Oral Naloxone for opioid associated constipation

22 Feb
NALOXONE:
–Oral administration of naloxone block enteric mu receptor
–but due to high first pass metabolism has low systemic effect. (2% systemic bioavailability taken orally)

SMALL STUDY DATA (N=22) 
By day 6 of using naloxone compared to the control period, the mean number of days with laxation increased from 2.1 to 3.5 (P<0.01)
–the number of days with other laxative medication decreased from 6 to 3.8 (P<0.01).
–the mean naloxone dose in the naloxone period was 17.5 mg/day.
–some side effects: (yawning, sweating, shivering and abdominal cramps) lasting 30 min to 6 hrs.
–Recommend starting at 2 mg and titrating upward.
Submitted by K. Sullivan.

Reference(s): Pain. 2000 Jan;84(1):105-9. http://www.ncbi.nlm.nih.gov/pubmed/10601678, picture

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