Danazol
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Diltiazem
- Dronedarone
- Duvelisib
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Ethotoin
- Fedratinib
- Fluconazole
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Fostamatinib
- Glecaprevir; Pibrentasvir
- grapefruit juice
- Hydantoins
- Idelalisib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Istradefylline
- Itraconazole
- Ketoconazole
- Lapatinib
- Lefamulin
- Letermovir
- Lomitapide
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Mefloquine
- Methylnaltrexone
- Mitotane
- Nalmefene
- Naloxone
- Naltrexone
- Nefazodone
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Nicardipine
- Nilotinib
- Ombitasvir; Paritaprevir; Ritonavir
- Opiate Antagonists
- Osimertinib
- Pentazocine; Naloxone
- Phenobarbital
- Phenytoin
- Posaconazole
- Primidone
- Quinine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rifampin
- Ritonavir
- Sapropterin
- Saquinavir
- Simeprevir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- St. John’s Wort, Hypericum perforatum
- Temsirolimus
- Tipranavir
- Trandolapril; Verapamil
- Tucatinib
- Verapamil
- Voriconazole
