Naldemedine-laxative combination: retrospective inpatient study

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Current guidelines for initiating peripherally acting μ-opioid receptor antagonists (PAMORAs) are challenging to implement in acute care settings.
• Naldemedine is a PAMORA used for opioid-induced constipation.

Purpose of the Study:

• To investigate the optimal introduction of naldemedine in combination with other laxatives within an acute care hospital setting.
• To evaluate the efficacy and safety of naldemedine-based regimens for opioid-induced constipation in inpatients.

Main Methods:

• A retrospective study of 93 inpatients receiving at least four doses of naldemedine.
• Analysis of changes in average daily defecation counts during the first 7 days post-nalemedine administration.
• Assessment of the incidence of diarrhea.

Main Results:

• Naldemedine combined with magnesium oxide (MgO) or other laxatives resulted in greater increases in daily defecation counts compared to naldemedine alone.
• Higher incidence rates of diarrhea were observed in patients receiving naldemedine in combination with MgO or other laxatives compared to naldemedine monotherapy.
• Naldemedine administration led to increased bowel movements in all evaluated groups.

Conclusions:

• Naldemedine monotherapy is a viable option for managing opioid-induced constipation in acute care.
• Combination therapy with naldemedine and MgO or other laxatives may enhance efficacy but requires careful monitoring for diarrhea.