• Sebastiano Mercadante and Antonello Giarratano.
• University of Palermo, La Maddalena Cancer Center, Anesthesia & Intensive Care and Pain Relief & Supportive Care Unit, Via San Lorenzo 312, 90146 Palermo, Italy. terapiadeldolore@lamaddalenanet.it
• Expert Opin Investig Drugs. 2013 Jan 1;22(1):161-6.

IntroductionThe use of opioids is associated with unwanted adverse effects, particularly opioid-induced constipation (OIC). The adverse effects of opioids on gastrointestinal function are mediated by the interaction with opioid receptors in the gastrointestinal tract. The most common drugs used for relieving OIC are laxatives, which do not address the opioid receptor-mediated bowel dysfunction and do not provide sufficient relief.Areas CoveredThis paper discusses the role of a combination of prolonged-release formulation of oxycodone (OX) and naloxone (N) in the prevention and management of OIC, reporting efficacy and safety outcome of controlled studies. In a therapeutic area of great unmet need, the combination tablet of prolonged release of OX and N (PR OXN) could offer patients effective analgesia, while improving opioid-induced bowel dysfunction.Expert OpinionPR OXN offers a unique and specific mechanism to control OIC in patients receiving chronic opioid therapy. This combination has the potential advantage of preventing OIC, particularly in subgroups of population, like elderly or advanced cancer patients. This approach can decrease the use of laxatives and additional medications, which represent a burden for patients presenting comorbidities requiring multiple medications.

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