Naloxegol Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Naloxegol is a prescription tablet used to treat constipation caused by opioid (narcotic) pain medicines in adults. It works in the gut to block the constipating effects of opioids without reducing their pain-relieving effects in the brain. It is taken once daily on an empty stomach, and dosing may be adjusted based on age and kidney function.

What is Naloxegol Tablet

Naloxegol is a prescription tablet belonging to the peripheral opioid receptor antagonist drug class. It is used to treat constipation caused by opioid (narcotic) pain medicines in adults.

Naloxegol Tablet uses

• Treats constipation caused by taking prescription opioid pain medicines in adults with long-term pain not caused by cancer, or pain from past cancer or its treatment, who do not need weekly increases in opioid dose
• Treats opioid-induced constipation (OIC) in adults
• Helps relieve constipation associated with chronic non-cancer pain treatment
• Improves bowel movement frequency
• Helps reduce difficulty passing stools caused by opioid medications

Benefits of Naloxegol Tablet

• Relieves opioid-induced constipation without reducing the pain-relieving effects of opioid medicines, because it rarely crosses into the brain
• Specifically targets opioid-induced constipation
• Helps restore more regular bowel movements
• May increase the frequency of spontaneous bowel movements
• Can reduce constipation-related discomfort and straining

How Naloxegol Tablet works

Naloxegol blocks the effects of opioids in the gut, which helps the intestinal muscles move stool and produce a bowel movement, without reversing the opioid's pain relief in the brain.

Naloxegol Tablet dosage

Take on an empty stomach, at least 1 hour before your first meal of the day or 2 hours after a meal. Swallow the tablet whole; do not crush, break, or chew it unless you have trouble swallowing. If you have trouble swallowing, the tablet may be crushed and mixed with water and taken right away, with an extra rinse of the glass to get the full dose. It can also be given through a nasogastric feeding tube if needed, following specific mixing instructions.

Stop other laxatives before starting this medicine; your doctor may allow laxatives again if this medicine is not working well enough after a few days. Stop taking this medicine if you stop taking your opioid pain medicine. Do not take more often or for longer than your doctor has directed. Use in children must be determined by a doctor, as safety and effectiveness in children have not been established.

Available forms and strengths

Naloxegol is available as a tablet.

Side effects of Naloxegol Tablet

Common

• Abdominal or stomach pain
• Diarrhea
• Nausea and vomiting
• Headache
• Gas or bloating
• Increased sweating
• Stuffy or runny nose

Serious

• Symptoms of opioid withdrawal: anxiety, chills, sweating, irritability, stomach pain, diarrhea, yawning
• Severe stomach pain or severe diarrhea that does not go away
• Tear (perforation) in the stomach or bowel wall
• Allergic reaction: rash, hives, swelling of face, lips, tongue, or throat
• Bloody, black, or tarry stools
• Vomiting material that looks like coffee grounds
• Trouble breathing

Warnings and precautions

• Do not use this medicine if you have a known or suspected blockage in your stomach or intestines.
• Avoid grapefruit and grapefruit juice while taking this medicine, since it can raise naloxegol levels and increase side effects.
• Do not take this medicine with certain antibiotics or antifungal medicines such as clarithromycin, itraconazole, or ketoconazole, as this can cause or worsen opioid withdrawal symptoms.
• This medicine can rarely cause a tear (perforation) in the stomach or bowel wall.
• This medicine is not approved for use in anyone younger than 18 years old.
• This medicine is not recommended during pregnancy unless necessary, because the baby could have opioid withdrawal symptoms. Talk with your doctor about the risks and benefits.
• Breastfeeding is not recommended while taking this medicine.
• People with moderate to severe kidney disease should use this medicine with caution, since the body may remove it more slowly, increasing its effects.
• Tell your doctor if you have liver disease before taking this medicine.
• It is not known how this medicine interacts with alcohol, so check with your doctor before drinking.
• Naloxegol is not generally considered sedating, but dizziness or other adverse effects may affect driving ability.

Storage

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Keep from freezing.
• Keep out of the reach of children.
• Do not keep outdated medicine or medicine no longer needed.
• Ask your healthcare professional how you should dispose of any medicine you do not use.
• Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F).

When to see a doctor

• Get emergency help right away if you have signs of an allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away if you have severe stomach pain or severe diarrhea that does not go away.
• Check with your doctor right away if you have severe stomach pain that does not go away, as this could be a sign of a tear in the stomach or bowel.
• Tell your doctor if you notice symptoms of opioid withdrawal such as anxiety, chills, sweating, irritability, stomach pain, diarrhea, or yawning.
• If you think you have taken too much of this medicine, contact a poison control center or emergency room right away.

Alternatives

• Lactulose
• Amitiza
• Relistor
• Movantik