Naloxegol Brand Name– MOVANTIK
What is Naloxegol
Naloxegol is an opioid antagonist indicated for the treatment of opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain.
Naloxegol has been shown to be efficacious in patients who have taken opioids for at least 4 weeks. At recommended doses, naloxegol functions peripherally in GI tissues with limited CNS penetration.
It is metabolized via CYP3A isoenzymes and dose adjustments are recommended in patients taking CYP3A4 inhibitors/inducers.
The most common adverse reactions reported in clinical trials were abdominal pain, diarrhea, nausea, flatulence, vomiting, and headache.
Naloxegol was approved by the FDA September 2014
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
- angioedema
- anxiety
- chills
- diarrhea
- flatulence
- GI perforation
- headache
- hyperhidrosis
- irritability
- nausea
- rash
- urticaria
- vomiting
- yawning
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abdominal pain
- acute opioid withdrawal
- breast-feeding
- cholelithiasis
- colitis
- Crohn’s disease
- diarrhea
- diverticulitis
- fecal impaction
- gastric cancer
- GI obstruction
- GI perforation
- hepatic disease
- inflammatory bowel disease
- pregnancy
- renal disease
- renal failure
- renal impairment
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
- Carbamazepine
- Ceritinib
- Chloramphenicol
- Cimetidine
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Conivaptan
- Crizotinib
- Cyclosporine
- Dabrafenib
- Danazol
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Diltiazem
- Dronedarone
- Duvelisib
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encorafenib
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Fedratinib
- Fluconazole
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- grapefruit juice
- Idelalisib
- Imatinib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lefamulin
- Letermovir
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Methylnaltrexone
- Mifepristone
- Mitotane
- Nalmefene
- Naloxone
- Naltrexone
- Nefazodone
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Nilotinib
- Ombitasvir; Paritaprevir; Ritonavir
- Opiate Antagonists
- Pentazocine; Naloxone
- Phenobarbital
- Phenytoin
- Posaconazole
- Primidone
- Quinine
- Ribociclib
- Ribociclib; Letrozole
- Rifampin
- Ritonavir
- Saquinavir
- St. John’s Wort, Hypericum perforatum
- Telithromycin
- Tipranavir
- Trandolapril; Verapamil
- Tucatinib
- Verapamil
- Voriconazole
