• Ivan Urits, Anjana Patel, Hayley Cornwall Kiernan, Conner Joseph Clay, Nikolas Monteferrante, Jai Won Jung, Amnon A Berger, Hisham Kassem, Jamal Hasoon, Alan D Kaye, Adam M Kaye, and Omar Viswanath.
• Urits, Berger, Hasoon, Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA. Patel, Jung, Georgetown University School of Medicine, Washington, DC. Cornwall Kiernan, Joseph Clay, Viswanath, University of Arizona College of Medicine - Phoenix, Department of Anesthesiology, Phoenix, AZ, Monteferrante, Viswanath, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Kassem, Mount Sinai Medical Center, Department of Anesthesiology, Miami Beach, FL, Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Kaye, Viswanath, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA, Viswanath, Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ.
• Psychopharmacol Bull. 2020 Jul 23; 50 (3): 97-118.

Purpose Of ReviewOpioid medications are a pillar of acute and chronic analgesia, though their use is often accompanied by side-effects, such as opioid-induced constipation. Unfortunately, tolerance rarely develops to this untoward side effect. This review presents the background, evidence, and indications for the use of Naldemedine (Brand name Symproic 0.2 mg tablets) to treat opioid-induced constipation.Recent FindingsOpioids are often used for the treatment of acute and chronic analgesia. Outside of the central effect they exert, they also interact with peripheral receptors, resulting in opioid-induced constipation, the commonest of side effects of chronic opioid usage. Complications include colonic distention, ileus, perforation, and can progress to other serious bowel complications, which can result in hospitalization and fatal events.For the most part, laxatives and other anti-constipation therapies are often inefficient and require intervention directed at the root cause, such as peripheral mu receptor agonists, including methylnaltrexone, naloxegol, and naldemedine. Naldemedine is the most recent to gain FDA approval of the group.An antagonist of Mu, Kappa, and Delta peripheral receptors, Naldemedine, is the only drug to counteract all three receptor classes. It was shown to be both safe and effective when compared with placebo. No data exists to compare its efficacy to that of other members of the group.SummaryOpioids are frequently used in the management of acute and chronic pain. The most common of the side effects is opioid-induced constipation, secondary to the peripheral activity of opioids. Naldemedine is an FDA-approved, once-daily oral tablet that counteracts this side effect by antagonizing mu, kappa, and delta-opioid receptors and has been shown to be safe and effective. Further investigation including head-to-head clinical trials are required to evaluate the relative efficacy of naldemedine compare with other peripheral opiate receptor antagonists.Copyright © 1964–2019 by MedWorks Media Inc, Los Angeles, CA All rights reserved. Printed in the United States.

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